Flagging a diagnosis as a repeat visit

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Andrew Kanter Andrew Kanter
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Flagging a diagnosis as a repeat visit

Has anyone properly tagged their diagnoses on the form as being a new visit/returned visit? We have been struggling over this for awhile and I don't think it is properly recorded on the MOH forms either. However, if we add a data element to the problem_added array for repeat visit (reattendance) then the javascript function which calls the task pane has to be redone. If we add a new array to keep track of those diagnoses which are repeats, then we have to subtract them each time. Any other ideas here?

It seems that best way to have done this would be to dynamically generate the form so that it already included prior diagnoses on a list. Then they could be checked as a reattendance, or even checked if they became resolved (rather than clicking the remove problem button).

Thanks!
Andy
 
--------------------
Andrew S. Kanter, MD MPH

- Director of Health Information Systems/Medical Informatics
Millennium Villages Project Earth Institute, Columbia University
- Asst. Prof. of Clinical Biomedical Informatics and Clinical Epidemiology
Columbia University


Email: [hidden email]
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Office: +1 (212) 305-4842
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Burke Mamlin Burke Mamlin
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Re: Flagging a diagnosis as a repeat visit

Andy,

We record PROBLEM ADDED and PROBLEM RESOLVED observations for diagnoses.  When we need the list of active problems (in the clinical summary module, for example), we create a list of all PROBLEM ADDED without a later PROBLEM RESOLVED.  So, duplicates of either (added or resolved) have no effect on the final list.

Eventually, we hope to have active lists within OpenMRS, so these problem added/resolved observations can be supplemented with a trigger to add or remove items from an active list of diagnoses.  In essence, this is just doing the work at the time data are received instead of deferring it to the time of retrieval... but it would undoubtedly be more efficient/easier in the long run.

-Burke

On Nov 24, 2008, at 11:43 AM, Andrew Kanter wrote:

Has anyone properly tagged their diagnoses on the form as being a new visit/returned visit? We have been struggling over this for awhile and I don't think it is properly recorded on the MOH forms either. However, if we add a data element to the problem_added array for repeat visit (reattendance) then the javascript function which calls the task pane has to be redone. If we add a new array to keep track of those diagnoses which are repeats, then we have to subtract them each time. Any other ideas here?

It seems that best way to have done this would be to dynamically generate the form so that it already included prior diagnoses on a list. Then they could be checked as a reattendance, or even checked if they became resolved (rather than clicking the remove problem button). 

Thanks!
Andy
 
-------------------- 
Andrew S. Kanter, MD MPH 

- Director of Health Information Systems/Medical Informatics
Millennium Villages Project Earth Institute, Columbia University
- Asst. Prof. of Clinical Biomedical Informatics and Clinical Epidemiology
Columbia University


Email: [hidden email] 
Mobile: +1 (646) 469-2421
Office: +1 (212) 305-4842
Skype: akanter-ippnw
Yahoo: andy_kanter


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Andrew Kanter Andrew Kanter
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Re: Flagging a diagnosis as a repeat visit

This is the same way we are using it. However, it is a bit confusing for actually documenting the reason for the current visit and it does not capture whether it is truly a new problem added or just added for today (and the patient has had this problem before... as in chronic).  I think primary care might have a different requirement than AMPATH in this case....

-Andy
 
--------------------
Andrew S. Kanter, MD MPH

- Director of Health Information Systems/Medical Informatics
Millennium Villages Project Earth Institute, Columbia University
- Asst. Prof. of Clinical Biomedical Informatics and Clinical Epidemiology
Columbia University


Email: [hidden email]
Mobile: +1 (646) 469-2421
Office: +1 (212) 305-4842
Skype: akanter-ippnw
Yahoo: andy_kanter



From: Burke Mamlin <[hidden email]>
To: [hidden email]
Sent: Monday, November 24, 2008 1:09:23 PM
Subject: Re: [OPENMRS-IMPLEMENTERS] Flagging a diagnosis as a repeat visit

Andy,

We record PROBLEM ADDED and PROBLEM RESOLVED observations for diagnoses.  When we need the list of active problems (in the clinical summary module, for example), we create a list of all PROBLEM ADDED without a later PROBLEM RESOLVED.  So, duplicates of either (added or resolved) have no effect on the final list.

Eventually, we hope to have active lists within OpenMRS, so these problem added/resolved observations can be supplemented with a trigger to add or remove items from an active list of diagnoses.  In essence, this is just doing the work at the time data are received instead of deferring it to the time of retrieval... but it would undoubtedly be more efficient/easier in the long run.

-Burke

On Nov 24, 2008, at 11:43 AM, Andrew Kanter wrote:

Has anyone properly tagged their diagnoses on the form as being a new visit/returned visit? We have been struggling over this for awhile and I don't think it is properly recorded on the MOH forms either. However, if we add a data element to the problem_added array for repeat visit (reattendance) then the javascript function which calls the task pane has to be redone. If we add a new array to keep track of those diagnoses which are repeats, then we have to subtract them each time. Any other ideas here?

It seems that best way to have done this would be to dynamically generate the form so that it already included prior diagnoses on a list. Then they could be checked as a reattendance, or even checked if they became resolved (rather than clicking the remove problem button). 

