I work in an ICU where we rely heavily on problem lists. Heidi does a great job of identifying problems in the transcript and in the context, but it is difficult to have a definitive problem list for the patient. While I understand that I can put a problem list into the patient context, Heidi cannot update this with new problems. Thus there is a risk that a problem is identified on a specific note and then eventually "falls off" the problem list. On the other hand, there could be a problem that Heidi identifies in the context, that I no longer want in my active (or even resolved) problem list. Also, the 500 character limit in the patient context is a bit limiting.

What I would like to see is a clear problem list attached to the patient. This would include items that the user has put in there, but also items that Heidi has added. The user can review these, edit the names, edit the order, remove things that aren't relevant, mark items as resolved, etc. So, for example, if the TSH is elevated, Heidi could add "Hyopthyroidism" to the problem list. We may not actively address that problem for some time, because it is a low priority issue and because we probably want to allow some time to go by before repeating this, but the item remaining in the problem list reminds people that it is still an item that needs to be addressed. When, a week later, we repeat the test and realize that the TSH is now normal, we may want to change the problem from "hypothyroidism" to "euthyroid-sick syndrome". Or we may just want to delete it.

It is important to have low priority problems remain in a list (and possibly in our daily notes) to remind us that this issue needs to be addressed when appropriate.