Problems vs. Diagnoses
Medical Problems: In a patient's chart, there is a section dedicated to a patient's reported problems. Of these problems, the most recent reported problems are surfaced, however there is an option to view an archive of "HISTORICAL" problems. The "Past Medical History" section of the History tab includes a patient's medical history documented in care episodes or uploaded onto the patient portal. In these circumstances, the ICD-9 or SNOMED code are not always recorded as these entries were not mapped to an ICD-10 or SNOMED code.
Diagnoses: During the intake stage of the appointment workflow, there is Orders and Results Section with a separate "Diagnoses & Orders" tab. In the "Diagnoses & Orders" tab, diagnoses can be written into the search tab to then populate a list of diagnoses that athena recognizes and has mapped to either a ICD-10 or SNOMED code. The chosen diagnoses, along with its ICD-10 or SNOMED code, is then recorded within the Orders and Result Section during a patient's intake or the Diagnoses and Orders or Assessment & Plan section during the a patient's exam.