Thanks!
Andy
 
-------------------- 
Andrew S. Kanter, MD MPH 

- Director of Health Information Systems/Medical Informatics
Millennium Villages Project Earth Institute, Columbia University
- Asst. Prof. of Clinical Biomedical Informatics and Clinical Epidemiology
Columbia University


Email: [hidden email] 
Mobile: +1 (646) 469-2421
Office: +1 (212) 305-4842
Skype: akanter-ippnw
Yahoo: andy_kanter


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Darius Jazayeri Darius Jazayeri
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Re: Flagging a diagnosis as a repeat visit

Hi Andy,

Would it solve your problem if there were a portlet on the patient dashboard that showed active problems? Or do you need this to show in the infopath forms?

In the old user-configurable patient summary I wrote an <openmrs:activeList/> tag, and that's still in the codebase. It would take 10 minutes to wrap it in a portlet and add it to the dashboard.

You would basically specify which concept means problem added, which means concept removed, and a few other optional settings, and you get a table like:

Active Problem

Date added

Recurring?

Diabetes

08/02/2008


Malaria

25/11/2008

Yes


It would probably be trivial to add the optional "recurring" column, which would be checked if the problem has been "added" more than once.

You wouldn't be able to add problems from this interface. Or that would take >10 minutes of work.

-Darius

Andrew Kanter wrote:
This is the same way we are using it. However, it is a bit confusing for actually documenting the reason for the current visit and it does not capture whether it is truly a new problem added or just added for today (and the patient has had this problem before... as in chronic).  I think primary care might have a different requirement than AMPATH in this case....

-Andy
 
--------------------
Andrew S. Kanter, MD MPH

- Director of Health Information Systems/Medical Informatics
Millennium Villages Project Earth Institute, Columbia University
- Asst. Prof. of Clinical Biomedical Informatics and Clinical Epidemiology
Columbia University


Email: [hidden email]
Mobile: +1 (646) 469-2421
Office: +1 (212) 305-4842
Skype: akanter-ippnw
Yahoo: andy_kanter



From: Burke Mamlin [hidden email]
To: [hidden email]
Sent: Monday, November 24, 2008 1:09:23 PM
Subject: Re: [OPENMRS-IMPLEMENTERS] Flagging a diagnosis as a repeat visit

Andy,

We record PROBLEM ADDED and PROBLEM RESOLVED observations for diagnoses.  When we need the list of active problems (in the clinical summary module, for example), we create a list of all PROBLEM ADDED without a later PROBLEM RESOLVED.  So, duplicates of either (added or resolved) have no effect on the final list.

Eventually, we hope to have active lists within OpenMRS, so these problem added/resolved observations can be supplemented with a trigger to add or remove items from an active list of diagnoses.  In essence, this is just doing the work at the time data are received instead of deferring it to the time of retrieval... but it would undoubtedly be more efficient/easier in the long run.

-Burke

On Nov 24, 2008, at 11:43 AM, Andrew Kanter wrote:

Has anyone properly tagged their diagnoses on the form as being a new visit/returned visit? We have been struggling over this for awhile and I don't think it is properly recorded on the MOH forms either. However, if we add a data element to the problem_added array for repeat visit (reattendance) then the javascript function which calls the task pane has to be redone. If we add a new array to keep track of those diagnoses which are repeats, then we have to subtract them each time. Any other ideas here?

It seems that best way to have done this would be to dynamically generate the form so that it already included prior diagnoses on a list. Then they could be checked as a reattendance, or even checked if they became resolved (rather than clicking the remove problem button). 

Thanks!
Andy
 
-------------------- 
Andrew S. Kanter, MD MPH 

- Director of Health Information Systems/Medical Informatics
Millennium Villages Project Earth Institute, Columbia University
- Asst. Prof. of Clinical Biomedical Informatics and Clinical Epidemiology
Columbia University


Email: [hidden email] 
Mobile: +1 (646) 469-2421
Office: +1 (212) 305-4842
Skype: akanter-ippnw
Yahoo: andy_kanter


[hidden email] from OpenMRS Implementers' mailing list


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Kouematchoua, Ghislain Kouematchoua, Ghislain
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AW: [OPENMRS-IMPLEMENTERS] Flagging a diagnosis as a repeat visit

In reply to this post by Andrew Kanter

Hi Andy,

 

for our test installation in Goettingen, we have developed a medical problem module, which allows a problem-oriented aggregation of patient data stored in OpenMRS. In our approach, each problem has a duration (opened date and closed date) and a description. To each new problem, you can add related existing problems of the patient. For example a diabetes patient who has hypertension or renal failure. Also, relevant existing encounters, programs, and observations records can be mapped to the new problem.

Take a look at the screenshots attached.

 

- Ghislain.

 

 

Ghislain B. Kouematchoua Tchuitcheu, MSc.

Medical Informatics Department

University of Goettingen

Robert-Koch-Str. 40

37075 Goettingen -Germany-

Phone: +49-(0)551-3922842

Fax:      +49-(0)551-3922493

 


Von: [hidden email] [mailto:[hidden email]] Im Auftrag von Darius Jazayeri
Gesendet: Dienstag, 25. November 2008 06:58
An: [hidden email]
Betreff: Re: [OPENMRS-IMPLEMENTERS] Flagging a diagnosis as a repeat visit

 

Hi Andy,

Would it solve your problem if there were a portlet on the patient dashboard that showed active problems? Or do you need this to show in the infopath forms?

