Key Tips to Document Operative Notes in a Practice [INFOGRAPHIC]

Operative note is an important part of the medical chart that refers to a surgeon’s report and includes all necessary documentation regarding all the procedures ranging from what operation a patient had, what was found during surgery, and the post-operative instructions from the surgeon. Operative note includes the patient’s name, date of the operation, pre- and post-operative diagnosis, surgeon’s name along with other co-surgeon’s name, procedure, indication for surgery, findings of surgery and other details. These reports are increasingly accessible in electronic format with widespread electronic health record (EHR) system adoption. Physicians can ensure accurate EHR documentation and management with reliable medical transcription services.

Check out the infographic below