I see a need for the separate MPL as well. It’s an important part of our current paper medical record. I really like your idea about structuring it similarly to the dx process. Would be nice if there could also be some way to automate addition of some select problems to the MPL based on a particular procedure that was done. Shirley Shirley Arck, PharmD, FSVHP Administrator Veterinary Health Center at Kansas State University 1800 Denison Ave. Manhattan, KS 66506 Tel: 785-532-5708 Fax: 785-532-4309 From: vvcemr-bounce@xxxxxxxxxxxxx [mailto:vvcemr-bounce@xxxxxxxxxxxxx] On Behalf Of Simon Roe Sent: Thursday, October 02, 2014 8:00 AM To: vvcemr@xxxxxxxxxxxxx Subject: [vvcemr] Diagnoses, Problems and Procedures It appears that, as in UVIS, it will be difficult to find the meaningful Procedures for a patient in VetView. It will be very easy to list everything that is categorized as a procedure and has a procedure code, but these are of limited help when a clinician is trying to understand the previous management of a case. An example would be Exploratory Laparotomy. This will be a procedure, but doesn't tell the clinician what was done. It might lead to a diagnosis of Liver Carcinoma, but was it removed/biopsied/?? There is a need for greater clarity, just as we have in the Problem/Diagnosis process. We need a Major Procedures list. Currently, on paper, I enter the major procedures in the Master Problem List. So, after a problem of hip dysplasia, I will add "Total Hip Replacement, BFX, Left". If the dog is later lame on the right hind limb, it could still be hip dysplasia. If he is lame on the left hind limb, the differential diagnosis list is quite different. While it is possible to continue this approach in an EMR, it muddies the MPL and makes an entry that doesn't fit the SOAP process. It would be better to have a separate list. My thoughts are that it would be very like the Diagnosis process where there would be a major term, the ability to add qualifiers, and a free text comment if needed. I would love to hear thoughts from others about this concept, and other suggestions for how this could be done Simon Roe -- Dr. Simon Roe, BVSc, PhD, Diplomate ACVS Professor, Small Animal Orthopaedic Surgery Randall B Terry Companion Animal Veterinary Medical Center 1052 William Moore Drive, Raleigh, NC 27607 Ph: 919-513-6334 office 919-513-6588 clinic "Live fully. Love wastefully. Be all that you can be." adapted from Bishop Spong 'All electronic mail messages in connection with State business which are sent to or received by this account are subject to the NC Public Records Law and may be disclosed to third parties.'