Remove Document Remove Medical History Remove Patient Records
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Therapy Notes vs. Progress Notes

Valant

Progress notes, on the other hand, record information relevant to the patient’s treatment and response to treatment. This covers information such as diagnosis, symptoms, medical history, test results, treatment plan, progress at appointments, prescription medications, etc.

HIPAA 98
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Best Practices for Managing the Patient Intake Process at a Large Behavioral Health Practice

Valant

Complete and accurate documentation is a crucial part of the therapy intake process. It ensures that important information is recorded for future reference and can be used as a baseline. A patient’s medical history, presenting concerns, treatment preferences, and any relevant psychosocial factors should all be documented.

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Key Applications of AI in Healthcare

Mobius MD

This diagnostic support helps ensure that no detail is overlooked, improving early detection and patient outcomes. Predicting Patient Outcomes – AI can process large amounts of patient data, including medical history, demographics, and lifestyle factors, to predict patient outcomes.

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In Demand Career Spotlight: Pediatric Medical Assistant

ACI Medical & Dental School

Phlebotomy & EKG: Performing phlebotomy procedures and administering electrocardiograms (EKGs) , which can be challenging for younger patients. Medical Records Management: Updating and maintaining accurate patient records, including documenting symptoms, medical histories, and treatment procedures.

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What Are EMR Systems in Healthcare and Key Benefits 

Medical Advantage

However, EMRs are limited in their ability to share information outside the original practice, making it challenging to coordinate care with other providers, and have a more complete patient record. Unlike digital records, paper-based charts are subject to wear and tear or getting lost. What is an EHR?

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Understanding EHR Systems in Healthcare 

Medical Advantage

Defining EHR Systems in Healthcare EHR records encompass a wide array of key administrative and clinical data, including patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data, radiology reports, and more.

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Difference Between EHR And Practice Management Software

Arkenea

Key Takeaway: EHR software is designed primarily for the documentation and management of patient clinical information, while PM software is designed for the administrative functions of healthcare practices. The documentation of medical diagnosis and procedure codes is also done using MPM software.