827. EPMO Open Source Coordination Office Redaction File Detail Report

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827.1 Files compared

#	Location	File	Last Modified
1	ehmp.zip\ehmp\ehmp\product\production\vx-sync\tests\data\ehmpJDS	document.json	Tue Dec 15 14:05:18 2015 UTC
2	ehmp.zip\ehmp\ehmp\product\production\vx-sync\tests\data\ehmpJDS	document.json	Mon Oct 2 20:02:56 2017 UTC

827.2 Comparison summary

Description	Between Files 1 and 2
Description	Text Blocks	Lines
Unchanged	18	8980
Changed	17	34
Inserted	0	0
Removed	0	0

827.3 Comparison options

Whitespace
Character case	Differences in character case are significant
Line endings	Differences in line endings (`CR` and `LF` characters) are ignored
CR/LF characters	Not shown in the comparison detail

827.4 Active regular expressions

No regular expressions were active.

827.5 Comparison detail

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	860	"conte nt": "CHIE F COMPLAIN T: diabeti c male pre sents with a chief \ r\ncomplai nt of weak ness and d isorientat ion. \r\n \r\nHISTOR Y OF PRESE NT ILLNESS : The pati ent awoke this morni ng feeling very \r\n weak, quea sy, and di soriented. This is s imilar to episodes t hat he's h ad \r\nin the past w hen he's h ad low blo od sugar. His wife h ad difficu lty \r\nge tting him up out of bed due to leg weakn ess and di scoordinat ion. She \ r\ngave hi m some ora nge juice and brough t him into the ER fo r evaluati on. \r\nHe reports t hat over t he past fe w days he has noted increased leg \r\nsw elling, fa cial puffi ness, and increased SOB. He ha s noted so me PND and \r\northo pnea. He h as had som e vague ch est discom fort this morning, l eft \r\nan terior che st, which is now res olved. Oth erwise, he reports t hat he's \ r\nbeen do ing reason ably well without ep isodes of hypoglycem ia. He's n ot \r\nbee n experien cing chest pain. He generally eats no ad ded salt d iet. He's \r\nbeen t aking his medication s as presc ribed, how ever, his wife quest ions \r\nt his at tim es. \r\n \ r\nCURRENT MEDICATIO NS: \r\n\r \nActive I npatient a nd Outpati ent Medica tions (inc luding Sup plies): \r \n\r\n Outpatien t Medicati ons Stat us \r\n=== ========== ========== ========== ========== ========== ========== ========== \r\n1) SIMVASTATI N 40MG TAB TAKE ONE TABLET BY BY MOUTH ACTIV E \r\n EVERY E VENING \r\ n\r\nALLER GIES: Peni cillins. \ r\n \r\nSO CIAL HISTO RY: The pa tient live s in Timbu ktu with h is spouse of many \r \nyears. H e's longti me retired . He does not smoke or use tob acco produ cts. \r\nH e does not use alcoh ol. \r\n \ r\nPAST ME DICAL HIST ORY: 1) Lo ngstanding type 2 di abetes mel litus with the \r\nf ollowing c omplicatio ns: nephro pathy, sev ere neurop athy. 2) R ecurrent \ r\nosteomy elitis of the toes w ith amputa tions. 3) Coronary a rtery dise ase, \r\ns tatus post CABG. 4) Chronic at rial fibri llation. 5 ) Chronic \r\nantico agulation. 6) Hyperl ipidemia. 7) Hyperte nsion. 8) Chronic re nal \r\nin sufficienc y. 9) Chro nic anemia . 10) Dive rticulosis . 11) Hist ory of \r\ ncongestiv e heart fa ilure. \r\ n \r\nPAST SURGICAL HISTORY: 1 ) CABG. 2) Toe amput ations as described above. \r\ n \r\nROS: As review ed in the HPI. \r\n \r\nPHYSIC AL EXAMINA TION: On a dmission B /P was 139 /73, pulse 63, weigh t 182 \r\n lbs. (this was up ab out 7 poun ds since l ast seen i n the clin ic two wee ks \r\nago ). In gene ral the pa tient appe ars an ill , weak, el derly appe aring \r\n male in no acute dis tress. He is oriente d and is a ble to giv e a good \ r\nhistory . \r\n \r\ nSkin: Som ewhat clam my without notable r ash. \r\n \r\nHEENT: Eyes: Scl erae anict eric. Orop harynx wit h moist mu cous membr anes. \r\n \r\nNeck: Supple wi thout palp able mass or adenopa thy. \r\n \r\nLungs: Diminishe d througho ut, partic ularly dim inished in the bases \r\nbilat erally. Th ere is dul lness to p ercussion in both ba ses. I hea r faint \r \nbasilar rales, not prominent . \r\n \r\ nHeart: Di stant, reg ular rate and rhythm with a 2 out of 6 s ystolic \r \nmurmur h eard loude st at the left upper sternal b order. S1 is normal. S2 \r\nha s a fixed split. I d o not hear and S3 ga llop. PMI is nondisp laced. \r\ n \r\nAbdo men: Nondi stended wi th active bowel soun ds. No foc al mass or \r\ntende rness. No organomega ly. \r\n \ r\nGU/Rect al: Deferr ed. \r\n \ r\nExtremi ties: Cool . Feet are somewhat cyanotic. Pedal puls es are \r\ ndiminishe d and sens ation is d iminished in a stock ing distri bution. \r \n \r\nNeu rologic: T he patient presently is alert and orient ed. Speech is \r\nno rmal. Thou ght proces ses are lo gical. The re is no f ocal motor deficit. \r\n \r\nE KG appears sinus rhy thm with a right bun dle branch block. Th ere is som e \r\nST a bnormality , nonspeci fic. Chest x-ray: Th ere is car diomegaly with \r\nh ilar fulln ess and ce phalizatio n. There a ppears to be bilater al pleural \r\neffus ions consi stent with heart fai lure. \r\n \r\nASSES SMENT: X: 1. Probabl e hypoglyc emic react ion. \r\n 2. Wor sening con gestive fa ilure. Rec ent echoca rdiogram \ r\n revealed good LV f unction. T here was a lso pulmon ary \r\n hyp ertension. It does a ppear that there is a \r\n component of right h eart failu re and pos sibly \r\n diasto lic dysfun ction. \r\ n 3. C hronic ren al insuffi ciency. Th e patient has not \r \n tolerated ace inhib itors in t he past. \ r\n 4. Coronary artery dis ease, stat us post CA BG. Cannot \r\n exclud e componen t of ische mia. \r\n 5. Typ e 2 diabet es mellitu s, longsta nding with multiple \r\n complic ations. \r \n \r\nPLA N: Admit p atient to Acute Medi cal Unit f or close o bservation and \r\nf urther eva luation. I nitially d ecrease In sulin by h alf and mo nitor his \r\ncapill ary blood sugars clo sely. Init iate diure sis with I V Furosemi de. \r\nMo nitor card iac enzyme s and seri al EKG's.\ r\n",
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	1195	"conte nt": "Oper ating Room : OR4\r\n\ r\nAnesthe tist: PROV IDER,THREE Relief Anesth: \r \nAnesthes iologist: TDPROVIDER ,TWO Assist A nesth: \r\ nAttending Code: 4. STAFF ASSI STING RESI DENT\r\n\r \nAnes Beg in: DEC 0 8, 2006 0 7:00 Anes End : DEC 08, 2006 10: 00\r\n\r\n ASA Class: 1-NO DIST URB.\r\n\r \nOperatio n Disposit ion: PACU (RECOVERY ROOM)\r\n\ r\nAnesthe sia Techni que(s): \r \nMONITORE D ANESTHES IA CARE ( PRINCIPAL) \r\n Agen t: PRO POFOL 10MG /ML INJ,EM ULSION\r\n Intubate d: NO\r\n\ r\nProcedu re(s) Perf ormed:\r\n Principal: LEFT INGU INAL HERNI A REPAIR\r \n\r\nMedi cations:\r \n BUPIVA CAINE 0.5% 50ML INJ\ r\n Tim e Administ ered: DEC 08, 2006 07:45\r\n Route : INFILTRA TE D osage: 15c c\r\n Ordered B y: PROVIDE R,ONE Admin By: PROVI DER,ONE\r\ n Com ments: USE D 1:1 WITH LIDOCAINE \r\n LIDO CAINE 1% 5 0ML MDV\r\ n Time Administer ed: DEC 08 , 2006 07 :45\r\n Route: INFILTRATE Dos age: 15cc\ r\n O rdered By: PROVIDER, ONE Admin B y: PROVIDE R,ONE\r\n Comme nts: USED 1:1 WITH B UPIVACAINE \r\n\r\nIn traoperati ve Blood L oss: 9 ml Ur ine Output : \r\nPAC( U) Admit S core: PAC( U) Dischar ge Score: \r\n\r\nPo stop Anest hesia Note Date/Time : \r\n",
	1196	"dateT ime": "200 612080730" ,
	1197	"statu s": "COMPL ETED",
	1198	"autho r": "PROVI DER,THREE" ,
	1199	"autho rUid": "ur n:va:user: 9E7A:986",
	1200	"autho rDisplayNa me": "Prov ider,Three ",
	1201	"signe rUid": "ur n:va:user: 9E7A:986",
	1202	"signe r": "PROVI DER,THREE" ,
	1203	"signe rDisplayNa me": "Prov ider,Three ",
	1204	"atten dingUid": "urn:va:us er:9E7A:10 000000066" ,
	1205	"atten ding": "TD PROVIDER,T WO",
	1206	"atten dingDispla yName": "T dprovider, Two",
	1207	"uid": "urn:va:d ocument:9E 7A:3:3525" ,
	1208	"summa ry": "Docu mentText{u id='urn:va :document: 9E7A:3:352 5'}"
	1209	}
	1210	],
	1211	"cod es": [],
	1212	"loc alId": "35 25",
	1213	"enc ounterUid" : "urn:va: visit:9E7A :3:5552",
	1214	"enc ounterName ": "OR4 De c 08, 2006 ",
	1215	"sta tus": "COM PLETED",
	1216	"sta tusDisplay Name": "Co mpleted",
	1217	"cli nicians": [
	1218	{
	1219	"name" : "PROVIDE R,THREE",
	1220	"displ ayName": " Provider,T hree",
	1221	"role" : "AU",
	1222	"uid": "urn:va:u ser:9E7A:9 86",
	1223	"summa ry": "Docu mentClinic ian{uid='u rn:va:user :9E7A:986' }"
	1224	},
	1225	{
	1226	"name" : "PROVIDE R,THREE",
	1227	"displ ayName": " Provider,T hree",
	1228	"role" : "S",
	1229	"signe dDateTime" : "2006120 8182805",
	1230	"signa ture": "TH REE PROVID ER PHYSICI AN",
	1231	"uid": "urn:va:u ser:9E7A:9 86",
	1232	"summa ry": "Docu mentClinic ian{uid='u rn:va:user :9E7A:986' }"
	1233	},
	1234	{
	1235	"name" : "PROVIDE R,THREE",
	1236	"displ ayName": " Provider,T hree",
	1237	"role" : "ES",
	1238	"uid": "urn:va:u ser:9E7A:9 86",
	1239	"summa ry": "Docu mentClinic ian{uid='u rn:va:user :9E7A:986' }"
	1240	},
	1241	{
	1242	"name" : "TO",
	1243	"displ ayName": " To",
	1244	"role" : "E",
	1245	"uid": "urn:va:u ser:9E7A:1 0000000016 ",
	1246	"summa ry": "Docu mentClinic ian{uid='u rn:va:user :9E7A:1000 0000016'}"
