If you have an electronic health record (EHR), you are familiar with the problem list — the list of conditions that have been associated with each patient at some point in time. At its best, the problem list gives a quick and easy-to-understand summary of the patient. If it's not up to date, however, the problem list can become so unwieldy it's not useful or, worse, it's deceptive.

Keeping problem lists orderly is more complicated if you work for a large organization with multiple specialties that share the lists. It requires the entire team; but as primary care physicians (PCPs) and “captains of the ship,” we often have ultimate control over — and therefore responsibility for — the list.

There is no single way to organize a problem list, and no national consensus about it in the U.S., although there is in some other countries.¹ Therefore, in many organizations, the problem list is a catch-all for capturing visit problems, symptoms, past medical history, family history, allergies, etc. In this article, we focus on using the problem list for only chronic conditions and recurrent acute problems considered important for patient care, and we present some principles to help you organize your lists.