Nephrology follow-up note
[date name="variable_1" default=""] Visit [text name="RAMQ" default=""] Nephrology follow-up note [text name="age" default=""]-year-old [select name="sex" value="male|female|binary/not declared/unknown sex"] patient followed for [text name="variable_1" default=""]. PMH: [textarea name="pmh" default=""] Medications: [textarea name="variable_10010" default="The medication list from DSQ was obtained and reviewed with the patient. Medication list attached at the end of this note."] Allergies: [textarea name="variable_10011" default="No known allergies."] Last evaluation in the clinic was on [date name="last_visit" default=""]. Interval health events or complications since last encounter: [textarea name="events" default="None reported."]. [checkbox name="variable_1" value="He experiences no uremic symptoms. He perceives that his energy level is stable and that his appetite is good. He reports no lower urinary tract symptoms. |She experiences no uremic symptoms. She perceives that his energy level is stable and that her appetite is good. She reports no lower urinary tract symptoms. "] Exam: BP [text name="BP" default=""] Weight [text name="weight" default=""] [checkbox name="self_exam" value="He has no dyspnea and no edema as far as he can appreciate.|She has no dyspnea and no edema as far as she can appreciate."] Labs: [textarea name="variable_10020" default="Please see labs data table attached."] [date name="variable_10014" default=""]: [textarea name="variable_100141" default="creatinine , GFR , bicarbonate , urinalysis , urine albumin to creatinine ratio, urine protein to creatinine ratio, Hb , transferrin saturation , ferritin , HbA1c , LDL , albumin , PTH"] [date name="variable_10015" default=""]: [textarea name="variable_100151" default="creatinine , GFR , bicarbonate , urinalysis , urine albumin to creatinine ratio, urine protein to creatinine ratio, Hb , transferrin saturation , ferritin , HbA1c , LDL , albumin , PTH"] Microbiology: [textarea name="variable_111112" default="No recent pertinent microbiology data available."] Imaging: [date name="variable_1" default=""] [select name="variable_1111116" value="No pertinent imaging studies available.|Ultrasound|CT scan C-|CT scan C+|MRI|Nuclear medicine scan|Abdominal XRay|Other"][text name="variable_109" default=""] [textarea name="variable_1" default=""] [date name="variable_1" default=""] [select name="variable_1111117" value="|Ultrasound|CT scan C-|CT scan C+|MRI|Nuclear medicine scan|Abdominal XRay|Other"][text name="variable_109" default=""] [textarea name="variable_1" default=""] [date name="variable_1" default=""] [select name="variable_1111118" value="|Ultrasound|CT scan C-|CT scan C+|MRI|Nuclear medicine scan|Abdominal XRay|Other"][text name="variable_109" default=""] [textarea name="variable_1" default=""] Impression and Plan: [textarea name="imp_plan" default=""] Return to clinic CC: Dr. [textarea name="CC_MD" default=""] [checkbox name="variable_1" value="This evaluation was done in person.|This was a telemedicine evaluation done by telephone due to CV19 pandemic. Patient already known to me. Double identification was done and patient’s consent for telemedicine was obtained. Patient was deemed as a suitable candidate for a telemedicine evaluation. Encounter time:"][text name="time_frame" default=""]
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Sandbox Metrics: Structured Data Index 0.39, 36 form elements, 40 boilerplate words, 9 text boxes, 13 text areas, 7 dates, 3 checkboxes, 4 drop downs, 39 total clicks
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