	1247	},
	1248	{
	1249	"name" : "TDPROVI DER,TWO",
	1250	"displ ayName": " Tdprovider ,Two",
	1251	"role" : "ATT",
	1252	"uid": "urn:va:u ser:9E7A:1 0000000066 ",
	1253	"summa ry": "Docu mentClinic ian{uid='u rn:va:user :9E7A:1000 0000066'}"
	1254	}
	1255	]
	1256	},
	1257	{
	1258	"aut horUid": " urn:va:use r:9E7A:100 00000016",
	1259	"aut horDisplay Name": "Td nurse,One" ,
	1260	"sig nerUid": " urn:va:use r:9E7A:100 00000016",
	1261	"sig nerDisplay Name": "Td nurse,One" ,
	1262	"sig nedDateTim e": "20061 208174808" ,
	1263	"kin d": "Surge ry Report" ,
	1264	"doc umentDefUi d": "urn:v a:doc-def: 9E7A:1286" ,
	1265	"isI nterdiscip linary": " false",
	1266	"fac ilityCode" : "500",
	1267	"fac ilityName" : "CAMP MA STER",
	1268	"ref erenceDate Time": "20 0612080730 ",
	1269	"doc umentTypeC ode": "SR" ,
	1270	"doc umentTypeN ame": "Sur gery Repor t",
	1271	"doc umentClass ": "SURGIC AL REPORTS ",
	1272	"loc alTitle": "NURSE INT RAOPERATIV E REPORT",
	1273	"sub ject": "Ca se #: 1001 4",
	1274	"uid ": "urn:va :document: 9E7A:3:352 6",
	1275	"sum mary": "NU RSE INTRAO PERATIVE R EPORT",
	1276	"pid ": "9E7A;3 ",
	1277	"aut hor": "TDN URSE,ONE",
	1278	"sig ner": "TDN URSE,ONE",
	1279	"ent ered": "20 0612081255 15",
	1280	"tex t": [
	1281	{
	1282	"clini cians": [
	1283	{
	1284	"name": "TDNURSE,O NE",
	1285	"display Name": "Td nurse,One" ,
	1286	"role": "AU",
	1287	"uid": " urn:va:use r:9E7A:100 00000016",
	1288	"summary ": "Docume ntClinicia n{uid='urn :va:user:9 E7A:100000 00016'}"
	1289	},
	1290	{
	1291	"name": "TDNURSE,O NE",
	1292	"display Name": "Td nurse,One" ,
	1293	"role": "S",
	1294	"signedD ateTime": "200612081 74808",
	1295	"signatu re": "ONE TDNURSE RN ",
	1296	"uid": " urn:va:use r:9E7A:100 00000016",
	1297	"summary ": "Docume ntClinicia n{uid='urn :va:user:9 E7A:100000 00016'}"
	1298	},
	1299	{
	1300	"name": "TDNURSE,O NE",
	1301	"display Name": "Td nurse,One" ,
	1302	"role": "ES",
	1303	"uid": " urn:va:use r:9E7A:100 00000016",
	1304	"summary ": "Docume ntClinicia n{uid='urn :va:user:9 E7A:100000 00016'}"
	1305	},
	1306	{
	1307	"name": "TO",
	1308	"display Name": "To ",
	1309	"role": "E",
	1310	"uid": " urn:va:use r:9E7A:100 00000016",
	1311	"summary ": "Docume ntClinicia n{uid='urn :va:user:9 E7A:100000 00016'}"
	1312	}
	1313	],
	1314	"conte nt": "Oper ating Room : OR4 Surg ical Prior ity: ELECT IVE\r\n\r\ nPatient i n Hold: DE C 08, 2006 07:00 Patient i n OR: DEC 08, 2006 07:30\r\n Operation Begin: DEC 08, 2006 08:00 Operation End: DEC 08, 2006 09:45\r\n P atient Out OR: DEC 0 8, 2006 1 0:00\r\n\r \nMajor Op erations P erformed:\ r\nPrimary : LEFT ING UINAL HERN IA REPAIR\ r\n\r\nWou nd Classif ication: C LEAN\r\nOp eration Di sposition: PACU (REC OVERY ROOM )\r\nDisch arged Via: STRETCHER \r\n\r\nSu rgeon: PRO VIDER,ONE Fi rst Assist : PROVIDER ,TWO\r\nAt tend Surg: TDPROVIDE R,ONE Se cond Assis t: N/A\r\n Anesthetis t: PROVIDE R,THREE Assistant Anesth: N/ A\r\n\r\nO ther Scrub bed Assist ants: N/A\ r\n\r\nOR Support Pe rsonnel:\r \n Scrubb ed Circulat ing\r\n N URSE,ONE ( ) TDN URSE,ONE ( )\r\n\r\nO ther Perso ns in OR: N/A\r\n\r\ nPreop Moo d: R ELAXED Preop Con sc: ALE RT-ORIENTE D\r\nPreop Skin Inte g: INTACT Preop Converse: N/A\r\n\r \nValid Co nsent/ID B and Confir med By: TD NURSE,ONE\ r\nMark on Surgical Site Confi rmed: YES\ r\n Marke d Site Com ments: NO COMMENTS E NTERED\r\n \r\nPreope rative Ima ging Confi rmed: YES \r\n Imag ing Confir med Commen ts: NO COM MENTS ENTE RED\r\n\r\ nTime Out Verificati on Complet ed: YES\r\ n Time Ou t Verified Comments: NO COMMEN TS ENTERED \r\n\r\nSk in Prep By : PROVIDER ,TWO Sk in Prep Ag ent: BETAD INE\r\nSki n Prep By (2): N/A 2nd Skin Prep Agent: N/ A\r\n\r\nP reop Surgi cal Site H air Remova l by: PROV IDER,ONE\r \nSurgical Site Hair Removal M ethod: SHA VING\r\n Hair Remov al Comment s: \r\n NO COMMENT S ENTERED\ r\n\r\nSur gery Posit ion(s): \r \n SUPINE Placed: N/A\r\n\r\ nRestraint s and Posi tion Aids: \r\n SAF ETY STRAP Applied B y: N/A\r\n ARMBOARD Appl ied By: N/ A\r\n\r\nE lectrocaut ery Unit: #4\r \nESU Coag ulation Ra nge: 3 0\r\nESU C utting Ran ge: N/A\r\nE lectrogrou nd Positio n(s): RIGH T ANT THIG H\r\n\r\nM aterial Se nt to Labo ratory for Analysis: \r\nSpeci mens: \r\n LEFT ING UINAL HERN IA SAC\r\n Cultures: N/A\r\n\r \nAnesthes ia Techniq ue(s):\r\n MONITORE D ANESTHES IA CARE ( PRINCIPAL) \r\n\r\nTu bes and Dr ains: N/A\ r\n\r\nTou rniquet: N /A\r\n\r\n Thermal Un it: N/A\r\ n\r\nProst hesis Inst alled: N/A \r\n\r\nMe dications: \r\n BUP IVACAINE 0 .5% 50ML I NJ\r\n Time Admin istered: D EC 08, 200 6 07:45\r \n Ro ute: INFIL TRATE Dosage: 15cc\r\n Ordere d By: PROV IDER,ONE Ad min By: PR OVIDER,ONE \r\n Comments: USED 1:1 W ITH LIDOCA INE\r\n L IDOCAINE 1 % 50ML MDV \r\n Ti me Adminis tered: DEC 08, 2006 07:45\r\n Rout e: INFILTR ATE Dosage: 15 cc\r\n Ordered By: PROVID ER,ONE Admi n By: PROV IDER,ONE\r \n Co mments: US ED 1:1 WIT H BUPIVACA INE\r\n\r\ nIrrigatio n Solution (s): \r\n NORMAL SA LINE\r\n\r \nBlood Re placement Fluids: N/ A\r\n\r\nS ponge Coun t Correct: YES\r \nSharps C ount Corre ct: YE S\r\nInstr ument Coun t Correct: YES\r\nCo unter: NURSE, ONE\r\nCou nts Verifi ed By: TDNURSE ,ONE\r\n\r \nDressing : 4X4\r\nP acking: N /A\r\n\r\n Blood Loss : 9 ml Urine Outp ut: \r\n\r \nPostoper ative Mood : RELAXED\ r\nPostope rative Con sciousness : ALERT-O RIENTED\r\ nPostopera tive Skin Integrity: INTACT\r\ nPostopera tive Skin Color: N/A\r\n\r \nLaser Un it(s): N/A \r\n\r\nSe quential C ompression Device: N O\r\n\r\nC ell Saver( s): N/A\r\ n\r\nDevic es: N/A\r\ n\r\nNursi ng Care Co mments: NO COMMENTS ENTERED\r\ n",
	1315	"dateT ime": "200 612080730" ,
	1316	"statu s": "COMPL ETED",
	1317	"autho r": "TDNUR SE,ONE",
	1318	"autho rUid": "ur n:va:user: 9E7A:10000 000016",
	1319	"autho rDisplayNa me": "Tdnu rse,One",
	1320	"signe rUid": "ur n:va:user: 9E7A:10000 000016",
	1321	"signe r": "TDNUR SE,ONE",
	1322	"signe rDisplayNa me": "Tdnu rse,One",
	1323	"uid": "urn:va:d ocument:9E 7A:3:3526" ,
	1324	"summa ry": "Docu mentText{u id='urn:va :document: 9E7A:3:352 6'}"
	1325	}
	1326	],
	1327	"cod es": [],
	1328	"loc alId": "35 26",
	1329	"enc ounterUid" : "urn:va: visit:9E7A :3:5552",
	1330	"enc ounterName ": "OR4 De c 08, 2006 ",
	1331	"sta tus": "COM PLETED",
	1332	"sta tusDisplay Name": "Co mpleted",
	1333	"cli nicians": [
	1334	{
	1335	"name" : "TDNURSE ,ONE",
	1336	"displ ayName": " Tdnurse,On e",
	1337	"role" : "AU",
	1338	"uid": "urn:va:u ser:9E7A:1 0000000016 ",
	1339	"summa ry": "Docu mentClinic ian{uid='u rn:va:user :9E7A:1000 0000016'}"
	1340	},
	1341	{
	1342	"name" : "TDNURSE ,ONE",
	1343	"displ ayName": " Tdnurse,On e",
	1344	"role" : "S",
	1345	"signe dDateTime" : "2006120 8174808",
	1346	"signa ture": "ON E TDNURSE RN",
	1347	"uid": "urn:va:u ser:9E7A:1 0000000016 ",
	1348	"summa ry": "Docu mentClinic ian{uid='u rn:va:user :9E7A:1000 0000016'}"
	1349	},
	1350	{
	1351	"name" : "TDNURSE ,ONE",
	1352	"displ ayName": " Tdnurse,On e",
	1353	"role" : "ES",
	1354	"uid": "urn:va:u ser:9E7A:1 0000000016 ",
	1355	"summa ry": "Docu mentClinic ian{uid='u rn:va:user :9E7A:1000 0000016'}"
	1356	},
	1357	{
	1358	"name" : "TO",
	1359	"displ ayName": " To",
	1360	"role" : "E",
	1361	"uid": "urn:va:u ser:9E7A:1 0000000016 ",
	1362	"summa ry": "Docu mentClinic ian{uid='u rn:va:user :9E7A:1000 0000016'}"
	1363	}
	1364	]
	1365	},
	1366	{
	1367	"aut horUid": " urn:va:use r:9E7A:983 ",
	1368	"aut horDisplay Name": "Pr ovider,One ",
	1369	"cos ignerUid": "urn:va:u ser:9E7A:1 0000000021 ",
	1370	"cos ignerDispl ayName": " Tdprovider ,One",
	1371	"cos ignedDateT ime": "200 6121108450 8",
	1372	"att endingUid" : "urn:va: user:9E7A: 1000000002 1",
	1373	"att endingDisp layName": "Tdprovide r,One",
	1374	"sig nerUid": " urn:va:use r:9E7A:983 ",
	1375	"sig nerDisplay Name": "Pr ovider,One ",
	1376	"sig nedDateTim e": "20061 208181955" ,
	1377	"kin d": "Surge ry Report" ,
	1378	"doc umentDefUi d": "urn:v a:doc-def: 9E7A:1288" ,
	1379	"isI nterdiscip linary": " false",
	1380	"fac ilityCode" : "500",
	1381	"fac ilityName" : "CAMP MA STER",
	1382	"ref erenceDate Time": "20 0612080730 ",
	1383	"doc umentTypeC ode": "SR" ,
	1384	"doc umentTypeN ame": "Sur gery Repor t",
	1385	"doc umentClass ": "SURGIC AL REPORTS ",
	1386	"loc alTitle": "OPERATION REPORT",
	1387	"sub ject": "Ca se #: 1001 4",
	1388	"uid ": "urn:va :document: 9E7A:3:356 1",
	1389	"sum mary": "OP ERATION RE PORT",
	1390	"pid ": "9E7A;3 ",
	1391	"aut hor": "PRO VIDER,ONE" ,
	1392	"cos igner": "T DPROVIDER, ONE",
	1393	"att ending": " TDPROVIDER ,ONE",
	1394	"sig ner": "PRO VIDER,ONE" ,
	1395	"ent ered": "20 0612081406 13",
	1396	"tex t": [
	1397	{
	1398	"clini cians": [
	1399	{
	1400	"name": "PROVIDER, ONE",
	1401	"display Name": "Pr ovider,One ",
	1402	"role": "AU",
	1403	"uid": " urn:va:use r:9E7A:983 ",
	1404	"summary ": "Docume ntClinicia n{uid='urn :va:user:9 E7A:983'}"
	1405	},
	1406	{
	1407	"name": "PROVIDER, ONE",
	1408	"display Name": "Pr ovider,One ",
	1409	"role": "S",
