I have to apologize to both Steven and Peggy before I write this in case I offend them. Steven, everything you wrote is true and is a good refresher, but I don't think it is the question. On the other hand, I have read the question now ten to fifteen times, and I still don't know if I understand it.
Reason being the only reason to edit the Current Meds on a visit is to obviously delete a medication they are no longer taking or add a medication that they started since the last visit.
NO MATTER WHAT YOU DO ON THE CURRENT MED LIST OF A VISIT BEFORE OR AFTER A VISIT, any prescription written by the script writer on the Assessment and Plan side of the note will NOT populate the current med section for that visit.
YES, if you save the note and open it again, you will see everything you did for that visit, AND you will see your new medications in the current med list as the patient has left and is now on those medications. This is even true if you delete a medication as PART of the plan, e.g. D/C Abilify, Start Seroquel.
Where the confusion may be coming in (if I am understanding the question or confusion) is when you open the progress note again from the Patient List after it is saved, you will see the current medication, and it may appear as though your note shows that they came to the visit on the medication that was actually started at that visit. And, while there is some value to opening that progress note after it is saved as you can get the gist of what you did, it is indeed after the fact and, therefore can not be looked at as the actual visit. It does not become accurate until the next visit after you open it and use CTRL - N and start a new note.
To be clear, again, if you want a true representation of the progress note of that day, then you have to go to the actual saved note in visit history. That note will reflect the correct medication list (if you edited it during the visit) and the correct medications that you prescribed in the plan.
Not to be too confusing with all of the details, but the note in the visit history will show in the medication history of the note what the patient came in on if you edit it. The same medication history will now show what the patient when home on if you order it in the plan, including any medication that you DELETE during that visit. After all, you show in the plan that you decided to take the patient off Atenolol, but he/she still came in on it so it should be in the current med history -- which it will be in the visit history but it will NOT be there if you simply open the note from the Patient List or open the script writer from the patient list.
I know this may sound jumbled and long, but it is accurate and makes complete sense to me.
Think about it this way, and it is easy:
1. Edit the current medication list when you see the patient.
2. Write for new scripts and delete any medications at THAT visit they had been on from the script writer.
If you do these two things, then your note and your records will be accurate and recorded properly.
