Some screen shots are shown below.

Creating, saving and playing with a patient record

Hello essor medicine user, this is a quick tutorial on how to use the essor medicine application. This is an application that promises to make medical diagnosis so easy by putting the thousands of years of medical knowledge and practice into the hands of whoever chooses to use it. As it is commonly said, 'Power is given to those that are willing to beg for it. Anyways lets get started, We really hope that by the end of this tutorial you will be comfortable with navigating your way through the application and getting the best out of it.

In this section we will show you how to create, save and play with a patient record. Now, after creating your profile, the screen will appear as shown here. There are various widgets that appear here, but we are interested in the first three for this part of the tutorial. That is the text input, the submit button and the Reports button.

When you want to create a new record, the first thing you do is to enter the name of the paient. In our case, let us say we have a patient called Mr. Plasmodium F.

We type in Mr. Plasmodium F in the text area and once that is done, we can click on the submit button. Now, this button creates a temporary record for that patient and then takes you to the main navigation screen. Now that we have a temporary record, it is essential to save it or else if the application crashes or maybe your phone blacks out for whatever reason, this record will be lost.

With that said, on this screen, in the left bottom corner, there is a 'Save' button. Click that button and you will go to the saving screen. In here, you can search for the diagnosis you think your patient has and also add the pressenting complaint of the patient.

For example, let us say, Mr. Plasmodium F came in with fever and night sweats for about 3 days. In this case, we click the 'Chief complaint button' and this will give us a text input option. Here we shall write. Fever for 3 days and Night sweats for 3 days

Then click on save to save the information or click on Ignore to leave the text area as it is. In our case let us save the chief complaints of Mr. Plasmodium F.

Now in case we have a diagnosis in mind, we can search search for it.

Let us say, we think Mr. Plasmodium has Malaria. We type in malaria and once we click on malaria, we shall have made malaria as our current diagnosis.

Important information such as age, where the paients age can be entered, gender, where the patients gender is selected and the vitals, where the patients vitals such as blood pressure, temperature, respiratory rate, pulse rate and oxygen saturation are entered, can also all be recorded as well.

Once that is done, we can then save the data and shall be taken back to the Welcoming screen. Now if the phone blackouts for any reason, or the application crashes for any reason, we can be sure that the information is kept safe.

In order to confirm the presence of a record, click on the 'Reports' button to see the available records. Click on Mr. Plasmodium and you will be provided with his basic information. This will include, the date which is automatically generated. The patient Name, Age, Gender and Provisional diagnosis.

Other options include, changing the profile picture, reviewing a patient report, continuing to clerk from where you left off and finally deleting the record.

If we are interested in seeing the patient report, we click "See report" and then are taken to an automitaclly generated report. Here we can see Mr. Plasmodium's bio data, his chief complaint, and other basic information.

The advantage of using this application, is the ability to own and manipulate your patient reports to your own style. In case you wanted to do that, check in the right bottom corner. There you will find the "Edit Report" button.

Click that button and now you can edit the report. After editing, you can click save and a copy will be saved on your local storage or you can choose to ignore.

That is basically it for creating, saving and playing with a patient record. This marks the end of this part of the tutorial

Now that we know how to create a record, let us see how to navigate through the application. We already have a record of Mr. Plasmodium. F that we are going to use throughout this section of the tutorial.

To access the records or patients saved, we click on Reports and then choose the record you want. In our case it is Mr. Plasmodium F. Choose the record and then click on continue clerking.

This takes you to the main navigation screen.

On this screen, you have a search option at the top. This helps you with quick access to various clinical features, diseases, Notes, scales, scores amongst others. The default is set to clinical features. It should be noted that results are based on a filter option given. That is to say, if i am to search for glasgow coma scale while the filter is set to clinical features instead of scales or scores, i will most likely not get anything related to glasow coma scale. But when I set the filters to scales or scores and then click on search again, there comes the scale. I can click it and then score my patient accordingly. Save the information and then go back.

This is the same protocol for any search, click the search result and you will be taken to the appropriate screen depending on the filters. For example under clinical features you can search for clonus, click onto the most appropriate result, and you will be redirected to all conditions in which clonus is a possible finding.

If we go back, and set our filter to diseases, then a search for a condition such as appendicitis. Click on the result and you will be redirected to the clerking page for that chosen disease. In our case, Appendicitis. The same principle applies to the Notes filter(However it should be noted that the Notes filter is not yet ready as per this tutorial).

That basically winds up the purpose of the search component. The important points to remember are that the search results will always depend on the search filter and that the default search filter is set to clinical features.