	1410	"signedD ateTime": "200612081 81955",
	1411	"signatu re": "ONE PROVIDER M D",
	1412	"uid": " urn:va:use r:9E7A:983 ",
	1413	"summary ": "Docume ntClinicia n{uid='urn :va:user:9 E7A:983'}"
	1414	},
	1415	{
	1416	"name": "TDPROVIDE R,ONE",
	1417	"display Name": "Td provider,O ne",
	1418	"role": "C",
	1419	"signedD ateTime": "200612110 84508",
	1420	"signatu re": "ONE TDPROVIDER MD",
	1421	"uid": " urn:va:use r:9E7A:100 00000021",
	1422	"summary ": "Docume ntClinicia n{uid='urn :va:user:9 E7A:100000 00021'}"
	1423	},
	1424	{
	1425	"name": "PROVIDER, ONE",
	1426	"display Name": "Pr ovider,One ",
	1427	"role": "ES",
	1428	"uid": " urn:va:use r:9E7A:983 ",
	1429	"summary ": "Docume ntClinicia n{uid='urn :va:user:9 E7A:983'}"
	1430	},
	1431	{
	1432	"name": "TDPROVIDE R,ONE",
	1433	"display Name": "Td provider,O ne",
	1434	"role": "EC",
	1435	"uid": " urn:va:use r:9E7A:100 00000021",
	1436	"summary ": "Docume ntClinicia n{uid='urn :va:user:9 E7A:100000 00021'}"
	1437	},
	1438	{
	1439	"name": "OP",
	1440	"display Name": "Op ",
	1441	"role": "E",
	1442	"uid": " urn:va:use r:9E7A:983 ",
	1443	"summary ": "Docume ntClinicia n{uid='urn :va:user:9 E7A:983'}"
	1444	},
	1445	{
	1446	"name": "TDPROVIDE R,ONE",
	1447	"display Name": "Td provider,O ne",
	1448	"role": "ATT",
	1449	"uid": " urn:va:use r:9E7A:100 00000021",
	1450	"summary ": "Docume ntClinicia n{uid='urn :va:user:9 E7A:100000 00021'}"
	1451	}
	1452	],
	1453	"conte nt": "SURG EON: PROVIDER,O NE \r\n \r \n 1ST ASS T: PRO VIDER,TWO \r\n \r\n ATTENDING: TDPROV IDER,ONE \ r\n \r\n P ROCEDURE: LEFT INGU INAL HERNI A REPAIR W ITH MESH\r \n \r\n HI STORY: Es sentially patient u nderwent preop eval uation fo r left \r \n inguina l mass no ted since Septembe r 2004. Recently PT became more \r\ n symptoma tic with increased size and tenderness . Patient denied a ny history \r\n of me lena or bl oody stool s. Denie d a histor y of const ipation or diarrhea. \r\n No r ecent feve rs or chil ls. He w as admitte d on Decem ber 7, 200 6,\r\n for an electi ve left in guinal her nia repair . \r\n \r\ n SUMMARY OF PROCEDU RES: Aft er consen t was obt ained, th e patient was \r\n prepped an d draped in steril e fashion. Lidocai ne 1% was used to \r\n anest hetize the skin and a 5-cm in cision was made in t he left gr oin. \r\n The skin and subcu was dissec ted down t o the ext ernal obli que fascia . \r\n Th e fascia w as incised to the ex ternal rin g and the spermatic cord and\r \n all its contents were isola ted with a Penrose drain. Th e hernia sac\r\n wa s then di ssected an d reduced into the l arge direc t inguinal defect. \r\n Three large me sh plugs were secur ed togeth er and us ed to plu g the\r\n direct de fect and secured in place with 2 i nterrupted Prolene\ r\n stitch es. An o nlay patch was then applied a nd secured to the p ubic\r\n t ubercle a nd secured to the fa scial edge s using a running 2- 0 Prolene\ r\n suture on eithe r side. T he externa l oblique was then c losed over the\r\n r epair, bei ng cogniza nt of the ilioingui nal nerve . All sup erficial\r \n bleedin g was con trolled wi th electro cautery. Copious i rrigation was\r\n us ed and ad ditional 1 % Lidocain e was use d to anes thetize th e subcu an d\r\n fasc ia. Scarp a fascia was closed using 4- 0 Vicryl. Addition al 4-0 \r \n Vicryl was used in a subc uticular fashion t o close t he skin. \r\n Steri -Strips we re applied and dress ings. Th e patient was extub ated and\r \n stable to recover y, tolerat ed the pro cedure wel l. The a ttending\r \n physici an, TDPROV DIER,ONE, was scrubb ed during the entire case.\r\n ",
	1454	"dateT ime": "200 612080730" ,
	1455	"statu s": "COMPL ETED",
	1456	"autho r": "PROVI DER,ONE",
	1457	"autho rUid": "ur n:va:user: 9E7A:983",
	1458	"autho rDisplayNa me": "Prov ider,One",
	1459	"signe rUid": "ur n:va:user: 9E7A:983",
	1460	"signe r": "PROVI DER,ONE",
	1461	"signe rDisplayNa me": "Prov ider,One",
	1462	"cosig nerUid": " urn:va:use r:9E7A:100 00000021",
	1463	"cosig ner": "TDP ROVIDER,ON E",
	1464	"cosig nerDisplay Name": "Td provider,O ne",
	1465	"atten dingUid": "urn:va:us er:9E7A:10 000000021" ,
	1466	"atten ding": "TD PROVIDER,O NE",
	1467	"atten dingDispla yName": "T dprovider, One",
	1468	"uid": "urn:va:d ocument:9E 7A:3:3561" ,
	1469	"summa ry": "Docu mentText{u id='urn:va :document: 9E7A:3:356 1'}"
	1470	}
	1471	],
	1472	"cod es": [],
	1473	"loc alId": "35 61",
	1474	"enc ounterUid" : "urn:va: visit:9E7A :3:5552",
	1475	"enc ounterName ": "OR4 De c 08, 2006 ",
	1476	"sta tus": "COM PLETED",
	1477	"sta tusDisplay Name": "Co mpleted",
	1478	"cli nicians": [
	1479	{
	1480	"name" : "PROVIDE R,ONE",
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Left v entricle: The ventri cle was mi ldly dilat ed. Systol ic functio n \r\nwas \r\nmodera tely to ma rkedly red uced. Ejec tion fract ion was es timated to be 25 \r\ n%. \r\nTh is study w as inadequ ate for th e evaluati on of regi onal wall motion. \r \nWall \r\ nthickness was mildl y increase d. There w as mild co ncentric h ypertrophy .\r\n \r\n 2) ECG\r\n EKG showed 4 mm ST e levation i n inferior leads. \r \nNew left axis devi ation and inverted T -waves in V3-6 were found.\r\n \r\n3) Ca rdiac cath erization. \r\nNo sig nificant c oronary di sease note d.\r\n \r\ nReason fo r Admissio n:\r\n \r\ nPatient i s 71yo wit h a histor y of poorl y controll ed DM and \r\nHTN wh o presente d to the E D today wi th a 5 day history o f worsenin g chest \r \npain and shortness of breath with asso ciated dys pnea at re st, PND, a nd \r\nort hopnea. Pa tient repo rts that b eginning 5 days ago experience d a \r\nfe eling of a nxiety whi le laying in bed. Patient ha d difficul ty \r\nbre athing and chest bec ame tight. Patient sat up in bed and th e feeling \r\neased. Since the n pateint has had in termittent feelings of pressur e, \r\npat ient had r esistance on his che st while l ying down. Patient feels like \r\nhe ca n't catch his breath . Patient reports R shoulder cramping, left \r\nl ower chest pain. The se episode s vary in length of time, but the \r\nsh ortness of breath la sts all da y. Patient reports t hinking th e symptoms \r\nare a ssociated with his t aking meto prolol. In the ED th e patient sats \r\nw ere 88 whi le lying d own. Patie nt was giv en lasix a nd after a while the \r\nfeeli ng of full ness in ch est dissip ated. Othe r associat ed symptom s: + \r\nc hest pain, duration longer tha n 10 minut es, + ches t pressure , heavy \r \nquality + discomfo rt, neck o r jaw or s houlder or arm. At l ast admiss ion \r\nha d metoprol ol for his BP contro l.\r\nPati ent was ad mitted to r/o ischem ic event. \r\n \r\nH ospital Co urse: \r\n 1) Chest p ain: Patei nt was rul ed in for an ischemi c event wi th positiv e \r\nseri al cardiac \r\nenzym es and not ed ST elev ation. Add itionally, new left axis devia tion and \ r\ninverte d T-\r\nwa ves in V3- 6 were fou nd. Patien t had pers istent but finally r esolved \r \nchest pa in over hi s \r\nadmi ssion. Car diac cathe terization done this admission did not r eveal any \r\nsignif icant coro nary disea se. In 20 03, pt was found to have non-i schemic \r \ndilated cardiomyop athy \r\nw ith an EF of 35-40% on GXT and Echo. Pt had TTE on 3/12/07 s howing an EF \r\nof \r\n25%. P t SOB cont inued to i mprove wit h Lasix. Sublingual nitroglyc erin \r\nw as also pr ovided to patient.\r \n \r\n2) Shortness of breath/ Non-ischem ic Dilated Cardiomyo pathy: Pat ient has \ r\nknown E F of 35%. Echo done today to d etermine i f EF is pr eserved an d had \r\n decreased to 25%. C XR and sym ptoms cons istent wit h CHF that improved \r\nwith d iuresis. Patient w as started on \r\nLa six IV whi ch bumped his Cr fro m 1.2 to 1 .5. Lasix was conver ted to po. \r\nWeigh t counseli ng provide d for CHF; patient has a scal e at home. \r\n \r\n3 ) Hyperten sion: Pati ent has co ntrolled h ypertensio n. On last admission , \r\npt w as \r\npre scribed Me toprolol. B/P durin g this adm ission and prior to this \r\na dmission a re well co ntrolled. Will cont inue patie nt on Meto prolol at \r\ndischa rge. \r\n \r\n4) Unc ontrolled DM II: Pat ient conti nues to ha ve glucose fingersti cks in \r\ n150s-175s . Patient is receivi ng metform in to cont rol diabet es. Patie nt \r\nis compliant with perfo rming and recording his sugars at home. Spoke in \r\ngreat depth abou t the nega tive conse quence of persisten tly elevat ed \r\nblo od glucose levels wi th the pat ient. 