SOAP Guidelines allow you to insert pre-typed words and phrases into your SOAP Notes for faster and more consistent documentation. Follow the steps below to set up and use these guidelines for your patient documentation.
Setting Up SOAP Guidelines
SOAP Guidelines can be created and managed under List Maintenance in the Manage Office tab.
- Navigate to SOAP Guidelines
- Go to Manage Office > List Maintenance, then click on SOAP Guidelines.
- Add a New Guideline
- Click the Add New button at the top of the page.
- Enter Guideline Information
- Add a Guideline Name in the space provided.
- Add Text to SOAP Sections
- Each text field corresponds to a section of the SOAP layout (e.g., Chief Complaint, History Of Present Illness, Medical History, etc.).
- Type the phrases you want to reuse into the appropriate text field. Whatever you enter will appear exactly as written in the guideline.
- Create Clickable Guidelines
- Highlight the specific text you want to make into a clickable guideline.
- Click the Insert Link button (found at the top right of the text field).
- This will insert the necessary HTML formatting to make that text a reusable guideline. Please note: If text is not surrounded by the necessary HTML tags, it will still appear in the guidelines for this section, but it will be plain text. This can sometimes be useful to communicate instructions to yourself or your team on how to utilize the section.
- Repeat as Needed
- Repeat steps 4–5 for each SOAP section you'd like to customize.
- Optional: Enable Populate Guideline
- Check the Populate Guideline box above any text field to include that section when using the Populate Guideline function (explained below).
- Save Your Guideline
- Once all desired sections are complete, click Update to save.
- You may create multiple guideline sets based on different needs or specialties.
Using SOAP Guidelines
SOAP Guidelines are applied while editing a SOAP Note.
- Select a Guideline
- In the SOAP Note Settings at the top of the note, choose a Guideline Name from the drop-down.
- Insert Guideline Text
- Clickable phrases will appear above each applicable section in blue.
- Click on a word or phrase to automatically insert it into the corresponding text box.
- Text can be edited manually after insertion if needed.
Using Populate Guidelines (Optional)
The Populate Guidelines feature allows you to insert all guideline text for selected sections in one step.
- Click Populate Guidelines
- Located to the right of the Guideline Name drop-down in the SOAP Note Settings.
- Insert Full Text Automatically
- Any section with the Populate Guideline box checked will automatically fill in with the guideline text, in the order it was entered.
- All populated text can still be edited manually if needed.
Use these tools to speed up your documentation process and ensure consistency across SOAP Notes.