Now let us set our filter back to clinical features and try out a case scenario. If you have been following from the start, you might remember that Mr.Plasmodium F, came in with complaints of fever and night sweats. As you continue to talk to him, he informs you that he has pain in the joints but he has not vomited and does not feel any pain in the stomach. The search option then comes in handy when trying to assess these clinical features.

But before we get started, it is important to note that, when searching for a clinical feature, the user should be aware of the standardised terms used to describe certain clinical features. For example searching for pain in the stomach may not yield any useful search results, but if the user knows that this is the description for abdominal pain, then a search for abdominal pain will definately produce reasonable search results. The same applies to pain in the joints, one should be aware that there is a standardised term for that, which is arthralgia. Otherwise even joint pain may give you a had time but in some cases if you are lucky, you might get what you are looking for after scrolling down the results. With that said, let us clerk Mr. Plasmodium F.

Let us start with fever, type in fevr in the search bar. Sometimes even with the wrong spelling, you might be able to get the result that you are looking for. Tap on fever and you will be redirected to a screen with all possible conditions that may cause fever. At the top of our list we have 337 direct causes of fever and 50 indirect causes of fever. The number in the brackects represents the indirect cause, for example if we randomly scroll down, we can see that someone with an Ovarian abscess, could actually present with peritonitis, and this peritonitis, would manifest as fever, hence Ovarian abscess should also be included amongst the indirect causes of fever. The same applies to conditions that could have complicated into another condition. For example, "Erythema gangrenosum", may progress to Sepsis, this sepsis can present with fever, and therefore Erythema gangrenosum should be listed amongst the possible other causes of fever. That is basically all about what the numbers in the brackets mean. They are the indirect causes of the clinical feature in question.

Now, when you look at the bottom of this screen, there are various buttons such as Rule in ALL and Rule Out All. These will be expounded upon later in the video. But Rule In All essentially saves all the current conditions on the screen to a special database, so that when you want to clerk only the ruled in conditions, only those conditions will appear. The Rule Out All does the opposite.

In between these Buttons, that is the Rule In All and the Rule Out All, there is another filter button. This button essentially filters out the current conditions by system.

If we click by System, the same conditions causing fever are now reclassified by their system or tags, and pressing the same button now relabeled as See All, takes you back to the general list.

When we go back to classifying the current conditions, by system, and let us assume that, we are interested in the conditions under Emergencies. When we click Emergencies, only those that come with fever and have been tagged as emergencies will be filtered and displayed. As you can see, indeed, these are conditions, that would require immediate attention and intervention. The same principle applies to other systems and available tags

Now below, Rule In All and Rule Out All, there is another line of buttons that consists of Add Present, Notes, and Add Absent

The Add Present, makes the clinical feature in question into a positive finding(in our case that would be fever), and the 'Add Absent' makes the clinical feature in question into a negative finding. In case you wanted to see some information on the clinical feature in question, you would have to click on the Notes button. If there is something about the clinical feature in the databse, then it will appear here, if there is nothing, dont worry, you still have the option to search the Web

Let us go back, and add fever as a positive finding. Click on add Present, and just like that, fever has become a positve fing.

Finally in the right bottom conner, there is another button labeled 'Assessment'. This button right here is the entire reason for the existence of the application. Let me explain. We have made fever a positive finding, now how do we know that fever is now a positive finding. That is where the Assessment button comes in handy. And because of its significance, you will find it on a lot of screens.

But let us add night sweats and arthralgia as positive findings, and then since Mr. Plasmodium F no history of vomiting or abdominal pain, let us make vomiting and abdominal pain negative findings

Now, When you click on Assessment, you will be redirected to the Assessment screen. It is divided into three tabs,

1. Diseases with all positive features. That is all possible conditions that may appear with all the current positive findings. In our case, all conditions that come with fever, night sweats and arthralgia. It will be quite a long list, since it includes all the direct and indirect causes of fever, night sweats and arthralgia. The next tab is the;

2. Present Features tab. This will show you all the clerked clinical features. That is the positive findings, under Present, the negative findings under Absent, and others such as features awaiting review under Review and finally those with no available information under No Data. If you notice a mistake, for example, we might have mistakenly added vomiting as a positive finding, yet Mr. Plasmodium F exclusively said he is not vomiting. While you are still in this very tab you can rearrange by clicking on the group you want to rearrange. Since we want to turn vomiting into a negative finding yet it is located under Present features, we click on the Present features group. Once in the rearranging screen we can then drag the clinical feature into the required cell. There are usually four cells which include the Present cell(Always on the left although it is not shown here, since these features are already present), the Absent cell(Always on the right), the Review cell(Alway at the top) and the No Data cell(Always at the bottom). Remember, there are always four cells unless in special screens like this one. Vomiting was a negative finding, so we drag the clinical feature into the Absent cell, go back, wait a little as the data is being reanalyzed and as expected, vomiting is now a negative finding. Even the differential list will adapt to the changes. The third tab, is the

3. Diseases with some feature, that is to say, the differentials are missing some of the positive findings, but may be worth checking out. The margin for error is as high as 3 missing features.

