Revising The Patient's Problem List - Example and Explanation

Example

Mr. Heart is 73 years old and has Ischemic Heart Disease, with stable angina pectoris. He suffered an anterior wall myocardial infarction in 1995. He has hypertension and diabetes mellitus - type II. Mr. heart also has a right inguinal hernia, and benign prostatic hypertrophy. His problem list would look like this:

Explanation

A more comprehensive revision of the patients’ problem lists, means that the problem-list of every patient with one or more major cardiovascular risk factors must undergo two changes.

• The first change is to re-arrange the patient’s problem list according to a fixed order, using a uniform set of diagnoses.
  The order recommended here has the cardiovascular disease (if present) heading the problem list, followed by its clinical manifestations, and then the patient’s cardiovascular risk factors.
  A uniform set of diagnoses means that, for example, from the terms Ischemic Heart Disease, Coronary Artery Disease and Coronary Heart Disease, you must regularly use only one. This enables you to retrieve a list of all your patients that have this diagnosis. (The computer does not understand that Ischemic Heart Disease, Coronary Artery Disease and Coronary Heart Disease are one and the same.) The same goes for all the other terms you use for cardiovascular diseases and cardiovascular risk factors.
  
• The second change is to give every patient who has one or more cardiovascular risk factors the " new diagnosis"- CARDIOVASCULAR RISK FACTOR/S.
  This enables you to retrieve a list of all your patients with one or more cardiovascular risk factors, the importance of which we will see later on.
  The patient’s other problems come at the end of the problem list.