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	2868	"conte nt": "CHIE F COMPLAIN T: diabeti c male pre sents with a chief \ r\ncomplai nt of weak ness and d isorientat ion. \r\n \r\nHISTOR Y OF PRESE NT ILLNESS : The pati ent awoke this morni ng feeling very \r\n weak, quea sy, and di soriented. This is s imilar to episodes t hat he's h ad \r\nin the past w hen he's h ad low blo od sugar. His wife h ad difficu lty \r\nge tting him up out of bed due to leg weakn ess and di scoordinat ion. She \ r\ngave hi m some ora nge juice and brough t him into the ER fo r evaluati on. \r\nHe reports t hat over t he past fe w days he has noted increased leg \r\nsw elling, fa cial puffi ness, and increased SOB. He ha s noted so me PND and \r\northo pnea. He h as had som e vague ch est discom fort this morning, l eft \r\nan terior che st, which is now res olved. Oth erwise, he reports t hat he's \ r\nbeen do ing reason ably well without ep isodes of hypoglycem ia. He's n ot \r\nbee n experien cing chest pain. He generally eats no ad ded salt d iet. He's \r\nbeen t aking his medication s as presc ribed, how ever, his wife quest ions \r\nt his at tim es. \r\n \ r\nCURRENT MEDICATIO NS: \r\n\r \nActive I npatient a nd Outpati ent Medica tions (inc luding Sup plies): \r \n\r\n Outpatien t Medicati ons Stat us \r\n=== ========== ========== ========== ========== ========== ========== ========== \r\n1) SIMVASTATI N 40MG TAB TAKE ONE TABLET BY BY MOUTH ACTIV E \r\n EVERY E VENING \r\ n\r\nALLER GIES: Peni cillins. \ r\n \r\nSO CIAL HISTO RY: The pa tient live s in Timbu ktu with h is spouse of many \r \nyears. H e's longti me retired . He does not smoke or use tob acco produ cts. \r\nH e does not use alcoh ol. \r\n \ r\nPAST ME DICAL HIST ORY: 1) Lo ngstanding type 2 di abetes mel litus with the \r\nf ollowing c omplicatio ns: nephro pathy, sev ere neurop athy. 2) R ecurrent \ r\nosteomy elitis of the toes w ith amputa tions. 3) Coronary a rtery dise ase, \r\ns tatus post CABG. 4) Chronic at rial fibri llation. 5 ) Chronic \r\nantico agulation. 6) Hyperl ipidemia. 7) Hyperte nsion. 8) Chronic re nal \r\nin sufficienc y. 9) Chro nic anemia . 10) Dive rticulosis . 11) Hist ory of \r\ ncongestiv e heart fa ilure. \r\ n \r\nPAST SURGICAL HISTORY: 1 ) CABG. 2) Toe amput ations as described above. \r\ n \r\nROS: As review ed in the HPI. \r\n \r\nPHYSIC AL EXAMINA TION: On a dmission B /P was 139 /73, pulse 63, weigh t 182 \r\n lbs. (this was up ab out 7 poun ds since l ast seen i n the clin ic two wee ks \r\nago ). In gene ral the pa tient appe ars an ill , weak, el derly appe aring \r\n male in no acute dis tress. He is oriente d and is a ble to giv e a good \ r\nhistory . \r\n \r\ nSkin: Som ewhat clam my without notable r ash. \r\n \r\nHEENT: Eyes: Scl erae anict eric. Orop harynx wit h moist mu cous membr anes. \r\n \r\nNeck: Supple wi thout palp able mass or adenopa thy. \r\n \r\nLungs: Diminishe d througho ut, partic ularly dim inished in the bases \r\nbilat erally. Th ere is dul lness to p ercussion in both ba ses. I hea r faint \r \nbasilar rales, not prominent . \r\n \r\ nHeart: Di stant, reg ular rate and rhythm with a 2 out of 6 s ystolic \r \nmurmur h eard loude st at the left upper sternal b order. S1 is normal. S2 \r\nha s a fixed split. I d o not hear and S3 ga llop. PMI is nondisp laced. \r\ n \r\nAbdo men: Nondi stended wi th active bowel soun ds. No foc al mass or \r\ntende rness. No organomega ly. \r\n \ r\nGU/Rect al: Deferr ed. \r\n \ r\nExtremi ties: Cool . Feet are somewhat cyanotic. Pedal puls es are \r\ ndiminishe d and sens ation is d iminished in a stock ing distri bution. \r \n \r\nNeu rologic: T he patient presently is alert and orient ed. Speech is \r\nno rmal. Thou ght proces ses are lo gical. The re is no f ocal motor deficit. \r\n \r\nE KG appears sinus rhy thm with a right bun dle branch block. Th ere is som e \r\nST a bnormality , nonspeci fic. Chest x-ray: Th ere is car diomegaly with \r\nh ilar fulln ess and ce phalizatio n. There a ppears to be bilater al pleural \r\neffus ions consi stent with heart fai lure. \r\n \r\nASSES SMENT: X: 1. Probabl e hypoglyc emic react ion. \r\n 2. Wor sening con gestive fa ilure. Rec ent echoca rdiogram \ r\n revealed good LV f unction. T here was a lso pulmon ary \r\n hyp ertension. It does a ppear that there is a \r\n component of right h eart failu re and pos sibly \r\n diasto lic dysfun ction. \r\ n 3. C hronic ren al insuffi ciency. Th e patient has not \r \n tolerated ace inhib itors in t he past. \ r\n 4. Coronary artery dis ease, stat us post CA BG. Cannot \r\n exclud e componen t of ische mia. \r\n 5. Typ e 2 diabet es mellitu s, longsta nding with multiple \r\n complic ations. \r \n \r\nPLA N: Admit p atient to Acute Medi cal Unit f or close o bservation and \r\nf urther eva luation. I nitially d ecrease In sulin by h alf and mo nitor his \r\ncapill ary blood sugars clo sely. Init iate diure sis with I V Furosemi de. \r\nMo nitor card iac enzyme s and seri al EKG's.\ r\n",
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	3043	"loc alTitle": "AUDIOLOGY - HEARING LOSS CONS ULT",
	3044	"uid ": "urn:va :document: C877:3:311 2",
	3045	"sum mary": "AU DIOLOGY - HEARING LO SS CONSULT ",
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	3047	"aut hor": "PAT HOLOGY,ONE ",
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	3049	"ent ered": "20 0404012257 41",
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	3053	{
	3054	"name": "PATHOLOGY ,ONE",
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	3084	"conte nt": "HX: Patient w as seen fo r hearing aid fittin g and orie ntation.\r \nThe batt eries supp lied for t his hearin g aid were : za312.\r \n \r\nIMP : The ve teran was seen for h earing aid fitting a nd orienta tion. A c omplete \r \norientat ion was pe rformed, a nd the pat ient can i nsert the aids(s), c hange the \r\nbatter ies, and a djust the volume. R esponse cu rves were obtained using a re al-\r\near probe mic rophone in -situ Meas urement Sy stem and i ndicated a ppropriate gain \r\n for the de monstrated hearing l oss. Care of the ai d(s), warr anty infor mation and \r\ndange rs of batt ery ingest ion were d iscussed w ith the ve teran. \r\ n \r\nREC: Continu ed use of present am plificatio n is recom mended\r\n ",
	3085	"dateT ime": "200 404012257" ,
	3086	"statu s": "COMPL ETED",
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	3153	"loc alTitle": "ANESTHESI A REPORT",
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	3160	"sig ner": "PRO VIDER,THRE E",
	3161	"ent ered": "20 0612081251 56",
	3162	"tex t": [
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	3203	"conte nt": "Oper ating Room : OR4\r\n\ r\nAnesthe tist: PROV IDER,THREE Relief Anesth: \r \nAnesthes iologist: TDPROVIDER ,TWO Assist A nesth: \r\ nAttending Code: 4. STAFF ASSI STING RESI DENT\r\n\r \nAnes Beg in: DEC 0 8, 2006 0 7:00 Anes End : DEC 08, 2006 10: 00\r\n\r\n ASA Class: 1-NO DIST URB.\r\n\r \nOperatio n Disposit ion: PACU (RECOVERY ROOM)\r\n\ r\nAnesthe sia Techni que(s): \r \nMONITORE D ANESTHES IA CARE ( PRINCIPAL) \r\n Agen t: PRO POFOL 10MG /ML INJ,EM ULSION\r\n Intubate d: NO\r\n\ r\nProcedu re(s) Perf ormed:\r\n Principal: LEFT INGU INAL HERNI A REPAIR\r \n\r\nMedi cations:\r \n BUPIVA CAINE 0.5% 50ML INJ\ r\n Tim e Administ ered: DEC 08, 2006 07:45\r\n Route : INFILTRA TE D osage: 15c c\r\n Ordered B y: PROVIDE R,ONE Admin By: PROVI DER,ONE\r\ n Com ments: USE D 1:1 WITH LIDOCAINE \r\n LIDO CAINE 1% 5 0ML MDV\r\ n Time Administer ed: DEC 08 , 2006 07 :45\r\n Route: INFILTRATE Dos age: 15cc\ r\n O rdered By: PROVIDER, ONE Admin B y: PROVIDE R,ONE\r\n Comme nts: USED 1:1 WITH B UPIVACAINE \r\n\r\nIn traoperati ve Blood L oss: 9 ml Ur ine Output : \r\nPAC( U) Admit S core: PAC( U) Dischar ge Score: \r\n\r\nPo stop Anest hesia Note Date/Time : \r\n",
	3204	"dateT ime": "200 612080730" ,
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	3223	"sta tus": "COM PLETED",
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	3279	"doc umentClass ": "SURGIC AL REPORTS ",
	3280	"loc alTitle": "NURSE INT RAOPERATIV E REPORT",
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	3283	"sum mary": "NU RSE INTRAO PERATIVE R EPORT",
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	3285	"aut hor": "TDN URSE,ONE",
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	3287	"ent ered": "20 0612081255 15",
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	3291	{
