COVID-19 Problem Overview
Standardized text blocks (accessible using SmartText and SmartPhrases) help simplify and standardize documentation tasks for persons with COVID-19 illness. The blocks are incorporated into templates for COVID-19 Progress notes, as well as Summary notes (admit, intake, discharge, handover, transfer). They can also be inserted into personalized SmartPhrases.
Most COVID-19 text blocks are "interactive". Although formatted in prose to make them easier to read, any text appearing in a dark blue font can be selected to activate popup data-entry tools for entering or editing structured data behind the prose.
The COVID-19 Overview text block aggregates key information that should be captured for all COVID-19 patients, including when symptoms started, morbidity risks, functional status, interventions experienced and the current course of illness.
Disease Management Overview SmartForm
The text block subheadings (e.g., "Onset" and all other text that appears in a dark blue font) are hyperlinks. Clicking them will bring up a COVID-19 disease management SmartForm, where structured data can be entered and edited. Upon saving the popup form, the source text editor can be refreshed (refresh button) to update the prose text. It is best to work through the popup SmartForm when editing the overview.
The following data elements are found in the COVID-19 overview SmartForm, with explanatory notes provided. Hovering over data-entry elements in the SmartForm usually causes helpful popup-explanations to appear.
Indicate which service is currently guiding COVID-19 health care. For inpatients, this is likely the admitting service. For outpatients, this may be a primary care provider or one or more post-COVID-19 follow-up speciality or rehabilitation services or clinics.
Date: Use the date selector to identify an (approximate) date of first COVID-19 attributable symptoms. For asymptomatic persons, this would be the date of the first positive COVID-19 swab.
Comments: Optionally use the Comments icon to briefly list the symptoms (e.g., diarrhea) or systems (e.g., GI) involved at onset.
Buttons: Select one or more of the button response options to capture the categories of co-existing health conditions that may affect the course of COVID-19 illness.
Comments: Optionally add comments about comorbidities not listed and be sure to add comments when the "Other" category is selected.
Buttons: Select one or more of the button response options to capture the categories of conditions that can affect immune function in a way known to affect COVID-19 risks.
Comments: Optionally add comments about important immunoregulatory considerations not listed and be sure to add comments when the "Other" category is selected.
Buttons: Select one or more of the button response options to capture the categories of complications attributable to COVID-19 illness.
Comments: Optionally add comments about important complications not listed and be sure to add comments when the "Other" category is selected.
Buttons: Select one button estimating the patient's current level of functional performance, inclusive of COVID-19 and non-COVID-19 disease processes. Selecting a button will expose a standardized interpretation of the particular class category.
Buttons: Select one button approximating the patient's functional compromise specifically attributable to COVID-19 disease processes. This attribute is most important to update after the acute phase of illness when a post-COVID baseline is achieved.
Buttons: Select one or more of the button response options to capture categories of health care interventions deployed specifically for managing COVID-19 illness. Selection of some buttons (e.g., Mechanical Ventilation, ECMO) will cause other data-entry fields to appear (e.g., number of ventilator days).
Buttons: Select one or more of the button response options to capture categories of pharmacotherapeutics used specifically for managing COVID-19 illness. Hover over buttons to get examples of drugs in each category.
Link: A link is provided that will open a popup-window listing COVID-19 medications actually administered during the current encounter.
Buttons: Select one button to reflect how the risk of thrombotic events is managed for the patient.
Buttons: Select one button to reflect the patient's overall course of COVID-19 illness.