Continuity of Care Record

Date Created:Wed Apr 25, 2007 at 11:11 PM UTC
From:Dr. Thomas E. Duitrite ( Consulting Provider)
Suffolk Cardiology, Inc.
Solventus CCR ViewPortV1.0
To:Dr. Frank Oliver MD ( Primary Care Provider)
Purpose:Consult Report

Patient Demographics
NameDate of BirthGenderIdentification NumbersAddress / Phone
OctaviaHelios
Jan 02, 1945
FemaleMRN: A21222
SSN: 555-55-5555
Main:
123 Bastile Dr.
Apt. 3
Boston, MA02102

Home: 999-999-9999
Alerts
TypeDateCodeDescriptionReactionSource
Adverse Reaction
Recorded:Feb 02, 2007
9158 (FDB ALLERGY) 295038004 (SNOMED CT) C0571941 (UMLS Concept) LisinoprilOther- MildDr. Thomas E. Duitrite
Adverse Reaction
Recorded:Feb 02, 2007
7052 (FDB ALLERGY) 293974008 (SNOMED CT) C0570893 (UMLS Concept) CarvedilolOther- SevereDr. Thomas E. Duitrite
Support Providers
RoleName
DaughterMarie
TranslatorMarie
Problems
TypeDateCodeDescriptionStatusSource
Problem
Onset:Nov 01, 2006
786.3 (ICD-9 CM) 66857006 (SNOMED CT) C0019079 (UMLS Concept) HemoptysisWorseningDr. Thomas E. Duitrite
Problem
Onset:Mar 31, 1979
275214002 (SNOMED CT) C0026268 (UMLS CONCEPT) Mitral Valve ReplacementChronicDr. Thomas E. Duitrite
Problem
Onset:0Years
Congenital Subaortic MembraneResolvedDr. Thomas E. Duitrite
Problem
Onset:Jun 24, 1977
427.31 (ICD-9 CM) 49436004 (SNOMED CT) C0004238 (UMLS Concept) Chronic Atrial FibrillationChronicDr. Thomas E. Duitrite
Problem
Onset:few years ago
250.90 (ICD-9 CM) C0375149 (UMLS CONCEPT) C0375149 (UMLS Concept) Diabetes Mellitus Type 2ChronicDr. Thomas E. Duitrite
Problem
Onset:7 years ago
313267000 (SNOMED CT) C0038454 (UMLS CONCEPT) C0038454 (UMLS Concept) Stroke without residual deficitResolvedDr. Thomas E. Duitrite
Problem
Onset:2 years ago
428.0 (ICD-9 CM) 42343007 (SNOMED CT) C0018802 (UMLS Concept) Congestive Heart FailureChronicDr. Thomas E. Duitrite
Problem
Onset:unknown
724.3 (ICD-9 CM) 23056005 (SNOMED CT) C0036396 (UMLS Concept) SciatiaIntermittentDr. Thomas E. Duitrite
Medications
MedicationDateStatusFormStrengthQuantitySIGIndicationsInstructionRefillsSource
spironolactone (Aldactone)
Prescription Date:Jan 31, 2007
Activetablet25mg360tablet
2 tablet PO 1id
6Dr. Thomas E. Duitrite
amoxicillin (Amoxicillin)
Prescription Date:Jan 31, 2007
Activetablet500mg4tablet
4 tablet PO Use for Prophylaxis for Endocarditis
3Dr. Thomas E. Duitrite
warfarin (Coumadin)
Prescription Date:Jan 31, 2007
Activetablet5mg180tablet
1 tablet PO 1id
3Dr. Thomas E. Duitrite
digoxin (Digitek)
Prescription Date:Jan 31, 2007
Activetablet250mcg (0.25 mg)90tablet
1 tablet PO 1id
3Dr. Thomas E. Duitrite
valsartan (Diovan)
Prescription Date:Jan 31, 2007
Activetablet80mg90tablet
1 tablet PO 1id
3Dr. Thomas E. Duitrite
ferrous gluconate (Ferrous Gluconate)
Prescription Date:Jan 31, 2007
Activetablet325mg90tablet
1 tablet PO 1id
3Dr. Thomas E. Duitrite
glyBURIDE (GlyBURIDE)
Prescription Date:Feb 16, 2007
Activetablet2.5mg60tablet
1 tablet PO 2id
5Dr. Thomas E. Duitrite
glyBURIDE (GlyBURIDE)
Prescription Date:Jan 31, 2007
Activetablet2.5mg90tablet
1 tablet PO 1id
3Dr. Thomas E. Duitrite
furosemide (Lasix)
Prescription Date:Jan 31, 2007
Activetablet40mg180tablet
2 tablet PO qam
3Dr. Thomas E. Duitrite
metformin (Metformin Hydrochloride)
Prescription Date:Jan 31, 2007
Activetablet500mg270tablet
1 tablet PO qam
3Dr. Thomas E. Duitrite
acetaminophen-hydrocodone (Vicodin)
Prescription Date:Jan 31, 2007
Activetablet500mg / 5mg30tablet
1 tablet PO 2id
3Dr. Thomas E. Duitrite
Social History
TypeDateCodeDescriptionStatusSource
Marital Status
MarriedDr. Thomas E. Duitrite
Language
FrenchDr. Thomas E. Duitrite
Living Children
3Dr. Thomas E. Duitrite
Tobacco Use
Non-smokerCurrentDr. Thomas E. Duitrite
ETOH Use
Rare UseCurrentDr. Thomas E. Duitrite

Additional Information About People & Organizations

People

NameSpecialtyRelationIdentification NumbersPhoneAddress/ E-mail
MarieDaughter
Home999-999-9999
Mobile888-999-9999
Dr. Frank Oliver MD
Dr. Thomas E. DuitriteCardiology
OctaviaHelios
A21222
555-55-5555
Home999-999-9999
Main:
123 Bastile Dr.
Apt. 3
Boston, MA02102

helios@none.com

Organizations

NameSpecialtyRelationIdentification NumbersPhoneAddress/ E-mail
Suffolk Cardiology, Inc.
Main999-999-9999
Main:
12080 Tension Dr.
Boston, MA02102

Information Systems

NameTypeVersionIdentification NumbersPhoneAddress/ E-mail
Solventus CCR ViewPortV1.0

This stylesheet is provided by the American Academy of Family Physicians and the CCR Acceleration Task Force
Powered by the ASTM E2369-05 Specification for the Continuity of Care Record (CCR) which includes:
Advance DirectivesAlerts / AllergiesEncountersFamily HistoryFunctional Status
Health Care ProvidersImmunizationsInsuranceMedical EquipmentMedications
Plan Of CareProblemsProceduresResultsSocial History
Support ProvidersVital Signs