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SMARText Introduction
Table of contents
- 1. Overview
- 2. Managing
- 3. SWICPC
- 4. How do I ?
- 5. Adding-Associating a Free Text (or typed) Comment to SMARText Items
- 6. Creating a new list in SMARText (needs content & screen shots)
- 6.1.
- 6.2.
- 6.3. When the Create button is clicked, each line in the field is turned into a new SMARText item. For example, in the video, below, the demonstration began with a list of items related to cough that the user had created in a Microsoft Word document. cough associated with dyspnea cough associated with wheezing cough that is croupy or barking cough that is dry cough that is hoarse cough that is loose cough that is moist cough that is non-productive cough that is paroxysmal cough that is productive cough that is rattling cough that is stridorous The List Creator was used to turn this list into individual SMARText items describing different types of cough. Those individual items can then be used to create sub-items for pick lists. Each of these sentences, on separate lines, was converted to an unstructured SMARText item. We could have turned them into a structured item by placing a check in front of Create Items as Structured Text. The individual words in each of the descriptions was also added as a keywords for the new items. This was accomplished by a check in front of Include Description in keywords. Because we wanted each of the newly created SMARText items to have a unique shortcut, a check was placed in front of Use First Word for Shortcut. So, the next step was to add a keyword in front of each item (i.e. on each line). Cou1 cough associated with dyspnea Cou2 cough associated with wheezing Cou3 cough that is croupy or barking Cou4 cough that is dry Cou5 cough that is hoarse Cou6 cough that is loose Cou7 cough that is moist Cou8 cough that is non-productive Cou9 cough that is paroxysmal Cou10 cough that is productive Cou11 cough that is rattling Cou12 cough that is stridorous These keywords were added to each of the newly created ST items - STempDemoCough, !Sub, !hpi, !ros, History, LUNGS/Respiratory, ROSLUNGS by placing them into the Additional Keywords field. We opted for the newly created items to not be automatically placed into a grouped item, but this would have been an option if we placed a check in front of Add Items to Group. This would have created an additional SMARText item of the Cluster Type that would automatically include all the other, newly created SMARText items. Warning: Items created in this fashion will not have any code/identifiers added to them. This could limit the data value of the medical records created via this method. For this reason, it is generally wise to use items within the online library whenever possible.
- 7. Toggle Multi-Sel List (need content/screen shots)
- 7.1. Also See:
- 7.2. SMARText stores itself in a hierarchal manor - that is the "Eye Color" pick list from above has a child item that contains the color. Put another way, the Rx Field Contains a Medication and the the Medication Contains items like Dosage, Route Frequency. This is important because Toggle lists operate in pairs and these pairs have to be at the same hierarchal level. So lets say we make two toggle lists and add some items to them: One called Reported Symptoms and the other called Denied Symptoms and we insert both of these into the subjective field. So we would have something like Subjective: Reported Symptoms: Denied Symptoms: Fever, Chills, Muscle Aches, Sore Throat. Ok now for the cool part - these two Toggle lists "know" about each other - so if you double click on the word Chills you will get the following: Subjective:
- 7.3.
- 7.4. Reported Symptoms: Chills. Denied Symptoms: Fever, Muscle Aches, Sore Throat. Double Click on Chills again and : Subjective: Reported Symptoms: Denied Symptoms: Fever, Chills, Muscle Aches, Sore Throat. Double Click on Fever and Sore Throat: Subjective: Reported Symptoms: Fever, Sore Throat. Denied Symptoms: Chills, Muscle Aches. Again all fully coded and structured so that you could query the system for all users who reported symptoms of Fever AND Sore Throat and all with just a click of the mouse (ok a Double Click of the mouse). The above is the absolute simplest usage of Toggles. Create a 'prefilled' Rx ? Add/Edit/Remove Keywords ? View all items that have a specific Keyword ? View all items of a specific type? Associate a item with a specific Chief Complaint or System ? Quick Access keyboard access ? Optimizing the Quick Access display ?
Overview
We briefly touched on SMARText in the Introduction to Chart chapter. Using SOAPware to it's fullest and maximizing your efficiency requires a more thorough understanding.
Simply put, SMARText is a Lego set for medical information. Just like the Lego's of your youth, SMARText has many different pieces that can be put together in almost limitless ways. The 'pieces' in SMARText are called types and they define what the SMARText item contains/represents. Some popular types are Medication, Assessment, Order, text snippet (Free Text and Structured) and lists. Staying with our Legos analology, you can stick multiple SMARText items together to produce a new and useful structure. For example, a SMARText medication item contains many other SMARText items: Start Date, End Date, Dose, Frequency etc.
