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Difference between revisions of "Clinicians on FHIR 2016 - January Orlando"

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===History===
 
===History===
 +
*Headache
 +
*The headache yesterday was the worst that she has ever had.
 +
*No headache in the past 24 hours.
  
 
===Physical Exam===
 
===Physical Exam===
 +
*Blood pressure 127/86
 +
*Deep tendon reflex 2+ - left knee
 +
*Deep tendon reflex absent - right knee
  
 
===Lab, Imaging and Other Results===
 
===Lab, Imaging and Other Results===
 
+
*Serum Sodium = 137 (normal range 135-145)
 
+
*Stool culture: No Salmonella, Shigella or Campylobacter isolated
 
+
*Chest AP & lateral: Impression: Pneumonia in the right lower lobe.
<br>
 

Revision as of 13:32, 15 January 2016

Back to: Patient Care
Return to: FHIR Clinical Resources - PCWG
Return to: Clinicians on FHIR
Return to: Clinician on FHIR 2016

Introduction


Care Plan Group

Webex [1]

Use Case Care Plan DAM Story Board


Observation vs. Condition Group

Lead: Rob Hausam

Webex: https://global.gotomeeting.com/meeting/join/605884653

Background and Use Case [| Observation vs Condition]

ClinFhir Tool: http://clinfhir.com/

Tracking spreadsheet: https://docs.google.com/spreadsheets/d/1FCQayhXe5h9INy-b-KhtnDG0eZgDD29YMh1qBESYxPA/edit?usp=sharing

Example Observations (including negation/negative statements)

History

  • Headache
  • The headache yesterday was the worst that she has ever had.
  • No headache in the past 24 hours.

Physical Exam

  • Blood pressure 127/86
  • Deep tendon reflex 2+ - left knee
  • Deep tendon reflex absent - right knee

Lab, Imaging and Other Results

  • Serum Sodium = 137 (normal range 135-145)
  • Stool culture: No Salmonella, Shigella or Campylobacter isolated
  • Chest AP & lateral: Impression: Pneumonia in the right lower lobe.