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	3322	"conte nt": "Oper ating Room : OR4 Surg ical Prior ity: ELECT IVE\r\n\r\ nPatient i n Hold: DE C 08, 2006 07:00 Patient i n OR: DEC 08, 2006 07:30\r\n Operation Begin: DEC 08, 2006 08:00 Operation End: DEC 08, 2006 09:45\r\n P atient Out OR: DEC 0 8, 2006 1 0:00\r\n\r \nMajor Op erations P erformed:\ r\nPrimary : LEFT ING UINAL HERN IA REPAIR\ r\n\r\nWou nd Classif ication: C LEAN\r\nOp eration Di sposition: PACU (REC OVERY ROOM )\r\nDisch arged Via: STRETCHER \r\n\r\nSu rgeon: PRO VIDER,ONE Fi rst Assist : PROVIDER ,TWO\r\nAt tend Surg: TDPROVIDE R,ONE Se cond Assis t: N/A\r\n Anesthetis t: PROVIDE R,THREE Assistant Anesth: N/ A\r\n\r\nO ther Scrub bed Assist ants: N/A\ r\n\r\nOR Support Pe rsonnel:\r \n Scrubb ed Circulat ing\r\n N URSE,ONE ( ) TDN URSE,ONE ( )\r\n\r\nO ther Perso ns in OR: N/A\r\n\r\ nPreop Moo d: R ELAXED Preop Con sc: ALE RT-ORIENTE D\r\nPreop Skin Inte g: INTACT Preop Converse: N/A\r\n\r \nValid Co nsent/ID B and Confir med By: TD NURSE,ONE\ r\nMark on Surgical Site Confi rmed: YES\ r\n Marke d Site Com ments: NO COMMENTS E NTERED\r\n \r\nPreope rative Ima ging Confi rmed: YES \r\n Imag ing Confir med Commen ts: NO COM MENTS ENTE RED\r\n\r\ nTime Out Verificati on Complet ed: YES\r\ n Time Ou t Verified Comments: NO COMMEN TS ENTERED \r\n\r\nSk in Prep By : PROVIDER ,TWO Sk in Prep Ag ent: BETAD INE\r\nSki n Prep By (2): N/A 2nd Skin Prep Agent: N/ A\r\n\r\nP reop Surgi cal Site H air Remova l by: PROV IDER,ONE\r \nSurgical Site Hair Removal M ethod: SHA VING\r\n Hair Remov al Comment s: \r\n NO COMMENT S ENTERED\ r\n\r\nSur gery Posit ion(s): \r \n SUPINE Placed: N/A\r\n\r\ nRestraint s and Posi tion Aids: \r\n SAF ETY STRAP Applied B y: N/A\r\n ARMBOARD Appl ied By: N/ A\r\n\r\nE lectrocaut ery Unit: #4\r \nESU Coag ulation Ra nge: 3 0\r\nESU C utting Ran ge: N/A\r\nE lectrogrou nd Positio n(s): RIGH T ANT THIG H\r\n\r\nM aterial Se nt to Labo ratory for Analysis: \r\nSpeci mens: \r\n LEFT ING UINAL HERN IA SAC\r\n Cultures: N/A\r\n\r \nAnesthes ia Techniq ue(s):\r\n MONITORE D ANESTHES IA CARE ( PRINCIPAL) \r\n\r\nTu bes and Dr ains: N/A\ r\n\r\nTou rniquet: N /A\r\n\r\n Thermal Un it: N/A\r\ n\r\nProst hesis Inst alled: N/A \r\n\r\nMe dications: \r\n BUP IVACAINE 0 .5% 50ML I NJ\r\n Time Admin istered: D EC 08, 200 6 07:45\r \n Ro ute: INFIL TRATE Dosage: 15cc\r\n Ordere d By: PROV IDER,ONE Ad min By: PR OVIDER,ONE \r\n Comments: USED 1:1 W ITH LIDOCA INE\r\n L IDOCAINE 1 % 50ML MDV \r\n Ti me Adminis tered: DEC 08, 2006 07:45\r\n Rout e: INFILTR ATE Dosage: 15 cc\r\n Ordered By: PROVID ER,ONE Admi n By: PROV IDER,ONE\r \n Co mments: US ED 1:1 WIT H BUPIVACA INE\r\n\r\ nIrrigatio n Solution (s): \r\n NORMAL SA LINE\r\n\r \nBlood Re placement Fluids: N/ A\r\n\r\nS ponge Coun t Correct: YES\r \nSharps C ount Corre ct: YE S\r\nInstr ument Coun t Correct: YES\r\nCo unter: NURSE, ONE\r\nCou nts Verifi ed By: TDNURSE ,ONE\r\n\r \nDressing : 4X4\r\nP acking: N /A\r\n\r\n Blood Loss : 9 ml Urine Outp ut: \r\n\r \nPostoper ative Mood : RELAXED\ r\nPostope rative Con sciousness : ALERT-O RIENTED\r\ nPostopera tive Skin Integrity: INTACT\r\ nPostopera tive Skin Color: N/A\r\n\r \nLaser Un it(s): N/A \r\n\r\nSe quential C ompression Device: N O\r\n\r\nC ell Saver( s): N/A\r\ n\r\nDevic es: N/A\r\ n\r\nNursi ng Care Co mments: NO COMMENTS ENTERED\r\ n",
	3323	"dateT ime": "200 612080730" ,
	3324	"statu s": "COMPL ETED",
	3325	"autho r": "TDNUR SE,ONE",
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	3339	"sta tus": "COM PLETED",
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	3353	"signe dDateTime" : "2006120 8174808",
	3354	"signa ture": "ON E TDNURSE RN",
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	3356	"summa ry": "Docu mentClinic ian{uid='u rn:va:user :C877:1000 0000016'}"
	3357	},
	3358	{
	3359	"name" : "TDNURSE ,ONE",
	3360	"displ ayName": " Tdnurse,On e",
	3361	"role" : "ES",
	3362	"uid": "urn:va:u ser:C877:1 0000000016 ",
	3363	"summa ry": "Docu mentClinic ian{uid='u rn:va:user :C877:1000 0000016'}"
	3364	},
	3365	{
	3366	"name" : "TO",
	3367	"displ ayName": " To",
	3368	"role" : "E",
	3369	"uid": "urn:va:u ser:C877:1 0000000016 ",
	3370	"summa ry": "Docu mentClinic ian{uid='u rn:va:user :C877:1000 0000016'}"
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	3374	{
	3375	"aut horUid": " urn:va:use r:C877:983 ",
	3376	"aut horDisplay Name": "Pr ovider,One ",
	3377	"cos ignerUid": "urn:va:u ser:C877:1 0000000021 ",
	3378	"cos ignerDispl ayName": " Tdprovider ,One",
	3379	"cos ignedDateT ime": "200 6121108450 8",
	3380	"att endingUid" : "urn:va: user:C877: 1000000002 1",
	3381	"att endingDisp layName": "Tdprovide r,One",
	3382	"sig nerUid": " urn:va:use r:C877:983 ",
	3383	"sig nerDisplay Name": "Pr ovider,One ",
	3384	"sig nedDateTim e": "20061 208181955" ,
	3385	"kin d": "Surge ry Report" ,
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	3387	"isI nterdiscip linary": " false",
	3388	"fac ilityCode" : "500",
	3389	"fac ilityName" : "CAMP BE E",
	3390	"ref erenceDate Time": "20 0612080730 ",
	3391	"doc umentTypeC ode": "SR" ,
	3392	"doc umentTypeN ame": "Sur gery Repor t",
	3393	"doc umentClass ": "SURGIC AL REPORTS ",
	3394	"loc alTitle": "OPERATION REPORT",
	3395	"sub ject": "Ca se #: 1001 4",
	3396	"uid ": "urn:va :document: C877:3:356 1",
	3397	"sum mary": "OP ERATION RE PORT",
	3398	"pid ": "C877;3 ",
	3399	"aut hor": "PRO VIDER,ONE" ,
	3400	"cos igner": "T DPROVIDER, ONE",
	3401	"att ending": " TDPROVIDER ,ONE",
	3402	"sig ner": "PRO VIDER,ONE" ,
	3403	"ent ered": "20 0612081406 13",
	3404	"tex t": [
	3405	{
	3406	"clini cians": [
	3407	{
	3408	"name": "PROVIDER, ONE",
	3409	"display Name": "Pr ovider,One ",
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	3422	},
	3423	{
	3424	"name": "TDPROVIDE R,ONE",
	3425	"display Name": "Td provider,O ne",
	3426	"role": "C",
	3427	"signedD ateTime": "200612110 84508",
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	3431	},
	3432	{
	3433	"name": "PROVIDER, ONE",
	3434	"display Name": "Pr ovider,One ",
	3435	"role": "ES",
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	3438	},
	3439	{
	3440	"name": "TDPROVIDE R,ONE",
	3441	"display Name": "Td provider,O ne",
	3442	"role": "EC",
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	3445	},
	3446	{
	3447	"name": "OP",
	3448	"display Name": "Op ",
	3449	"role": "E",
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	3451	"summary ": "Docume ntClinicia n{uid='urn :va:user:C 877:983'}"
	3452	},
	3453	{
	3454	"name": "TDPROVIDE R,ONE",
	3455	"display Name": "Td provider,O ne",
	3456	"role": "ATT",
	3457	"uid": " urn:va:use r:C877:100 00000021",
	3458	"summary ": "Docume ntClinicia n{uid='urn :va:user:C 877:100000 00021'}"
	3459	}
	3460	],
	3461	"conte nt": "SURG EON: PROVIDER,O NE \r\n \r \n 1ST ASS T: PRO VIDER,TWO \r\n \r\n ATTENDING: TDPROV IDER,ONE \ r\n \r\n P ROCEDURE: LEFT INGU INAL HERNI A REPAIR W ITH MESH\r \n \r\n HI STORY: Es sentially patient u nderwent preop eval uation fo r left \r \n inguina l mass no ted since Septembe r 2004. Recently PT became more \r\ n symptoma tic with increased size and tenderness . Patient denied a ny history \r\n of me lena or bl oody stool s. Denie d a histor y of const ipation or diarrhea. \r\n No r ecent feve rs or chil ls. He w as admitte d on Decem ber 7, 200 6,\r\n for an electi ve left in guinal her nia repair . \r\n \r\ n SUMMARY OF PROCEDU RES: Aft er consen t was obt ained, th e patient was \r\n prepped an d draped in steril e fashion. Lidocai ne 1% was used to \r\n anest hetize the skin and a 5-cm in cision was made in t he left gr oin. \r\n The skin and subcu was dissec ted down t o the ext ernal obli que fascia . \r\n Th e fascia w as incised to the ex ternal rin g and the spermatic cord and\r \n all its contents were isola ted with a Penrose drain. Th e hernia sac\r\n wa s then di ssected an d reduced into the l arge direc t inguinal defect. \r\n Three large me sh plugs were secur ed togeth er and us ed to plu g the\r\n direct de fect and secured in place with 2 i nterrupted Prolene\ r\n stitch es. An o nlay patch was then applied a nd secured to the p ubic\r\n t ubercle a nd secured to the fa scial edge s using a running 2- 0 Prolene\ r\n suture on eithe r side. T he externa l oblique was then c losed over the\r\n r epair, bei ng cogniza nt of the ilioingui nal nerve . All sup erficial\r \n bleedin g was con trolled wi th electro cautery. Copious i rrigation was\r\n us ed and ad ditional 1 % Lidocain e was use d to anes thetize th e subcu an d\r\n fasc ia. Scarp a fascia was closed using 4- 0 Vicryl. Addition al 4-0 \r \n Vicryl was used in a subc uticular fashion t o close t he skin. \r\n Steri -Strips we re applied and dress ings. Th e patient was extub ated and\r \n stable to recover y, tolerat ed the pro cedure wel l. The a ttending\r \n physici an, TDPROV DIER,ONE, was scrubb ed during the entire case.\r\n ",
	3462	"dateT ime": "200 612080730" ,
	3463	"statu s": "COMPL ETED",
	3464	"autho r": "PROVI DER,ONE",
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	3470	"cosig nerUid": " urn:va:use r:C877:100 00000021",
	3471	"cosig ner": "TDP ROVIDER,ON E",
	3472	"cosig nerDisplay Name": "Td provider,O ne",
	3473	"atten dingUid": "urn:va:us er:C877:10 000000021" ,
	3474	"atten ding": "TD PROVIDER,O NE",
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	3482	"enc ounterUid" : "urn:va: visit:C877 :3:5552",
	3483	"enc ounterName ": "OR4 De c 08, 2006 ",
	3484	"sta tus": "COM PLETED",
	3485	"sta tusDisplay Name": "Co mpleted",
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	3494	{
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	3498	"signe dDateTime" : "2006120 8181955",
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	3502	},
	3503	{
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	3511	},
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	3528	"displ ayName": " Op",
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	3533	{