In the old user-configurable patient summary I wrote an <openmrs:activeList/> tag, and that's still in the codebase. It would take 10 minutes to wrap it in a portlet and add it to the dashboard.

You would basically specify which concept means problem added, which means concept removed, and a few other optional settings, and you get a table like:

Active Problem

Date added

Recurring?

Diabetes

08/02/2008

 

Malaria

25/11/2008

Yes


It would probably be trivial to add the optional "recurring" column, which would be checked if the problem has been "added" more than once.

You wouldn't be able to add problems from this interface. Or that would take >10 minutes of work.

-Darius

Andrew Kanter wrote:

This is the same way we are using it. However, it is a bit confusing for actually documenting the reason for the current visit and it does not capture whether it is truly a new problem added or just added for today (and the patient has had this problem before... as in chronic).  I think primary care might have a different requirement than AMPATH in this case....

 

-Andy

 

--------------------
Andrew S. Kanter, MD MPH

- Director of Health Information Systems/Medical Informatics
Millennium Villages Project Earth Institute, Columbia University
- Asst. Prof. of Clinical Biomedical Informatics and Clinical Epidemiology
Columbia University

 

Email: [hidden email]
Mobile: +1 (646) 469-2421
Office: +1 (212) 305-4842
Skype: akanter-ippnw
Yahoo: andy_kanter

 

 


From: Burke Mamlin [hidden email]
To: [hidden email]
Sent: Monday, November 24, 2008 1:09:23 PM
Subject: Re: [OPENMRS-IMPLEMENTERS] Flagging a diagnosis as a repeat visit

Andy,

 

We record PROBLEM ADDED and PROBLEM RESOLVED observations for diagnoses.  When we need the list of active problems (in the clinical summary module, for example), we create a list of all PROBLEM ADDED without a later PROBLEM RESOLVED.  So, duplicates of either (added or resolved) have no effect on the final list.

 

Eventually, we hope to have active lists within OpenMRS, so these problem added/resolved observations can be supplemented with a trigger to add or remove items from an active list of diagnoses.  In essence, this is just doing the work at the time data are received instead of deferring it to the time of retrieval... but it would undoubtedly be more efficient/easier in the long run.

 

-Burke

 

On Nov 24, 2008, at 11:43 AM, Andrew Kanter wrote:



Has anyone properly tagged their diagnoses on the form as being a new visit/returned visit? We have been struggling over this for awhile and I don't think it is properly recorded on the MOH forms either. However, if we add a data element to the problem_added array for repeat visit (reattendance) then the javascript function which calls the task pane has to be redone. If we add a new array to keep track of those diagnoses which are repeats, then we have to subtract them each time. Any other ideas here?

It seems that best way to have done this would be to dynamically generate the form so that it already included prior diagnoses on a list. Then they could be checked as a reattendance, or even checked if they became resolved (rather than clicking the remove problem button). 

Thanks!
Andy

 

-------------------- 
Andrew S. Kanter, MD MPH 

- Director of Health Information Systems/Medical Informatics
Millennium Villages Project Earth Institute, Columbia University
- Asst. Prof. of Clinical Biomedical Informatics and Clinical Epidemiology
Columbia University

 

Email: [hidden email] 
Mobile: +1 (646) 469-2421
Office: +1 (212) 305-4842
Skype: akanter-ippnw
Yahoo: andy_kanter

 


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screenshots Problem oriented data presentation OpenMRS.doc (814K) Download Attachment
Andrew Kanter Andrew Kanter
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Re: Flagging a diagnosis as a repeat visit

In reply to this post by Darius Jazayeri
Thanks, Darius, I do want to work on the dashboard view similar to what PIH has done. I wanted something geared to preparing for the current encounter... with some decision support (like the original popup) which this might help. We definitely need a problem list view, but some problems are not necessarily reattendance even if duped, such as Malaria. Hard to know whether this is the same Malaria or another bout. So I think we need to work this through.

As for the documentation... we did want something we can use in Infopath. It would be nice to actually have the form display the current problems and then be able to add a check if the problem was dealt with during the current visit, or if it was a repeat visit for the same problem. Then "problem added" really means adding a new problem for the first time.

Andy
 
--------------------
Andrew S. Kanter, MD MPH

- Director of Health Information Systems/Medical Informatics
Millennium Villages Project Earth Institute, Columbia University
- Asst. Prof. of Clinical Biomedical Informatics and Clinical Epidemiology
Columbia University


Email: [hidden email]
Mobile: +1 (646) 469-2421
Office: +1 (212) 305-4842
Skype: akanter-ippnw
Yahoo: andy_kanter



From: Darius Jazayeri <[hidden email]>
To: [hidden email]
Sent: Tuesday, November 25, 2008 12:57:36 AM
Subject: Re: [OPENMRS-IMPLEMENTERS] Flagging a diagnosis as a repeat visit

Hi Andy,

Would it solve your problem if there were a portlet on the patient dashboard that showed active problems? Or do you need this to show in the infopath forms?

In the old user-configurable patient summary I wrote an <openmrs:activeList/> tag, and that's still in the codebase. It would take 10 minutes to wrap it in a portlet and add it to the dashboard.