Above the Diseases with some features tab, is a Filter Diseases button. This gives you access to all the ruled in conditions, and ruled out conditions. There is another button 'Clerk Ruled IN Conditions' . This allows you to clerk only the Ruled in conditions. While clerking only the ruled in conditions, the theme colors will also change. This is to give you a visual clue that you are dealing with only the ruled in conditions. The workings of this screen mirror that of main navigation screen. Therefore, we shall navigate back to the main navigation screen, and explain all of it at once.

Once back on the main navigation screen, just below the Save and Assessment buttons. There are the Subjective and Objective data buttons. Let me explain. The subjective data includes all the clinical features, that a patient is most likely to tell you that they have, such as headache, nausea, pruritus, such you cant see, and are hence classified as subjective even the ones that patients can easily describe like rashes, fever, dyspnea will also be found here.

The objective data, includes that data that you through experience can observe. These are divided into different sections, like inspection,palpation, percussion amongst others. Below are a few filters with which you can classify the features you want to see. More on this latter on.

Now, let us focus on the subjective Data for now. It has four tabs, the symptoms tab, the risks tab, the systems tab, and the Socrates tab. On the symptoms tab, you will find various common symptoms that patients usually present with. These symptoms have a button like behaviour that is to say that they can be clicked, to take you to the screen in which all possible conditions causing the symptom will appear as seen before or these can be clerked by dragging the symptom into any of the four cells as needed.

Draging a feature into the cell on the left indicates that the feature is a present hence it is added to the positive findings list.

Draging a feature into the cell on the right indicates that the feature is a absent hence it is added to the negative findings list.

Draging a feature into the cell at the top indicates that the feature is awaiting review, this comes in handy when you are not sure of what you are looking at. For example, in case the health provider, is not sure if they are listening to a wheeze or stridor, they can save the data in this cell so that another colleague can also auscultate and confirm the presence of the a wheeze or stridor.

Draging a feature into the cell at the botton indicates that there isnt enough information about the feature in question. This becomes helpful when documentation is needed but there is simply no information about the feature in question. For example when assessing family history in a suspected diabetic patient, the patient may not know if their parents had Diabetes mellitus but documentation will be neccessary. In such situations, the assessd feature is added to the No Data cell.

This can be done for all symptoms in the list as you scroll down, or you can alternatively search for a symptom in the search button. For example we can search for diplopia and then also clerk respectively. Let us say there is diplopia for the purpose of learning how the application works.

We can also undo the clerked features. Simply click the undo button and then search for the clinical feature you want to undo. In this case, Mr. Plasmodium did not have diplopia, hence we have search for diplopia. To undo you simply click on the symptom and it is un done.

The next tab is the Risks tab. It includes the common risks factors of any group history chosen. For example if we choose substance history, we get a list of commonly abused substances. and these can be clerked accordingly.

The next tab represents the Systems tab. It rearranges the common symptoms by system. For example if we choose Respiratory system, we get the common symptoms in the respiratory system. These can also be clerked accordingly. If we choose the Gastrointestinal system, the common gastrointestinal symptoms would appear. Those can also be clerked accordingly

The final tab is the Socrates tab. It includes only the positve findings that may have various defining descriptive features such as characterisitcs, onset, associations amongst others. for example if we choose night sweats, we find characteristics, and this can furthur be clicked to see more options. Under characteristics of night sweats, there is drecnching night sweats, and this can be clerked as present or absent or also you can click to see the specific conditions that come with drenching night sweats. In this case, we have hodgkin lymphoma. The same can also be done for the various present features like arthralgia and fever.

That was a basic introduction to the Subjective data. Next up is the Objective data

On the signs tab are different sections, like inspection,palpation, percussion amongst others. Let us say, you wanted to find the common things you would observe on general inspection. Click on inspection and then click on general. There you will find common observations in general. The principle of dragging remains the same. The same goes for palpation, and others.

We have already seen how the Socrates tab works. Only that this time it will display the signs.

Next up is the Investigations tab. This tab contains the important investigations that can be done. from vitals recording to genetic studies. The concept is always the same. click where necesary, enter information where needed and drag to clerk accordingly. The same applies to the miscellaneos tab. With that said, i can officially say that you are ready to use the Essor medicine application. Thank you for watching.