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	3547	"sig nedDateTim e": "20070 516095030" ,
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	3554	"doc umentTypeC ode": "D",
	3555	"doc umentTypeN ame": "Adv ance Direc tive",
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	3558	"nat ionalTitle ": {
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	3564	"sum mary": "AD VANCE DIRE CTIVE COMP LETED",
	3565	"pid ": "C877;3 ",
	3566	"aut hor": "LAB TECH,FIFTY NINE",
	3567	"sig ner": "LAB TECH,FIFTY NINE",
	3568	"ent ered": "20 0705160950 30",
	3569	"tex t": [
	3570	{
	3571	"clini cians": [
	3572	{
	3573	"name": "LABTECH,F IFTYNINE",
	3574	"display Name": "La btech,Fift ynine",
	3575	"role": "AU",
	3576	"uid": " urn:va:use r:C877:100 00000049",
	3577	"summary ": "Docume ntClinicia n{uid='urn :va:user:C 877:100000 00049'}"
	3578	},
	3579	{
	3580	"name": "LABTECH,F IFTYNINE",
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	3582	"role": "S",
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	3584	"signatu re": "FIFT YNINE LABT ECH",
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	3587	},
	3588	{
	3589	"name": "LABTECH,F IFTYNINE",
	3590	"display Name": "La btech,Fift ynine",
	3591	"role": "ES",
	3592	"uid": " urn:va:use r:C877:100 00000049",
	3593	"summary ": "Docume ntClinicia n{uid='urn :va:user:C 877:100000 00049'}"
	3594	},
	3595	{
	3596	"name": "MG",
	3597	"display Name": "Mg ",
	3598	"role": "E",
	3599	"uid": " urn:va:use r:C877:100 00000049",
	3600	"summary ": "Docume ntClinicia n{uid='urn :va:user:C 877:100000 00049'}"
	3601	}
	3602	],
	3603	"conte nt": " V istA Imagi ng - Scann ed Documen t\r\n",
	3604	"dateT ime": "200 705160950" ,
	3605	"statu s": "COMPL ETED",
	3606	"autho r": "LABTE CH,FIFTYNI NE",
	3607	"autho rUid": "ur n:va:user: C877:10000 000049",
	3608	"autho rDisplayNa me": "Labt ech,Fiftyn ine",
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	3610	"signe r": "LABTE CH,FIFTYNI NE",
	3611	"signe rDisplayNa me": "Labt ech,Fiftyn ine",
	3612	"uid": "urn:va:d ocument:C8 77:3:3853" ,
	3613	"summa ry": "Docu mentText{u id='urn:va :document: C877:3:385 3'}"
	3614	}
	3615	],
	3616	"cod es": [],
	3617	"loc alId": "38 53",
	3618	"enc ounterUid" : "urn:va: visit:C877 :3:5670",
	3619	"enc ounterName ": "20 MIN UTE May 16 , 2007",
	3620	"sta tus": "COM PLETED",
	3621	"sta tusDisplay Name": "Co mpleted",
	3622	"cli nicians": [
	3623	{
	3624	"name" : "LABTECH ,FIFTYNINE ",
	3625	"displ ayName": " Labtech,Fi ftynine",
	3626	"role" : "AU",
	3627	"uid": "urn:va:u ser:C877:1 0000000049 ",
	3628	"summa ry": "Docu mentClinic ian{uid='u rn:va:user :C877:1000 0000049'}"
	3629	},
	3630	{
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	3632	"displ ayName": " Labtech,Fi ftynine",
	3633	"role" : "S",
	3634	"signe dDateTime" : "2007051 6095030",
	3635	"signa ture": "FI FTYNINE LA BTECH",
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	3639	{
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	3642	"role" : "ES",
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	3645	},
	3646	{
	3647	"name" : "MG",
	3648	"displ ayName": " Mg",
	3649	"role" : "E",
	3650	"uid": "urn:va:u ser:C877:1 0000000049 ",
	3651	"summa ry": "Docu mentClinic ian{uid='u rn:va:user :C877:1000 0000049'}"
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	3654	},
	3655	{
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	3657	"aut horDisplay Name": "Ve hu,Ten",
	3658	"att endingUid" : "urn:va: user:C877: 20012",
	3659	"att endingDisp layName": "Vehu,Ten" ,
	3660	"sig nerUid": " urn:va:use r:C877:200 12",
	3661	"sig nerDisplay Name": "Ve hu,Ten",
	3662	"sig nedDateTim e": "20070 529123935" ,
	3663	"urg ency": "ro utine",
	3664	"kin d": "Disch arge Summa ry",
	3665	"doc umentDefUi d": "urn:v a:doc-def: C877:1",
	3666	"isI nterdiscip linary": " false",
	3667	"fac ilityCode" : "998",
	3668	"fac ilityName" : "ABILENE (CAA)",
	3669	"ref erenceDate Time": "20 0403251917 05",
	3670	"doc umentTypeC ode": "DS" ,
	3671	"doc umentTypeN ame": "Dis charge Sum mary",
	3672	"doc umentClass ": "DISCHA RGE SUMMAR Y",
	3673	"loc alTitle": "Discharge Summary",
	3674	"nat ionalTitle ": {
	3675	"name": "D ISCHARGE S UMMARY",
	3676	"vuid": "u rn:va:vuid :4693715"
	3677	},
	3678	"doc umentDefUi dVuid": "u rn:va:vuid :4693715",
	3679	"uid ": "urn:va :document: C877:3:396 0",
	3680	"sum mary": "Di scharge Su mmary",
	3681	"pid ": "C877;3 ",
	3682	"aut hor": "VEH U,TEN",
	3683	"att ending": " VEHU,TEN",
	3684	"sig ner": "VEH U,TEN",
	3685	"ent ered": "20 0705291239 18",
	3686	"tex t": [
	3687	{
	3688	"clini cians": [
	3689	{
	3690	"name": "VEHU,TEN" ,
	3691	"display Name": "Ve hu,Ten",
	3692	"role": "AU",
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	3694	"summary ": "Docume ntClinicia n{uid='urn :va:user:C 877:20012' }"
	3695	},
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	3700	"signedD ateTime": "200705291 23935",
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	3704	},
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	3708	"role": "ES",
	3709	"uid": " urn:va:use r:C877:200 12",
	3710	"summary ": "Docume ntClinicia n{uid='urn :va:user:C 877:20012' }"
	3711	},
	3712	{
	3713	"name": "VEHU,TEN" ,
	3714	"display Name": "Ve hu,Ten",
	3715	"role": "EC",
	3716	"uid": " urn:va:use r:C877:200 12",
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	3718	},
	3719	{
	3720	"name": "V10",
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	3727	"name": "VEHU,TEN" ,
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	3734	"conte nt": "Admi ssion Diag nosis: \r\ n1) Chest pain\r\n2) Shortness of breath \r\n \r\nD ischarge D iagnosis:\ r\n1) Acut e coronary syndromes \r\n2) CHF exacerbat ion\r\n3) Hyperlipid emia\r\n4) Hypertens ion\r\n5) Controlled Diabetes Mellitus I I:\r\n \r\ n \r\nHome Outpatien t Medicati ons:\r\n1) Metopro lol 50mg P O BID\r\n2 ) Metfor min HCL 50 0 mg PO BI D\r\n3) Simvastati n 40mg PO QPM\r\n4) Asprin 8 1mg PO QDA Y\r\n \r\n Discharge Medication s:\r\n1) Metoprolo l 50 mg PO BID\r\n2) Metform in HCL 500 mg PO BID \r\n3) S imvastatin 40mg PO Q PM\r\n \r\ nNon VA Me dications: \r\n1) Asp irin 81mg PO QDAY\r\ n \r\nI ha d reviewed and compl eted medic ation reco nciliation .\r\n \r\n Tests: \r\ n1) Transt horacic EC HOcardiogr am\r\nImpr essions\r\ nMild LVH with signi ficantly r educed LV systolic f unction. E F visually \r\nestim ated to be 25%.\r\nS ummary\r\n A). Indica tion: Asse ss left ve ntricular function. Assess lef t ventricu lar \r\nej ection fra ction.\r\n B). Left v entricle: The ventri cle was mi ldly dilat ed. Systol ic functio n \r\nwas \r\nmodera tely to ma rkedly red uced. Ejec tion fract ion was es timated to be 25 \r\ n%. \r\nTh is study w as inadequ ate for th e evaluati on of regi onal wall motion. \r \nWall \r\ nthickness was mildl y increase d. There w as mild co ncentric h ypertrophy .\r\n \r\n 2) ECG\r\n EKG showed 4 mm ST e levation i n inferior leads. \r \nNew left axis devi ation and inverted T -waves in V3-6 were found.\r\n \r\n3) Ca rdiac cath erization. \r\nNo sig nificant c oronary di sease note d.\r\n \r\ nReason fo r Admissio n:\r\n \r\ nPatient i s 71yo wit h a histor y of poorl y controll ed DM and \r\nHTN wh o presente d to the E D today wi th a 5 day history o f worsenin g chest \r \npain and shortness of breath with asso ciated dys pnea at re st, PND, a nd \r\nort hopnea. Pa tient repo rts that b eginning 5 days ago experience d a \r\nfe eling of a nxiety whi le laying in bed. Patient ha d difficul ty \r\nbre athing and chest bec ame tight. Patient sat up in bed and th e feeling \r\neased. Since the n pateint has had in termittent feelings of pressur e, \r\npat ient had r esistance on his che st while l ying down. Patient feels like \r\nhe ca n't catch his breath . Patient reports R shoulder cramping, left \r\nl ower chest pain. The se episode s vary in length of time, but the \r\nsh ortness of breath la sts all da y. Patient reports t hinking th e symptoms \r\nare a ssociated with his t aking meto prolol. In the ED th e patient sats \r\nw ere 88 whi le lying d own. Patie nt was giv en lasix a nd after a while the \r\nfeeli ng of full ness in ch est dissip ated. Othe r associat ed symptom s: + \r\nc hest pain, duration longer tha n 10 minut es, + ches t pressure , heavy \r \nquality + discomfo rt, neck o r jaw or s houlder or arm. At l ast admiss ion \r\nha d metoprol ol for his BP contro l.\r\nPati ent was ad mitted to r/o ischem ic event. \r\n \r\nH ospital Co urse: \r\n 1) Chest p ain: Patei nt was rul ed in for an ischemi c event wi th positiv e \r\nseri al cardiac \r\nenzym es and not ed ST elev ation. Add itionally, new left axis devia tion and \ r\ninverte d T-\r\nwa ves in V3- 6 were fou nd. Patien t had pers istent but finally r esolved \r \nchest pa in over hi s \r\nadmi ssion. Car diac cathe terization done this admission did not r eveal any \r\nsignif icant coro nary disea se. In 20 03, pt was found to have non-i schemic \r \ndilated cardiomyop athy \r\nw ith an EF of 35-40% on GXT and Echo. Pt had TTE on 3/12/07 s howing an EF \r\nof \r\n25%. P t SOB cont inued to i mprove wit h Lasix. Sublingual nitroglyc erin \r\nw as also pr ovided to patient.