You would basically specify which concept means problem added, which means concept removed, and a few other optional settings, and you get a table like:

Active Problem

Date added

Recurring?

Diabetes

08/02/2008


Malaria

25/11/2008

Yes


It would probably be trivial to add the optional "recurring" column, which would be checked if the problem has been "added" more than once.

You wouldn't be able to add problems from this interface. Or that would take >10 minutes of work.

-Darius

Andrew Kanter wrote:
This is the same way we are using it. However, it is a bit confusing for actually documenting the reason for the current visit and it does not capture whether it is truly a new problem added or just added for today (and the patient has had this problem before... as in chronic).  I think primary care might have a different requirement than AMPATH in this case....

-Andy
 
--------------------
Andrew S. Kanter, MD MPH

- Director of Health Information Systems/Medical Informatics
Millennium Villages Project Earth Institute, Columbia University
- Asst. Prof. of Clinical Biomedical Informatics and Clinical Epidemiology
Columbia University


Email: [hidden email]
Mobile: +1 (646) 469-2421
Office: +1 (212) 305-4842
Skype: akanter-ippnw
Yahoo: andy_kanter



From: Burke Mamlin [hidden email]
To: [hidden email]
Sent: Monday, November 24, 2008 1:09:23 PM
Subject: Re: [OPENMRS-IMPLEMENTERS] Flagging a diagnosis as a repeat visit

Andy,

We record PROBLEM ADDED and PROBLEM RESOLVED observations for diagnoses.  When we need the list of active problems (in the clinical summary module, for example), we create a list of all PROBLEM ADDED without a later PROBLEM RESOLVED.  So, duplicates of either (added or resolved) have no effect on the final list.

Eventually, we hope to have active lists within OpenMRS, so these problem added/resolved observations can be supplemented with a trigger to add or remove items from an active list of diagnoses.  In essence, this is just doing the work at the time data are received instead of deferring it to the time of retrieval... but it would undoubtedly be more efficient/easier in the long run.

-Burke

On Nov 24, 2008, at 11:43 AM, Andrew Kanter wrote:

Has anyone properly tagged their diagnoses on the form as being a new visit/returned visit? We have been struggling over this for awhile and I don't think it is properly recorded on the MOH forms either. However, if we add a data element to the problem_added array for repeat visit (reattendance) then the javascript function which calls the task pane has to be redone. If we add a new array to keep track of those diagnoses which are repeats, then we have to subtract them each time. Any other ideas here?

It seems that best way to have done this would be to dynamically generate the form so that it already included prior diagnoses on a list. Then they could be checked as a reattendance, or even checked if they became resolved (rather than clicking the remove problem button). 

Thanks!
Andy
 
-------------------- 
Andrew S. Kanter, MD MPH 

- Director of Health Information Systems/Medical Informatics
Millennium Villages Project Earth Institute, Columbia University
- Asst. Prof. of Clinical Biomedical Informatics and Clinical Epidemiology
Columbia University


Email: [hidden email] 
Mobile: +1 (646) 469-2421
Office: +1 (212) 305-4842
Skype: akanter-ippnw
Yahoo: andy_kanter


[hidden email] from OpenMRS Implementers' mailing list


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Darius Jazayeri Darius Jazayeri
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Re: Flagging a diagnosis as a repeat visit

Okay, well, if you (or anyone) wants this feature, they should create a
ticket. :-)

-Darius

Andrew Kanter wrote:

> Thanks, Darius, I do want to work on the dashboard view similar to
> what PIH has done. I wanted something geared to preparing for the
> current encounter... with some decision support (like the original
> popup) which this might help. We definitely need a problem list view,
> but some problems are not necessarily reattendance even if duped, such
> as Malaria. Hard to know whether this is the same Malaria or another
> bout. So I think we need to work this through.
>
> As for the documentation... we did want something we can use in
> Infopath. It would be nice to actually have the form display the
> current problems and then be able to add a check if the problem was
> dealt with during the current visit, or if it was a repeat visit for
> the same problem. Then "problem added" really means adding a new
> problem for the first time.
>
> Andy
>  
> --------------------
> Andrew S. Kanter, MD MPH
>
> - Director of Health Information Systems/Medical Informatics
> Millennium Villages Project Earth Institute, Columbia University
> - Asst. Prof. of Clinical Biomedical Informatics and Clinical Epidemiology
> Columbia University
>
>
> Email: [hidden email]
> Mobile: +1 (646) 469-2421
> Office: +1 (212) 305-4842
> Skype: akanter-ippnw
> Yahoo: andy_kanter
>
>
> ------------------------------------------------------------------------
> *From:* Darius Jazayeri <[hidden email]>
> *To:* [hidden email]
> *Sent:* Tuesday, November 25, 2008 12:57:36 AM
> *Subject:* Re: [OPENMRS-IMPLEMENTERS] Flagging a diagnosis as a repeat
> visit
>
> Hi Andy,
>
> Would it solve your problem if there were a portlet on the patient
> dashboard that showed active problems? Or do you need this to show in
> the infopath forms?
>
> In the old user-configurable patient summary I wrote an
> <openmrs:activeList/> tag, and that's still in the codebase. It would
> take 10 minutes to wrap it in a portlet and add it to the dashboard.
>
> You would basically specify which concept means problem added, which
> means concept removed, and a few other optional settings, and you get
> a table like:
>
> Active Problem
>
>
>
> Date added
>
>
>
> Recurring?
>
> Diabetes
>
>
>
> 08/02/2008
>
>
>
>
> Malaria
>
>
>
> 25/11/2008
>
>
>
> Yes
>
>
> It would probably be trivial to add the optional "recurring" column,
> which would be checked if the problem has been "added" more than once.
>
> You wouldn't be able to add problems from this interface. Or that
> would take >10 minutes of work.
>
> -Darius
>
> Andrew Kanter wrote:
>> This is the same way we are using it. However, it is a bit confusing
>> for actually documenting the reason for the current visit and it does
>> not capture whether it is truly a new problem added or just added for
>> today (and the patient has had this problem before... as in chronic).
>>  I think primary care might have a different requirement than AMPATH
>> in this case....
>>
>> -Andy
>>  
>> --------------------
>> Andrew S. Kanter, MD MPH
>>
>> - Director of Health Information Systems/Medical Informatics
>> Millennium Villages Project Earth Institute, Columbia University
>> - Asst. Prof. of Clinical Biomedical Informatics and Clinical
>> Epidemiology
>> Columbia University
>>
>>
>> Email: [hidden email]
>> Mobile: +1 (646) 469-2421
>> Office: +1 (212) 305-4842
>> Skype: akanter-ippnw
>> Yahoo: andy_kanter
>>
>>
>> ------------------------------------------------------------------------
>> *From:* Burke Mamlin <[hidden email]>
>> *To:* [hidden email]
>> *Sent:* Monday, November 24, 2008 1:09:23 PM
>> *Subject:* Re: [OPENMRS-IMPLEMENTERS] Flagging a diagnosis as a
>> repeat visit
>>
>> Andy,
>>
>> We record PROBLEM ADDED and PROBLEM RESOLVED observations for
>> diagnoses.  When we need the list of active problems (in the clinical
>> summary module, for example), we create a list of all PROBLEM ADDED
>> without a later PROBLEM RESOLVED.  So, duplicates of either (added or
>> resolved) have no effect on the final list.
>>
>> Eventually, we hope to have active lists within OpenMRS, so these
>> problem added/resolved observations can be supplemented with a
>> trigger to add or remove items from an active list of diagnoses.  In
>> essence, this is just doing the work at the time data are received
>> instead of deferring it to the time of retrieval... but it would
>> undoubtedly be more efficient/easier in the long run.
>>
>> -Burke
>>
>> On Nov 24, 2008, at 11:43 AM, Andrew Kanter wrote:
>>
>>> Has anyone properly tagged their diagnoses on the form as being a
>>> new visit/returned visit? We have been struggling over this for
>>> awhile and I don't think it is properly recorded on the MOH forms
>>> either. However, if we add a data element to the problem_added array
>>> for repeat visit (reattendance) then the javascript function which
>>> calls the task pane has to be redone. If we add a new array to keep
>>> track of those diagnoses which are repeats, then we have to subtract
>>> them each time. Any other ideas here?
>>>
>>> It seems that best way to have done this would be to dynamically
>>> generate the form so that it already included prior diagnoses on a
>>> list. Then they could be checked as a reattendance, or even checked
>>> if they became resolved (rather than clicking the remove problem
>>> button).
>>>
>>> Thanks!
>>> Andy
>>>  
>>> --------------------
>>> Andrew S. Kanter, MD MPH
>>>
>>> - Director of Health Information Systems/Medical Informatics
>>> Millennium Villages Project Earth Institute, Columbia University
>>> - Asst. Prof. of Clinical Biomedical Informatics and Clinical
>>> Epidemiology
>>> Columbia University
>>>
>>>
>>> Email: [hidden email] <mailto:[hidden email]>
>>> Mobile: +1 (646) 469-2421
>>> Office: +1 (212) 305-4842
>>> Skype: akanter-ippnw
>>> Yahoo: andy_kanter
>>>
>>> ------------------------------------------------------------------------
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>>> <mailto:[hidden email]?body=SIGNOFF%20openmrs-implement-l> from
>>> OpenMRS Implementers' mailing list
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Re: Flagging a diagnosis as a repeat visit

In reply to this post by Kouematchoua, Ghislain
Ghislain,
I would be interested in taking more of a look at this problem module. Are you also using the Program section to manage problems, or was this just an example in the screenshots? I especially like the timeline for problems, although one year might be too short for chronic problems and too long for acute ones. I still cannot see how an infopath form can be used to identify reattendance, so if anyone else has any ideas or is currently using a form which results in a report where new diagnoses are separated out from repeat visits I would really be interested in that.

