Create/Edit Patient Clinical Data

Patient Clinical Data comprises five mandatory sections that must always be included in a Patient Summary Health History:

• Allergies and intolerances
• Current problems and diagnoses
• Medical devices (implanted or external)
• Major interventions
• List of current medications

They also include several optional modules, such as:

• Vaccinations
• Problems that no longer exist
• Social history (e.g., smoking, alcohol consumption)
• Pregnancy history (for women)

• 

  Figure 2.6: Create/Edit Patient Data.

Allergies

• 

  Figure 2.6: Allergies & Intolerances

Drug Allergies

• 

  Figure 2.6: Drug Allergy

• 

  Figure 2.6: Add Drug Allergy

No Drug Allergies

• 

  Figure 2.6: No Drug Allergy

• 

  Figure 2.6: Add No Drug Allergy

Surgical Procedures

• 

  Figure 2.6: Short description

• 

  Figure 2.6: Short description

• 

  Figure 2.6: Short description

• 

  Figure 2.6: Short description

Medication Summary

• 

  Figure 2.6: Short description

• 

  Figure 2.6: Short description

• 

  Figure 2.6: Short description

• 

  Figure 2.6: Short description

Back