In order to build your SOAP encounter note with the SMARText 'legos' you would normally utilize many different pieces. You might use a few free text snippets to fill in the Subjective, a large Objective SMARText item that contains many pick lists (also SMARText) to choose exam values, an assessment, a few medications and an order or two. All of these pices will snap togthether to produce a clean, structured detailed SOAP encounter note that is unique to your practice.
The only thing you can't do with the SMARText 'legos' is blow them up with firecrackers !
Also See:
Managing
As you can imagine a typical practice has thousands of SMARText items in SOAPware and managing all of them can be quite a challenge. SOAPware maintains an Encyclopedia of SMARText items and just like with a paper Encyclopedia, SMARText has an index. In SOAPware we 'index' each SMARText item with keywords. Keywords can be used to identify single items or to group multiple items together. Every SMARText item can have an almost unlimited number of keywords.
In the SOAPware Charts Introduction we introduced a way to insert a SMARText item into the chart by typing in a word and then having SOAPware search for it - SOAPware was searching for Keyword matches when you did this.
This capability makes available a large number of optimizations. First and foremost it makes finding new items straightforward. Looking for a medication - type it's name in and press F11, if nothing is found try again with SHIFT + F11 (to include the SOAPware Online Library in the search).
Other optimizations include:
- Tag all Rx's that belong to a given formulary.
- Group related codes together - for example commonly used Rx's and the Dx's they are used with
- Group your favorite items into easy to access lists (Dx, Rx etc.)
The SMARText encyclopedia can be accessed via the SMARText Manager located under Docutainers - SMARText Manager. This manager provides a way to list/find items, ability to upload/download item to/from the SOAPware Online Library, creation of new items and editing of existing ones.
SWICPC
(Applies to versions after SOAPware 2008.0.395.0)
SWICPC is an odd looking word but it provides some very cool functionality. In a nutshell, ICPC is a coding scheme used internationally to identify Systems and Chief Complaints. SWICPC is SOAPware's americanization of ICPC (the coding is the same the category names have just been edited to be more recognizable) and provides tremendous functionality improvements - here's why.
In order for SOAPware to help you it has to know something about the visit type and the Chief Complaint is probably the most obvious and universally used starting point. When you define a Chief Complaint in a SOAPware Encounter SOAPware will automatically begin to display SMARText items (in the Quick Access display - docked to the right side of the screen by default) that are related to both the selected Chief Complaint and the System the Chief Complaint belongs to: exams, Rx's, Dx's, Orders and more. SOAPware comes preloaded with many SWICPC relationships but also includes the ability for you to quickly build your own.
Also See:
SWICPC - Relating SMARText Items (Geeks only)
How do I ?
The section below lists commonly performed tasks and links you to more detailed information for each of them. For those of you reading this in its paper form please use a web browser and go to www.soapedia.com\XXXXXX
Adding-Associating a Free Text (or typed) Comment to SMARText Items
In the example below, we have clicked on the CHIEF COMPLAINT and selected Allergic rhinitis by clicking in the checkbox next to it in the Quick Access list. At this point, the pointer is placed over Allergic rhinitis (i.e. in the Subjective field). Simply clicking on "Allergic rhinitis" and starting to type causes a box to be presented into which free text can be entered (below). Now, pressing the Enter Key or clicking the save button (above) results in the typed, free text comment to be added to Allergic rhinitis (below)
All SMARText items can have free text comments attached to them. You can edit/add a comment by either clicking on a ST item to activate it, then entering the text in the Comment entry field displayed on the Quick Access service or by simply clicking on an item. Click-typing on a SMARText item displays a small comment editor immediately next to the ST item to which the comment is being added.
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Creating a new list in SMARText (needs content & screen shots)
When the Create button is clicked, each line in the field is turned into a new SMARText item. For example, in the video, below, the demonstration began with a list of items related to cough that the user had created in a Microsoft Word document.
cough associated with dyspnea
cough associated with wheezing
cough that is croupy or barking
cough that is dry
cough that is hoarse
cough that is loose
cough that is moist
cough that is non-productive
cough that is paroxysmal
cough that is productive
cough that is rattling
cough that is stridorous
The List Creator was used to turn this list into individual SMARText items describing different types of cough. Those individual items can then be used to create sub-items for pick lists.
Each of these sentences, on separate lines, was converted to an unstructured SMARText item. We could have turned them into a structured item by placing a check in front of Create Items as Structured Text.
The individual words in each of the descriptions was also added as a keywords for the new items. This was accomplished by a check in front of Include Description in keywords.