Thanks!
Andy
 
--------------------
Andrew S. Kanter, MD MPH

- Director of Health Information Systems/Medical Informatics
Millennium Villages Project Earth Institute, Columbia University
- Asst. Prof. of Clinicaral Biomedical Informatics and Clinical Epidemiology
Columbia University


Email: [hidden email]
Mobile: +1 (646) 469-2421
Office: +1 (212) 305-4842
Skype: akanter-ippnw
Yahoo: andy_kanter



From: "Kouematchoua, Ghislain" <[hidden email]>
To: [hidden email]
Sent: Tuesday, November 25, 2008 4:30:37 AM
Subject: [OPENMRS-IMPLEMENTERS] AW: [OPENMRS-IMPLEMENTERS] Flagging a diagnosis as a repeat visit

Hi Andy,

 

for our test installation in Goettingen, we have developed a medical problem module, which allows a problem-oriented aggregation of patient data stored in OpenMRS. In our approach, each problem has a duration (opened date and closed date) and a description. To each new problem, you can add related existing problems of the patient. For example a diabetes patient who has hypertension or renal failure. Also, relevant existing encounters, programs, and observations records can be mapped to the new problem.

Take a look at the screenshots attached.

 

- Ghislain.

 

 

Ghislain B. Kouematchoua Tchuitcheu, MSc.

Medical Informatics Department

University of Goettingen

Robert-Koch-Str. 40

37075 Goettingen -Germany-

Phone: +49-(0)551-3922842

Fax:      +49-(0)551-3922493

 


Von: [hidden email] [mailto:[hidden email]] Im Auftrag von Darius Jazayeri
Gesendet: Dienstag, 25. November 2008 06:58
An: [hidden email]
Betreff: Re: [OPENMRS-IMPLEMENTERS] Flagging a diagnosis as a repeat visit

 

Hi Andy,

Would it solve your problem if there were a portlet on the patient dashboard that showed active problems? Or do you need this to show in the infopath forms?

In the old user-configurable patient summary I wrote an <openmrs:activeList/> tag, and that's still in the codebase. It would take 10 minutes to wrap it in a portlet and add it to the dashboard.

You would basically specify which concept means problem added, which means concept removed, and a few other optional settings, and you get a table like:

Active Problem

Date added

Recurring?

Diabetes

08/02/2008

 

Malaria

25/11/2008

Yes


It would probably be trivial to add the optional "recurring" column, which would be checked if the problem has been "added" more than once.

You wouldn't be able to add problems from this interface. Or that would take >10 minutes of work.

-Darius

Andrew Kanter wrote:

This is the same way we are using it. However, it is a bit confusing for actually documenting the reason for the current visit and it does not capture whether it is truly a new problem added or just added for today (and the patient has had this problem before... as in chronic).  I think primary care might have a different requirement than AMPATH in this case....

 

-Andy

 

--------------------
Andrew S. Kanter, MD MPH

- Director of Health Information Systems/Medical Informatics
Millennium Villages Project Earth Institute, Columbia University
- Asst. Prof. of Clinical Biomedical Informatics and Clinical Epidemiology
Columbia University

 

Email: [hidden email]
Mobile: +1 (646) 469-2421
Office: +1 (212) 305-4842
Skype: akanter-ippnw
Yahoo: andy_kanter

 

 


From: Burke Mamlin [hidden email]
To: [hidden email]
Sent: Monday, November 24, 2008 1:09:23 PM
Subject: Re: [OPENMRS-IMPLEMENTERS] Flagging a diagnosis as a repeat visit

Andy,

 

We record PROBLEM ADDED and PROBLEM RESOLVED observations for diagnoses.  When we need the list of active problems (in the clinical summary module, for example), we create a list of all PROBLEM ADDED without a later PROBLEM RESOLVED.  So, duplicates of either (added or resolved) have no effect on the final list.

 

Eventually, we hope to have active lists within OpenMRS, so these problem added/resolved observations can be supplemented with a trigger to add or remove items from an active list of diagnoses.  In essence, this is just doing the work at the time data are received instead of deferring it to the time of retrieval... but it would undoubtedly be more efficient/easier in the long run.

 

-Burke

 

On Nov 24, 2008, at 11:43 AM, Andrew Kanter wrote:



Has anyone properly tagged their diagnoses on the form as being a new visit/returned visit? We have been struggling over this for awhile and I don't think it is properly recorded on the MOH forms either. However, if we add a data element to the problem_added array for repeat visit (reattendance) then the javascript function which calls the task pane has to be redone. If we add a new array to keep track of those diagnoses which are repeats, then we have to subtract them each time. Any other ideas here?

It seems that best way to have done this would be to dynamically generate the form so that it already included prior diagnoses on a list. Then they could be checked as a reattendance, or even checked if they became resolved (rather than clicking the remove problem button). 

Thanks!
Andy

 

-------------------- 
Andrew S. Kanter, MD MPH 

- Director of Health Information Systems/Medical Informatics
Millennium Villages Project Earth Institute, Columbia University
- Asst. Prof. of Clinical Biomedical Informatics and Clinical Epidemiology
Columbia University

 

Email: [hidden email] 
Mobile: +1 (646) 469-2421
Office: +1 (212) 305-4842
Skype: akanter-ippnw
Yahoo: andy_kanter

 


[hidden email] from OpenMRS Implementers' mailing list

 


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Maros Cunderlik Maros Cunderlik
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Re: Flagging a diagnosis as a repeat visit

