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FirstName Rogerio
LastName Luz
OrganisationName Dr. Rogerio Luz
Country Brazil
InstantMessaging (IM)
Comment GP, Family Practitioner and Medical Acupunturist in Curitiba-Brasil

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Mr. R comes to the clinician for a first consultation, _system_ generates an Encounter.

Clinician askes the reasson for the visit, Mr R says he has Hypertension. Clinician opens a "Health Issue" with Hypertension as the name, brings up a SOAP via the "Progress Notes" tab in the bottom of the GNUmed sreen, and takes past and family history, when he discovers that patient has Aortic Aneurism, Clinician opens a new "Health Issue" with Aortic Aneurism as the name, where he opens a SOAP via "Progress Notes" and includes the time of onset and current treatment regimens - _SAVES_ and goes back to Hypertension Health Issue, continues the interview, registering current medications (should include these medications in the "Current Medication" field of the "Patient" tab on the uppermost part of GNUmed), conducting a physical exam, orientation and medication adjustment etc... _SAVES_.

As Mr R is leaving he says to clinician "Doc, I´ll be hosnest, I do smoke, but I can´t let my wife know" Clinician opens a new Health Issue puts Smoking Status in the name and starts a SOAP via "Progress Notes" where he takes the history of the smoking use, time, how much, in what instances, the will to quit; if so, mmedication prescribed, etc... _SAVES_

Patient leaves, Clinician opens new patient, when going to call new patient, Mr R. asks if he can talk just one more minute. Says he is now noticing a sever pain in his chest. Clinician opens the patient again, _system_
Topic revision: 17 Aug 2008, RogerioLuz
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