Academic Medicine wiki-based narrative

The purpose of this page is to illustrate how a wiki-based clinical document might appear; the content is based on a series of notes that can found here. These details are derived from the de-identified EHR of a real patient but details have been changed such that any resemblance to a real patient is entirely coincidental.

Note: some of the links below are to external websites such as Wikipedia and the NCI Thesaurus. In a true medical wiki, these external links would likely be replaced with application programming interfaces (APIs), which would enforce HIPAA-compliant authentication and authorization.

Demographics

Note: the linked "female" is to a value set that specifies a set of structured choices for gender, as an example of how wiki-based formatting can be linked to structured concepts. Likewise, the "Race" and "Ethnicity" concepts can be linked directly to the CDC Race and Ethnicity Code Set Version 1.0, which is required for certified EHRs. Note also that some versions of wiki software can calculate dates, such as the current age based on DOB (not currently enabled here).

• Patient Name: PatientX
• Gender: Female
• DOB: January 1, 1960
• Race: White (2106-3)
• Ethnicity: Not Hispanic or Latino (2186-5)
  • Note that "concept codes" such as 2106-3 do not have to be shown, and can be toggled/hidden.

Allergies

• Penicillin
  • Category: Medication
  • Reaction: Maculopapular rash
  • Level of certainty: Confirmed

Medications

• Gabapentin 600 mg PO TID