\r \n \r\n2) Shortness of breath/ Non-ischem ic Dilated Cardiomyo pathy: Pat ient has \ r\nknown E F of 35%. Echo done today to d etermine i f EF is pr eserved an d had \r\n decreased to 25%. C XR and sym ptoms cons istent wit h CHF that improved \r\nwith d iuresis. Patient w as started on \r\nLa six IV whi ch bumped his Cr fro m 1.2 to 1 .5. Lasix was conver ted to po. \r\nWeigh t counseli ng provide d for CHF; patient has a scal e at home. \r\n \r\n3 ) Hyperten sion: Pati ent has co ntrolled h ypertensio n. On last admission , \r\npt w as \r\npre scribed Me toprolol. B/P durin g this adm ission and prior to this \r\na dmission a re well co ntrolled. Will cont inue patie nt on Meto prolol at \r\ndischa rge. \r\n \r\n4) Unc ontrolled DM II: Pat ient conti nues to ha ve glucose fingersti cks in \r\ n150s-175s . Patient is receivi ng metform in to cont rol diabet es. Patie nt \r\nis compliant with perfo rming and recording his sugars at home. Spoke in \r\ngreat depth abou t the nega tive conse quence of persisten tly elevat ed \r\nblo od glucose levels wi th the pat ient. Pat ient agree s to follo w diabetic \r\nmanag ement inst ructions a t home.\r\ n \r\nDisp osition: Patient is being dis charged to home toda y in good \r\ncondit ion. Pati ent has fo llow-up ar ranged in the Cardio logy clini c. \r\nPat ient also has follow -up schedu led with t heir prima ry care pr ovider. \r \n",
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	4279	"conte nt": "Pati ent: VICKE RS, CURTIS \nDate: 19 Nov 2013 1525 EST\n Appt Type: ACUT\nTre atment Fac ility: JAM ES A LOVEL L FED HEAL TH CARE CE NTER\nClin ic: FAMILY PRACTICE CLINIC\nPr ovider: BH IEONE\nPat ient Statu s: Outpati ent\n\n\n \nAutoCite s Refreshe d by BHIE, USERONE @ 19 Nov 201 3 1525 EST \t\nProble ms \nChron ic: \n-His tory of ga stroduoden al artery aneurysm \ n-History of maligna nt neoplas m of the g astrointes tinal trac t \n-Previ ous histor y of gastr ointestina l symptoms \n-Previo us history of visit for: preop erative ga strointest inal exam \n-Cough v ariant ast hma \nAcut e: \n-Appe ndix disor ders \n \n Family Hi story \nNo Family Hi story Foun d. \n\n A llergies \ n-Iodine C ontaining Agents: Na usea (test )\n \n \n Social His tory \nNo Social His tory Found . \n\n Pr ocedures \ n-Gastric Acid, Free (18 Nov 2 013) \n \n Active Med ications\n No Active Medication s Found.\n Expired Me dications\ nNo Expire d Medicati ons Found. \n \nAppoi ntment Com ments: Wri tten by BH IE,USERONE @ 19 Nov 2013 1525 EST\ntest \n\nQuesti onnaire Au toCites Re freshed by BHIE,USER ONE @ 19 N ov 2013 15 25 EST\t\n Questionna ires\n\n \ nA/P Last Updated by BHIE,USER ONE @ 19 N ov 2013 15 34 EST\t\n 1. ankle j oint pain\ n \nDispos ition Writ ten by BHI E,USERONE @ 19 Nov 2 013 1539 E ST\t\nRele ased w/ Wo rk/Duty Li mitations \nDiscusse d: Diagnos is, Medica tion(s)/Tr eatment(s) , Alternat ives, Pote ntial Side Effects w ith Patien t who indi cated unde rstanding. \n \n\nSi gned By B HIE, USERO NE (Physic ian/Workst ation) @ 1 9 Nov 2013 1539 \n",
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	4314	"dateT ime": "201 3120221392 8",
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	4347	"conte nt": "Pati ent: VICKE RS, CURTIS \nDate: 03 Dec 2013 1103 EST\n Appt Type: ACUT\nTre atment Fac ility: JAM ES A LOVEL L FED HEAL TH CARE CE NTER\nClin ic: FAMILY PRACTICE CLINIC\nPr ovider: BH IEONE\nPat ient Statu s: Outpati ent\n\n\n \nAutoCite s Refreshe d by BHIE, USERONE @ 03 Dec 201 3 1104 EST \t\nProble ms \nChron ic: \n-Nec k pain rad iating up the back o f the head \n-Headac he \n-Prev ious histo ry of sinu s pressure \n-Previo us history of pain o ver the no se \n-Ankl e joint pa in \n-Hist ory of gas troduodena l artery a neurysm \n -History o f malignan t neoplasm of the ga strointest inal tract \n-Previo us history of gastro intestinal symptoms \n-Previou s history of visit f or: preope rative gas trointesti nal exam \ n-Cough va riant asth ma \nAcute : \n-Acute viral cys titis \n-A ppendix di sorders \n \n Family History \ nNo Family History F ound. \n\ n Allergie s \n-Tetra cyclines: Rash\n-Iod ine Contai ning Agent s: Nausea (test)\n \ nActive Me dications\ nNo Active Medicatio ns Found.\ nExpired M edications \nNo Expir ed Medicat ions Found .\n \nAppo intment Co mments: Wr itten by B HIE,USERON E @ 03 Dec 2013 1103 EST\ntest 123 \n\nQu estionnair e AutoCite s Refreshe d by BHIE, USERONE @ 03 Dec 201 3 1104 EST \t\nQuesti onnaires\n \n \nA/P W ritten by BHIE,USERO NE @ 03 De c 2013 114 9 EST\t\n1 . neck pai n\n\tProce dure(s): \n-Hepatit is B Vacci ne (Active ); 20 Year s and Abov e x 1 - He p B - Adul t; Series #: 1; .1 m L; IM; Rig ht Thigh; Mfg: Abbot t; Lot: 15 b.\n \n-Im munization Administr ation One Vaccine x 1\n \nDisp osition Wr itten by B HIE,USERON E @ 03 Dec 2013 1149 EST\t\nSi ck at Home / Quarter s - for \ n \nNote W ritten by BHIE,USERO NE @ 03 De c 2013 110 7 EST\narc test \ntes t \nthis i s a test\n \n \nSigne d By BHIE , USERONE (Physician /Workstati on) @ 03 D ec 2013 11 50 \n",
	4348	"dateT ime": "201 3120316491 7",
	4349	"statu s": "compl eted",
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	4357	"syste m": "DOD_N OTES"
	4358	}
	4359	],
	4360	"sta tus": "com pleted",
	4361	"sta tusDisplay Name": "Co mpleted",
	4362	"cli nicians": [],
	4363	"sta tusName": "completed "
	4364	},
	4365	{
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	4370	"fac ilityCode" : "DOD",
	4371	"fac ilityName" : "DOD",
	4372	"ref erenceDate Time": "20 1312051726 10",
	4373	"doc umentTypeN ame": "Pro gress Note ",
	4374	"loc alTitle": "Progress Note",
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	4376	"sum mary": "Pr ogress Not e",
	4377	"pid ": "DOD;00 00000003",
	4378	"aut hor": "BHI E, USERONE ",
	4379	"tex t": [
	4380	{
	4381	"conte nt": "Pati ent: VICKE RS, CURTIS \nDate: 05 Dec 2013 1214 EST\n Appt Type: ACUT\nTre atment Fac ility: JAM ES A LOVEL L FED HEAL TH CARE CE NTER\nClin ic: FAMILY PRACTICE CLINIC\nPr ovider: BH IEONE\nPat ient Statu s: Outpati ent\n\n\n \nAutoCite s Refreshe d by BHIE, USERONE @ 05 Dec 201 3 1215 EST \t\nProble ms \nChron ic: \n-Foo t pain \n- Neck pain \n-Neck pa in radiati ng up the back of th e head \n- Headache \ n-Previous history o f sinus pr essure \n- Previous h istory of pain over the nose \ n-Ankle jo int pain \ n-History of gastrod uodenal ar tery aneur ysm \n-His tory of ma lignant ne oplasm of the gastro intestinal tract \n- Previous h istory of gastrointe stinal sym ptoms \n-P revious hi story of v isit for: preoperati ve gastroi ntestinal exam \n-Co ugh varian t asthma \ nAcute: \n -Acute vir al cystiti s \n-Appen dix disord ers \n \n Family His tory \nNo Family His tory Found . \n\n Al lergies \n -Tetracycl ines: Rash \n-Iodine Containing Agents: N ausea (tes t)\n \nAct ive Medica tions\nNo Active Med ications F ound.\nExp ired Medic ations\nNo Expired M edications Found.\n \nAppointm ent Commen ts: Writte n by BHIE, USERONE @ 05 Dec 201 3 1214 EST \ntesttest \n\nVital s\nVitals Written by BHIE,USER ONE @ 05 D ec 2013 12 15 EST\n B P: 110/40, HR: 4 0, T: 98 ?F, HT: 5' 3' ', WT: 127 lbs, BMI: 2 2.5, B SA: 1.594 square met ers, T obacco Use : No, Alcohol Us e: No\nCom ments: tes t \n \nQu estionnair e AutoCite s Refreshe d by BHIE, USERONE @ 05 Dec 201 3 1215 EST \t\nQuesti onnaires\n \n \nA/P W ritten by BHIE,USERO NE @ 05 De c 2013 122 6 EST\t\n1 . limb swe lling\n\tP rocedure(s ): \n-Ace llular Der m Allograf t Feet Sur face Area 100+ Sq Cm - 100 Sq Cm Or Less x 1\n \nD isposition Written b y BHIE,USE RONE @ 05 Dec 2013 1 226 EST\t\ nSick at H ome / Quar ters - for 24 Hours \nDiscusse d: Diagnos is, Medica tion(s)/Tr eatment(s) , Alternat ives, Pote ntial Side Effects w ith Patien t who indi cated unde rstanding. \n \nNote Written b y BHIE,USE RONE @ 05 Dec 2013 1 222 EST\nP rogress no te \narc t est note \ nThe patie nt visit w ith a prob lem in the leg. More Diagnosis yet to be followed. \n\n\n\n \ nSigned By BHIE, US ERONE (Phy sician/Wor kstation) @ 05 Dec 2 013 1227 \ n",
	4382	"dateT ime": "201 3120517261 0",
	4383	"statu s": "compl eted",
	4384	"uid": "urn:va:d ocument:DO D:00000000 03:1000010 661",
	4385	"summa ry": "Docu mentText{u id='urn:va :document: DOD:000000 0003:10000 10661'}"
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	4390	"code" : "34109-9 ",
	4391	"syste m": "DOD_N OTES"
	4392	}
	4393	],
	4394	"sta tus": "com pleted",
	4395	"sta tusDisplay Name": "Co mpleted",
	4396	"cli nicians": [],
	4397	"sta tusName": "completed "
	4398	},
	4399	{
	4400	"aut horDisplay Name": "BH IE, USERON E",
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	4404	"fac ilityCode" : "DOD",
	4405	"fac ilityName" : "DOD",
