SMARText Introduction

What is SMARText?

• Table of Contents

  1. 1. What is SMARText?
  2. 2. Legos for Medical Records
  3. 3. SMARText Literacy vs. Traditional Medical Record Illiteracy
  4. 4. Why are there so many different SMARText Item types?
  5. 5. Can one SMARText item type be converted into another type?
  6. 6. Why are the tools to manage SMARText difficult to use?
  7. 7. AMP Up Your Documentation TODAY!
  A Lego set for medical information.
• Replaces and extends macros to auto-enter blocks of text.
• The pieces of information can be words, and/or combinations of lists, images, photographs, videos, audio files, and more.
  
• The pieces of information, or objects, can be read by both humans and computers.
  
• The pieces often look like ordinary words on the screen or when printed, but are objects or chunks of information associated with machine-readable classification systems (i.e. codes such as ICD or CPT codes) in the background.
  
• So, the pieces that look like words in the actual documentation know what they are, and know how they relate to everything else in the chart and entire chart rack.
  
• The pieces turn chart racks into true databases for data mining, pay for performance, etc.
• SMARText make documentation speak many "languages" with identifiers/coding.
  
   

Legos for Medical Records

SMARText is a Lego set for medical information. it has many different pieces that can be put together in almost limitless ways. The pieces are called types, and they define what the SMARText item contains/represents. Some popular types are Medications, Assessments, Plan items, Orders, text snippets and lists. Multiple SMARText items can be placed together to produce a new and useful structures. For example, a SMARText medication item contains many other SMARText items as sub-items (e.g. Strength, Dose, Frequency, Refills, etc.), an Order can contain Ordering Physcian, CPT code, Destination where the order is to be performed etc. In order to build documentation with the SMARText Legos, many different pieces are brought together. About the only thing you can't do with the SMARText Legos is blow them up with firecrackers.

SMARText Literacy vs. Traditional Medical Record Illiteracy

SMARText is a revolutionary approach to medical documentation. To date, nothing similar to it exists in other products. To make a long story short, it makes the notion of a simple document containing only words as obsolete. A document in SOAPware is now a container that can contain not just groups of typed letters (i.e. words), but can contain a near infinite number of different pieces of information, or objects, that the computer can read and use. These pieces of information can even be combinations of images, photographs, videos, or audio files. Many of these pieces of information appear very much the same as ordinary, typed, free-text would appear, however SMARText is much more than free-text.

At the top of the above screenshot is displayed part of a docutainer containing an encounter note. In the lower area a Document Preview is displayed showing how it would appear as a printed document. Even though it appears similar to typed information in the printed document, it is much, more. For example, in most encounter documentation (whether from transcription or other EMR systems), the computer usually has no means of knowing what is the Subjective information unless it is entered into a separate field or box. In the screenshot above, we have made the brackets visible that the computer can now use to identify where the Subjective information begins and ends. Information systems simply can't create these boundaries of information as the human mind can do. SMARText bridges the world of the human mind and information technology. Most other systems force documentation to be created by clicking through dozens of fields or pick lists with little ability for flexibility or free text. With SMARText, everything can be either free text, or structured text, or any combination, and it can be created at any time starting at any point within the documentation. Arguably, there is complete flexibility that is unequaled in any system available in early 2009.

The Nausea in the SOAPware encounter docutainer above was actually selected from a pick list and was not typed. If it had been typed, then there would not be a means for the computer or information systems to know what nausea is other than just a string of 6 letters. To the computer, uesaan and nausea are indistinguishable. In this example, Nausea is actually a SMARText item that the computer and other systems can identify. This is because, in the background, it is actually an object or chunk of information associated with machine-readable classification systems (i.e. codes). On the screen, you see Nausea and behind the scene, the computer can understand that this patient had nausea and can report this using at least 8 different coding systems.

In order to see the this screenshot in SOAPware, Alternatively, Press F10 to bring up the SMARText Items Manager; Type nausea in the Search field/box; Click the Search button; Click on Type to sort that column; Click on the RFE - Nausea (in description) list item; and Click on the Edit button.

So, the difference of Nausea typed into most systems and Nausea as a SMARText item is profound. It is the same difference as comparing an illiterate individual to one who can read and speak at least 8 different languages. We are moving clinicians out of their information system illiteracy via SMARText! As a user, you never need to know or deal with all the languages your medical records can speak. All of that is hidden during the normal, daily process of creating documentation.

When SOAPware users use structured or coded items in their documentation, the pick lists get smarter over time. In contrast, most systems have fixed inflexibilities where lists do not learn user's preferences. As a result, SOAPware users can often create, almost instantly, what typically takes months and thousands of dollars in most systems. Additionally, SMARText items can contain other SMARText items.

Lastly (this is a bit difficult to explain without getting really geeky). SMARText makes it possible for the items you use in documentation (that appear to be simple words) to have underlying relationships to the other items in the medical record. The words you use in your documentation actually know what they are and what their relationship is to everything else in your entire chart rack. This is truly revolutionary, and it will take some time and experience to comprehend the full implications.

 You do not have to understand all the behind the scenes coding to use SMARText. Think of all the behind the scenes coding as similar to a bar code on a Pringles can. You are barely aware of the bar code but when it is scanned at the register, information is distributed to various places like inventory and to those who look at market trends etc.

Why are there so many different SMARText Item types?

The multitude of different types of SMARText items are required to define to SOAPware the various medical concepts. For example, medication, physical finding, diagnoses, etc. In addition to medical related types, there are a number of utility types such as toggle lists, multi-select lists etc. These types don't directly correspond to medical concepts but are used to make selecting and displaying information easier.

Can one SMARText item type be converted into another type?

For some of the utility SMARText item types, they can be changed from one type into another. However, switching between Structured text and Multi-select list doesn't work, as a structured text item defines a single piece of information, and a Multi-select list would hold multiple pieces of information.
Additionally most types (especially those dealing with medical concepts) can’t be switched, because the concepts are not related. For example, there is no way to directly map a diagnosis into a medication, so switching an item from a diagnosis to a medication would result in both data loss and incomplete data representation.

Why are the tools to manage SMARText difficult to use?

The current tools to create and manage SMARText are on the crude side. They basically represent the lowest common denominator required to work with any SMARText item type. In the future, we have plans to significantly simplify this process with type-specific wizards that will make the creation and editing of SMARText much more intuitive and step-by-step.

AMP Up Your Documentation TODAY!

Using SMARText structured items for documentation in the below fields will best prepare clinics for reporting on quality measures in the future.

A - Assessment
M - Medications
P - Plan

Review: 

• Explain what SMARText is and does.
• Explain why plain typed or written documentation is a type of illiteracy.
• Visualize how SMARText appears in final documentation if it is printed.
• Explain what the purpose of the brackets are for in SMARText.
• Show how SMARText is more flexible than just about any type of medical documentation to date.
• What makes documentation readable by computers and information systems.
• Explain how SMARText is revolutionary.

Path - Select Data Entry Methods - Part II