Andrew,

I am in a process of helping to support management of data in openMRS
for chronic care, starting with heart failure. One of the first issues
from usability perspective is lack of longitudinal view in infopath
data entry for visits, labs,  meds, hospitalizations and diagnoses. We
are starting with just normal intake and follow up visit infopath
forms however what we are looking at next is replacing follow-up form
with an online flowsheet-style representation of data; this is what
the clinicians use on paper and having it online appears essential to
effective use of the system, especially for HF patients where
management of disease often requires frequent adjustments in regimen.
We looked at expanding infopath to be able to do this (i.e.
pre-populate infopath with existing diagnoses, hospitalizations, and
meds) however it wold be non-trivial amount of work and we feel like
if we are going to put some effort into it we may as well put it into
making online flowsheet-style pages as opposed to investing into
infopath. In mid-tem, what I imagine we will end up with is something
similar to what Dave T. did for PIH with MDR-TB module but for chronic
care starting with HF. Does this sounds like something you would be
interested in? If so do let me know. Hope this helps,

Maros


On Sun, Nov 30, 2008 at 10:03 AM, Andrew Kanter <[hidden email]> wrote:

> Ghislain,
> I would be interested in taking more of a look at this problem module. Are
> you also using the Program section to manage problems, or was this just an
> example in the screenshots? I especially like the timeline for problems,
> although one year might be too short for chronic problems and too long for
> acute ones. I still cannot see how an infopath form can be used to identify
> reattendance, so if anyone else has any ideas or is currently using a form
> which results in a report where new diagnoses are separated out from repeat
> visits I would really be interested in that.
> Thanks!
> Andy
>
> --------------------
> Andrew S. Kanter, MD MPH
>
> - Director of Health Information Systems/Medical Informatics
> Millennium Villages Project Earth Institute, Columbia University
> - Asst. Prof. of Clinicaral Biomedical Informatics and Clinical Epidemiology
> Columbia University
>
> Email: [hidden email]
> Mobile: +1 (646) 469-2421
> Office: +1 (212) 305-4842
> Skype: akanter-ippnw
> Yahoo: andy_kanter
>
> ________________________________
> From: "Kouematchoua, Ghislain" <[hidden email]>
> To: [hidden email]
> Sent: Tuesday, November 25, 2008 4:30:37 AM
> Subject: [OPENMRS-IMPLEMENTERS] AW: [OPENMRS-IMPLEMENTERS] Flagging a
> diagnosis as a repeat visit
>
> Hi Andy,
>
>
>
> for our test installation in Goettingen, we have developed a medical problem
> module, which allows a problem-oriented aggregation of patient data stored
> in OpenMRS. In our approach, each problem has a duration (opened date and
> closed date) and a description. To each new problem, you can add related
> existing problems of the patient. For example a diabetes patient who has
> hypertension or renal failure. Also, relevant existing encounters, programs,
> and observations records can be mapped to the new problem.
>
> Take a look at the screenshots attached.
>
>
>
> - Ghislain.
>
>
>
>
>
> Ghislain B. Kouematchoua Tchuitcheu, MSc.
>
> Medical Informatics Department
>
> University of Goettingen
>
> Robert-Koch-Str. 40
>
> 37075 Goettingen -Germany-
>
> Phone: +49-(0)551-3922842
>
> Fax:      +49-(0)551-3922493
>
>
>
> ________________________________
>
> Von: [hidden email] [mailto:[hidden email]] Im Auftrag
> von Darius Jazayeri
> Gesendet: Dienstag, 25. November 2008 06:58
> An: [hidden email]
> Betreff: Re: [OPENMRS-IMPLEMENTERS] Flagging a diagnosis as a repeat visit
>
>
>
> Hi Andy,
>
> Would it solve your problem if there were a portlet on the patient dashboard
> that showed active problems? Or do you need this to show in the infopath
> forms?
>
> In the old user-configurable patient summary I wrote an
> <openmrs:activeList/> tag, and that's still in the codebase. It would take
> 10 minutes to wrap it in a portlet and add it to the dashboard.
>
> You would basically specify which concept means problem added, which means
> concept removed, and a few other optional settings, and you get a table
> like:
>
> Active Problem
>
> Date added
>
> Recurring?
>
> Diabetes
>
> 08/02/2008
>
>
>
> Malaria
>
> 25/11/2008
>
> Yes
>
> It would probably be trivial to add the optional "recurring" column, which
> would be checked if the problem has been "added" more than once.
>
> You wouldn't be able to add problems from this interface. Or that would take
>>10 minutes of work.
>
> -Darius
>
> Andrew Kanter wrote:
>
> This is the same way we are using it. However, it is a bit confusing for
> actually documenting the reason for the current visit and it does not
> capture whether it is truly a new problem added or just added for today (and
> the patient has had this problem before... as in chronic).  I think primary
> care might have a different requirement than AMPATH in this case....
>
>
>
> -Andy
>
>
>
> --------------------
> Andrew S. Kanter, MD MPH
>
> - Director of Health Information Systems/Medical Informatics
> Millennium Villages Project Earth Institute, Columbia University
> - Asst. Prof. of Clinical Biomedical Informatics and Clinical Epidemiology
> Columbia University
>
>
>
> Email: [hidden email]
> Mobile: +1 (646) 469-2421
> Office: +1 (212) 305-4842
> Skype: akanter-ippnw
> Yahoo: andy_kanter
>
>
>
>
>
> ________________________________
>
> From: Burke Mamlin <[hidden email]>
> To: [hidden email]
> Sent: Monday, November 24, 2008 1:09:23 PM
> Subject: Re: [OPENMRS-IMPLEMENTERS] Flagging a diagnosis as a repeat visit
>
> Andy,
>
>
>
> We record PROBLEM ADDED and PROBLEM RESOLVED observations for diagnoses.
>  When we need the list of active problems (in the clinical summary module,
> for example), we create a list of all PROBLEM ADDED without a later PROBLEM
> RESOLVED.  So, duplicates of either (added or resolved) have no effect on
> the final list.
>
>
>
> Eventually, we hope to have active lists within OpenMRS, so these problem
> added/resolved observations can be supplemented with a trigger to add or
> remove items from an active list of diagnoses.  In essence, this is just
> doing the work at the time data are received instead of deferring it to the
> time of retrieval... but it would undoubtedly be more efficient/easier in
> the long run.
>
>
>
> -Burke
>
>
>
> On Nov 24, 2008, at 11:43 AM, Andrew Kanter wrote:
>
> Has anyone properly tagged their diagnoses on the form as being a new
> visit/returned visit? We have been struggling over this for awhile and I
> don't think it is properly recorded on the MOH forms either. However, if we
> add a data element to the problem_added array for repeat visit
> (reattendance) then the javascript function which calls the task pane has to
> be redone. If we add a new array to keep track of those diagnoses which are
> repeats, then we have to subtract them each time. Any other ideas here?
>
> It seems that best way to have done this would be to dynamically generate
> the form so that it already included prior diagnoses on a list. Then they
> could be checked as a reattendance, or even checked if they became resolved
> (rather than clicking the remove problem button).
>
> Thanks!
> Andy
>
>
>
> --------------------
> Andrew S. Kanter, MD MPH
>
> - Director of Health Information Systems/Medical Informatics
> Millennium Villages Project Earth Institute, Columbia University
> - Asst. Prof. of Clinical Biomedical Informatics and Clinical Epidemiology
> Columbia University
>
>
>
> Email: [hidden email]
> Mobile: +1 (646) 469-2421
> Office: +1 (212) 305-4842
> Skype: akanter-ippnw
> Yahoo: andy_kanter
>
>
>
> ________________________________
>
> Click here to unsubscribe from OpenMRS Implementers' mailing list
>
>
>
> ________________________________
>
> Click here to unsubscribe from OpenMRS Implementers' mailing list
>
> ________________________________
>
> Click here to unsubscribe from OpenMRS Implementers' mailing list
>
> ________________________________
> Click here to unsubscribe from OpenMRS Implementers' mailing list
> ________________________________
> Click here to unsubscribe from OpenMRS Implementers' mailing list
> ________________________________
> Click here to unsubscribe from OpenMRS Implementers' mailing list

