SOAP Template

NextGen® Adaptive Content Engine Help Enterprise 8

Documenting SOAP Information

Use the SOAP template to enter history, exam, assessment, and plan information. Reason for Visit on the SOAP Template You can use the Reason for Visit to enter the patient introduction and additional details about the reason for visit. Physical Exam Panel You can document physical exam details. Document Review of Systems Details You can review and update symptoms entered during the patient intake process in the Review of Systems section on the SOAP template. Review and Reconcile Allergies Review the Patient's Vital Signs SOAP Link Icons The icons for various links appear on the SOAP template. Parent topic: Provider Workflow

NextGen® Adaptive Content Engine Help Enterprise 8

Reviewing Patient History on SOAP

You can review and edit a patient's medical history in the History panel on the SOAP template. The following categories in the History panel provide the corresponding history details. Past Medical/Surgical Interim Social Family Diagnostic History Panel The Social Determinants of Health and PRAPARE® links appear based on the Practice Configuration practice template settings. For more information on these settings, go to NextGen Healthcare Success Community, and download the latest Practice Configuration Template User Guide forNextGen®Adaptive Content Engine. Review Patient's History Summary on SOAP You can review and update a patient's history summary documented by the intake staff during the previous encounters, in the History panel on the SOAP template. Adding Patient's History Summary on SOAP You can update the history details entered by the intake staff and add any additional history details in the History panel on the SOAP template. Parent topic: Review of SOAP Details by Provider

NextGen® Adaptive Content Engine Help Enterprise 8

Allergy Home Page Template

You can review the historical information of the patient on the Home Page - Allergy template. The panels displayed on the Home Page - Allergy template can be customized by the practice. Panel Description General Enables you to indicate if the patient is new or an established patient for the current encounter. Allergy Test Flowsheet Enables you to list the allergy testing orders of the patient. Summary Enables you to view the details of the patient's past medical or surgical history, interim, social, family, diagnostic study, HPI, plan, lab, assessments and so on from the historical encounters. Problem List Enables you to list the patient's ongoing clinical problems and chronic conditions from past encounters. History Enables you to display the patient history documented by the intake staff on the Histories template. Allergies Enables you to list the allergies associated with the patient. Medications Enables you to list the patient's current medications. Vital Signs Enables you to docum

NextGen® Adaptive Content Engine Help Enterprise 8

Review of SOAP Details by Provider

You can review and modify the patient’s reasons for visit, review of systems, and vital signs documented by the intake staff on the SOAP template. You can also review the patient's visit type, alerts, and risk indicators. In addition, you can document the physical examination details, assessment plans, and provider communications. You can review and modify the following details on the SOAP template. General information Reasons for visit History Review of systems Vital signs Physical examination Assessment and plan You can select the Record contains substance use disorder information check box on the SOAP template header to include the long or short form of disclosure for Substance Abuse and Mental Health Services Administration (SAMHSA) 42 CFR Part 2 provisions in the generated documents and reports. You can use Quick Notes to save the documented SOAP findings as a default set that can be used in future encounters. For more information on these settings, go to NextGen Healthcare Succes

NextGen® Adaptive Content Engine Help Enterprise 8

Review of Intake Details by Provider

You can start the visit by reviewing the patient's details entered by the intake staff on the Home Page template, to determine if any updates should be made. The Home Page template consists of the following panels. Panel Description Medical Chart Summary Displays the details documented by the intake staff and provider during an encounter. The details from the previous encounters also appear in this panel. The categories in the left pane in the grid enable you to select and view the documented data. Some of the categories include filters at the top of the grid, which enable you to filter and review the desired data. The data that appears in the grid is read-only. Problem List Displays the patient's chronic and secondary problems documented by the intake staff. History Summary Displays the patient history details previously document by the intake staff and provider on the Intake, Histories, and SOAP templates. The categories in the left pane in the grid enable you to view and document th

NextGen® Adaptive Content Engine Help Enterprise 8

Overview of the Provider Workflow

You can review the patient's medical summary details on the Home Page template and then proceed to the SOAP and Finalize templates. The provider workflow includes the following: Reviewing and updating the data documented by the intake staff during the patient encounter and providing any additional information. Documenting the problems and various physical examination findings. Documenting the performed procedures. Documenting the treatment plan. Documenting Evaluation and Management (E&M) codes. For more information on the SOAP and Finalize templates, go to NextGen Healthcare Success Community, and download the latest Getting Started User Guide forNextGen®Adaptive Content Engine. Patient Tracking in the Provider Workflow You can update the patient tracking details using the Patient Tracking on the Patient Information Card (PIC). Review of Intake Details by Provider You can start the visit by reviewing the patient's details entered by the intake staff on the Home Page template, to deter

SOAP Template

Recommendations

Documenting SOAP Information

Reviewing Patient History on SOAP

Allergy Home Page Template

Review of SOAP Details by Provider

Review of Intake Details by Provider

Overview of the Provider Workflow

Documenting SOAP Information

Reviewing Patient History on SOAP

Allergy Home Page Template

Review of SOAP Details by Provider

Review of Intake Details by Provider

Overview of the Provider Workflow