	4406	"ref erenceDate Time": "20 1401131755 35",
	4407	"doc umentTypeN ame": "Pro gress Note ",
	4408	"loc alTitle": "Progress Note",
	4409	"uid ": "urn:va :document: DOD:000000 0003:10000 10662",
	4410	"sum mary": "Pr ogress Not e",
	4411	"pid ": "DOD;00 00000003",
	4412	"aut hor": "BHI E, USERONE ",
	4413	"tex t": [
	4414	{
	4415	"conte nt": "Pati ent: VICKE RS, CURTIS \nDate: 09 Jan 2014 1500 EST\n Appt Type: ACUT\nTre atment Fac ility: JAM ES A LOVEL L FED HEAL TH CARE CE NTER\nClin ic: FAMILY PRACTICE CLINIC\nPr ovider: BH IEONE\nPat ient Statu s: Outpati ent\n\n\n \nAutoCite s Refreshe d by BHIE, USERONE @ 09 Jan 201 4 1503 EST \t\nProble ms \nChron ic: \n-Pre vious hist ory of lim b pain \n- Limb swell ing \n-Foo t pain \n- Neck pain \n-Neck pa in radiati ng up the back of th e head \n- Headache \ n-Previous history o f sinus pr essure \n- Previous h istory of pain over the nose \ n-Ankle jo int pain \ n-History of gastrod uodenal ar tery aneur ysm \n-His tory of ma lignant ne oplasm of the gastro intestinal tract \n- Previous h istory of gastrointe stinal sym ptoms \n-P revious hi story of v isit for: preoperati ve gastroi ntestinal exam \n-Co ugh varian t asthma \ n \n Famil y History \n-Intermi ttent gene ralized pa in (Genera l FHx)\n \ n\n Allerg ies \n-Tet racyclines : Rash\n-I odine Cont aining Age nts: Nause a (test)\n \nActive Medication s\nNo Acti ve Medicat ions Found .\nExpired Medicatio ns\nNo Exp ired Medic ations Fou nd.\n \nAp pointment Comments: Written by BHIE,USER ONE @ 09 J an 2014 15 00 EST\nte st \n\nVit als\nVital s Written by BHIE,US ERONE @ 09 Jan 2014 1503 EST\n BP: 110/4 0, HR: 36, R R: 40, T: 98 ?F, HT: 5 ' 7'', WT: 135 l bs, BM I: 21.14, BSA: 1 .711 squar e meters, Tobacc o Use: No\ nComments: test \n \nQuestion naire Auto Cites Refr eshed by B HIE,USERON E @ 09 Jan 2014 1503 EST\t\nQu estionnair es\n\n \nA /P Written by BHIE,U SERONE @ 0 9 Jan 2014 1520 EST\ t\n1. join t pain fin gers\n \nD isposition Written b y BHIE,USE RONE @ 09 Jan 2014 1 522 EST\t\ nReleased w/ Work/Du ty Limitat ions \nDis cussed: Di agnosis, M edication( s)/Treatme nt(s), Alt ernatives, Potential Side Effe cts with P atient who indicated understan ding. \n \ nNote Writ ten by BHI E,USERONE @ 09 Jan 2 014 1507 E ST\nTest C linical No te \nClini cal \n\n\n \nSigned By BHIE, USERONE (P hysician/W orkstation ) @ 09 Jan 2014 1523 \n_______ __________ __________ __________ __________ __________ __________ __________ __________ __________ ________ \ nCHANGE HI STORY\nThe following Allergy w as Added: <CHCS IEN\| DESC>:1000 \|Penicilli ns by BHI E,USERONE @ 09 Jan 2 014 1518 E ST:\n \n",
	4416	"dateT ime": "201 4011317553 5",
	4417	"statu s": "compl eted",
	4418	"uid": "urn:va:d ocument:DO D:00000000 03:1000010 662",
	4419	"summa ry": "Docu mentText{u id='urn:va :document: DOD:000000 0003:10000 10662'}"
	4420	}
	4421	],
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	4424	"code" : "34109-9 ",
	4425	"syste m": "DOD_N OTES"
	4426	}
	4427	],
	4428	"sta tus": "com pleted",
	4429	"sta tusDisplay Name": "Co mpleted",
	4430	"cli nicians": [],
	4431	"sta tusName": "completed "
	4432	},
	4433	{
	4434	"aut horDisplay Name": "BH IE, USERON E",
	4435	"kin d": "Progr ess Note",
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	4438	"fac ilityCode" : "DOD",
	4439	"fac ilityName" : "DOD",
	4440	"ref erenceDate Time": "20 1401131755 42",
	4441	"doc umentTypeN ame": "Pro gress Note ",
	4442	"loc alTitle": "Progress Note",
	4443	"uid ": "urn:va :document: DOD:000000 0003:10000 10663",
	4444	"sum mary": "Pr ogress Not e",
	4445	"pid ": "DOD;00 00000003",
	4446	"aut hor": "BHI E, USERONE ",
	4447	"tex t": [
	4448	{
	4449	"conte nt": "Pati ent: VICKE RS, CURTIS \nDate: 10 Jan 2014 1208 EST\n Appt Type: ACUT\nTre atment Fac ility: JAM ES A LOVEL L FED HEAL TH CARE CE NTER\nClin ic: FAMILY PRACTICE CLINIC\nPr ovider: BH IEONE\nPat ient Statu s: Outpati ent\n\n\n \nAutoCite s Refreshe d by BHIE, USERONE @ 10 Jan 201 4 1209 EST \t\nProble ms \nChron ic: \n-A s hocklike s ensation f rom the le ft elbow t o the hand \n-Previo us history of bone p ain, left fingers \n -Previous history of limb pain \n-Limb s welling \n -Foot pain \n-Neck p ain \n-Nec k pain rad iating up the back o f the head \n-Headac he \n-Prev ious histo ry of sinu s pressure \n-Previo us history of pain o ver the no se \n-Ankl e joint pa in \n-Hist ory of gas troduodena l artery a neurysm \n -History o f malignan t neoplasm of the ga strointest inal tract \n-Previo us history of gastro intestinal symptoms \n-Previou s history of visit f or: preope rative gas trointesti nal exam \ n-Cough va riant asth ma \n \n F amily Hist ory \n-Pal mar pain ( General FH x)\n-Inter mittent ge neralized pain (Gene ral FHx)\n \n\n Alle rgies \n-P enicillins : Vomiting (This Pat ient is al lergic to Pencillin) \n-Tetracy clines: Ra sh\n-Iodin e Containi ng Agents: Nausea (t est)\n \nA ctive Medi cations\nN o Active M edications Found.\nE xpired Med ications\n No Expired Medicatio ns Found.\ n \nAppoin tment Comm ents: Writ ten by BHI E,USERONE @ 10 Jan 2 014 1208 E ST\nthis i s a new te st \n\nVit als\nVital s Written by BHIE,US ERONE @ 10 Jan 2014 1210 EST\n BP: 110/4 0, HR: 40, R R: 40, T: 98 ?F, HT: 5 ' 3'', WT: 135 l bs, BM I: 23.91, BSA: 1 .636 squar e meters, Tobacc o Use: No\ nComments: test \n \nQuestion naire Auto Cites Refr eshed by B HIE,USERON E @ 10 Jan 2014 1209 EST\t\nQu estionnair es\n\n \nA /P Last Up dated by B HIE,USERON E @ 10 Jan 2014 1216 EST\t\n1. headache\ n \nDispos ition Writ ten by BHI E,USERONE @ 13 Jan 2 014 1011 E ST\t\nRele ased w/o L imitations \nDiscuss ed: Diagno sis, Medic ation(s)/T reatment(s ), Alterna tives, Pot ential Sid e Effects with Patie nt who ind icated und erstanding . \n \nNot e Written by BHIE,US ERONE @ 10 Jan 2014 1211 EST\n Test note \nNote \nw e are test ing notes from add n otes\n\n \ nSigned By BHIE, US ERONE (Phy sician/Wor kstation) @ 13 Jan 2 014 1012 \ n",
	4450	"dateT ime": "201 4011317554 2",
	4451	"statu s": "compl eted",
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	4454	}
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	4458	"code" : "34109-9 ",
	4459	"syste m": "DOD_N OTES"
	4460	}
	4461	],
	4462	"sta tus": "com pleted",
	4463	"sta tusDisplay Name": "Co mpleted",
	4464	"cli nicians": [],
	4465	"sta tusName": "completed "
	4466	},
	4467	{
	4468	"aut horDisplay Name": "DE MO USER,",
	4469	"kin d": "Initi al Evaluat ion Note",
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	4471	"isI nterdiscip linary": " false",
	4472	"fac ilityCode" : "DOD",
	4473	"fac ilityName" : "DOD",
	4474	"ref erenceDate Time": "20 1105021141 50",
	4475	"doc umentTypeN ame": "Ini tial Evalu ation Note ",
	4476	"loc alTitle": "Pulmonary Nursing F ollow-Up",
	4477	"uid ": "urn:va :document: DOD:000000 0003:3cc44 5968192d50 0d5a2ddbf2 3ab4952605 f0b0c_2011 0502114150 ",
	4478	"sum mary": "Pu lmonary Nu rsing Foll ow-Up",
	4479	"pid ": "DOD;00 00000003",
	4480	"aut hor": "DEM O USER,",
	4481	"tex t": [
	4482	{
	4483	"conte nt": "Pers onal Data Privacy Ac t of 1974 (PL 93 579 )\nPatient : \nBOB BT EST \nSSN: \n000-00- 1102\n\n12 34 Cherry Blossom La ne\n, \nHP : \nBirthd ate: \nJan uary 1, 19 45\nSex: \ nFemale\nC onsultant: \n\nCreat ed On: \nM ay 2, 2011 \n\nPulmon ary Nursin g Follow-U p\nPULMONA RY NURSING FOLLOW-UP NOTE\n- P OST OPERAT IVE FOLLOW UP PHONE CALL -\nPh one number \n800-555- 4444\n\nDa te\nTime\n Results\nI nitials\n0 2May\n0600 \nLeft mes sage\nDEMO \n- ATTEMP TS TO CONT ACT PATIEN T -\n\nDat e\nTime\nR esults\nIn itials\n\n #1\n02May\ n0900\nRea ched patie nt and dis cussed.\nD EMO\n\nPAT IENT RESPO NSE\n* Add itional Co mments Req uired For All Yes Re sponses *\ n\nNO\n[X] \nYES\n[ ] \nColor an d amount?? of sputum produced w ith cough\ n\nNO\n[X] \nYES\n[ ] \nUnusual Pain\n\nNO \n[X]\nYES \n[ ]\nFev er\n\nNO\n [ ]\nYES\n [X]\nOther Problems: \nA little tired tod ay.\nPatie nt / Signi ficant Oth er communi cates know ledge of a nd underst ands follo w-up instr uctions.\n Patient's condition: \nGood\nAd ditional i nformation \n\nSignat ure of Nur se/Physici an: See ab ove electr onic signa ture.\n\nS F 509 - E - Progress Notes\n\n Authored b y: \nDEMO USER on Ma y 2, 2011\ n\n9040 Fi tzsimmons Ave\nTacom a, WA 9843 1\nWP: (25 3) 968-111 0\n\nHealt hcare Prov iders\n\nS upport Pro viders\n\n Insurance Informatio n\nFor Off icial Use Only (FOUO )\n",
	4484	"dateT ime": "201 1050211415 0",
	4485	"statu s": "compl eted",
	4486	"uid": "urn:va:d ocument:DO D:00000000 03:3cc4459 68192d500d 5a2ddbf23a b4952605f0 b0c_201105 02114150",
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	4488	}
	4489	],
	4490	"cod es": [
	4491	{
	4492	"code" : "28636-9 ",
	4493	"syste m": "DOD_N CID"
	4494	},
	4495	{
	4496	"code" : "28563-5 ",
	4497	"syste m": "DOD_N OTES"
	4498	}
	4499	],
	4500	"sta tus": "com pleted",
	4501	"sta tusDisplay Name": "Co mpleted",
	4502	"cli nicians": [],
	4503	"sta tusName": "completed "
	4504	}
	4505	]
	4506	}
	4507	}