MED 111 Ch 23

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Across
  1. 2. one of the most widely used methods of charting, to collect patient visit information; appropriate for most types of patient encounters
  2. 4. inspection
  3. 6. noted in the patient’s medical record as the main reason for the patient’s visit
  4. 9. a system of cross-referencing information contained in office files so that the data may be searched using different characteristics as the query term
  5. 10. refers to both the act of preparing and the evidence created when a health care professional records information
  6. 12. information or symptoms that can be observed such as vital signs
Down
  1. 1. process that lays out a chronological account of the patient reports, provider’s evaluation, prescribed treatment, and responses to treatment as well as the need for further follow-up
  2. 3. when referring to charting, information is supplied by the patient and includes routine information about the patient, past personal and medical history, family history, and chief complaint
  3. 5. acronym that provides a structured charting method for data acquired during a routine health care visit
  4. 7. the arrangement of events, dates, and so on in order of occurrence
  5. 8. record of the continuing progress and treatment of a patient
  6. 11. patient records in a digital format