Because we wanted each of the newly created SMARText items to have a unique shortcut, a check was placed in front of Use First Word for Shortcut. So, the next step was to add a keyword in front of each item (i.e. on each line).
Cou1 cough associated with dyspnea
Cou2 cough associated with wheezing
Cou3 cough that is croupy or barking
Cou4 cough that is dry
Cou5 cough that is hoarse
Cou6 cough that is loose
Cou7 cough that is moist
Cou8 cough that is non-productive
Cou9 cough that is paroxysmal
Cou10 cough that is productive
Cou11 cough that is rattling
Cou12 cough that is stridorous
These keywords were added to each of the newly created ST items - STempDemoCough, !Sub, !hpi, !ros, History, LUNGS/Respiratory, ROSLUNGS by placing them into the Additional Keywords field.
We opted for the newly created items to not be automatically placed into a grouped item, but this would have been an option if we placed a check in front of Add Items to Group. This would have created an additional SMARText item of the Cluster Type that would automatically include all the other, newly created SMARText items.
Warning: Items created in this fashion will not have any code/identifiers added to them. This could limit the data value of the medical records created via this method. For this reason, it is generally wise to use items within the online library whenever possible.
Toggle Multi-Sel List (need content/screen shots)
SMARText stores itself in a hierarchal manor - that is the "Eye Color" pick list from above has a child item that contains the color. Put another way, the Rx Field Contains a Medication and the the Medication Contains items like Dosage, Route Frequency. This is important because Toggle lists operate in pairs and these pairs have to be at the same hierarchal level. So lets say we make two toggle lists and add some items to them: One called Reported Symptoms and the other called Denied Symptoms and we insert both of these into the subjective field.
So we would have something like
Subjective:
Reported Symptoms:
Denied Symptoms: Fever, Chills, Muscle Aches, Sore Throat.
Ok now for the cool part - these two Toggle lists "know" about each other - so if you double click on the word Chills you will get the following:
Subjective:
SMARText stores itself in a hierarchal manor - that is the "Eye Color" pick list from above has a child item that contains the color. Put another way, the Rx Field Contains a Medication and the the Medication Contains items like Dosage, Route Frequency. This is important because Toggle lists operate in pairs and these pairs have to be at the same hierarchal level. So lets say we make two toggle lists and add some items to them: One called Reported Symptoms and the other called Denied Symptoms and we insert both of these into the subjective field.
So we would have something like
Subjective:
Reported Symptoms:
Denied Symptoms: Fever, Chills, Muscle Aches, Sore Throat.
Ok now for the cool part - these two Toggle lists "know" about each other - so if you double click on the word Chills you will get the following:
Subjective:
Reported Symptoms: Chills.
Denied Symptoms: Fever, Muscle Aches, Sore Throat.
Double Click on Chills again and :
Subjective:
Reported Symptoms:
Denied Symptoms: Fever, Chills, Muscle Aches, Sore Throat.
Double Click on Fever and Sore Throat:
Subjective:
Reported Symptoms: Fever, Sore Throat.
Denied Symptoms: Chills, Muscle Aches.
Again all fully coded and structured so that you could query the system for all users who reported symptoms of Fever AND Sore Throat and all with just a click of the mouse (ok a Double Click of the mouse). The above is the absolute simplest usage of Toggles.
- Create a 'prefilled' Rx ?
- Add/Edit/Remove Keywords ?
- View all items that have a specific Keyword ?
- View all items of a specific type?
- Associate a item with a specific Chief Complaint or System ?
- Quick Access keyboard access ?
- Optimizing the Quick Access display ?
- Create a 'prefilled' Rx ?
- Add/Edit/Remove Keywords ?
- View all items that have a specific Keyword ?
- View all items of a specific type?
- Associate a item with a specific Chief Complaint or System ?
- Quick Access keyboard access ?
- Optimizing the Quick Access display ?
Reported Symptoms: Chills.
Denied Symptoms: Fever, Muscle Aches, Sore Throat.
Double Click on Chills again and :
Subjective:
Reported Symptoms:
Denied Symptoms: Fever, Chills, Muscle Aches, Sore Throat.
Double Click on Fever and Sore Throat:
Subjective:
Reported Symptoms: Fever, Sore Throat.
Denied Symptoms: Chills, Muscle Aches.
Again all fully coded and structured so that you could query the system for all users who reported symptoms of Fever AND Sore Throat and all with just a click of the mouse (ok a Double Click of the mouse). The above is the absolute simplest usage of Toggles.
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.jpg?size=webview "Item comment (1).jpg")
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