Electronic Medical Records

Examples of the types of information that can be captured are:

• Evaluation history of present illness
• Psychiatric diagnosis and related symptoms
• Medical diagnosis and related symptoms
• Substance abuse disorders and habits with related symptoms
• Past psychiatric history including hospitalizations and risk factors, diagnosis and treatment
• Prescription medication tracking
• Track allergies and adverse reactions
• Psychosocial and family history
• Mental status exam
• Choose your own Scale to monitor the progress of treatment
• Review of systems and client symptoms
• Enter results of a physical exam
• Family relationships
• Enrollment into departments and programs
• Billing Information (Sliding fees and third parties)
• Electronic "post it" notes
• Service, payment and adjustment history

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