_________________________________________

To unsubscribe from OpenMRS Implementers' mailing list, send an e-mail to [hidden email] with "SIGNOFF openmrs-implement-l" in the  body (not the subject) of your e-mail.

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Andrew Kanter Andrew Kanter
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Re: Flagging a diagnosis as a repeat visit

This is interesting, but we don't think we are going to be able to support online entry for providers in the short term. We had hoped to have a more dynamic form approach which would allow for printed forms with prior data. Building something in Infopath would be cool, but doesn't have the longevity requirement since we want to get off of infopath. Having an X-forms approach to this would be great, so it is possible that we could move easily to provider-entry when time was right.

The flowsheet approach has been tossed around lately, and I think it is a good idea for several reasons: 1) it reduces data entry, 2) it provides historical data easily, and 3) it help group data for the provider to act on. I am sure there are lots of other good reasons to do it... but we just can't expect a computer on each providers table at the moment.

Thanks again,
Andy
 
--------------------
Andrew S. Kanter, MD MPH

- Director of Health Information Systems/Medical Informatics
Millennium Villages Project Earth Institute, Columbia University
- Asst. Prof. of Clinical Biomedical Informatics and Clinical Epidemiology
Columbia University


Email: [hidden email]
Mobile: +1 (646) 469-2421
Office: +1 (212) 305-4842
Skype: akanter-ippnw
Yahoo: andy_kanter



From: Maros Cunderlik <[hidden email]>
To: [hidden email]
Sent: Sunday, November 30, 2008 12:08:57 PM
Subject: Re: [OPENMRS-IMPLEMENTERS] Flagging a diagnosis as a repeat visit

Andrew,

I am in a process of helping to support management of data in openMRS
for chronic care, starting with heart failure. One of the first issues
from usability perspective is lack of longitudinal view in infopath
data entry for visits, labs,  meds, hospitalizations and diagnoses. We
are starting with just normal intake and follow up visit infopath
forms however what we are looking at next is replacing follow-up form
with an online flowsheet-style representation of data; this is what
the clinicians use on paper and having it online appears essential to
effective use of the system, especially for HF patients where
management of disease often requires frequent adjustments in regimen.
We looked at expanding infopath to be able to do this (i.e.
pre-populate infopath with existing diagnoses, hospitalizations, and
meds) however it wold be non-trivial amount of work and we feel like
if we are going to put some effort into it we may as well put it into
making online flowsheet-style pages as opposed to investing into
infopath. In mid-tem, what I imagine we will end up with is something
similar to what Dave T. did for PIH with MDR-TB module but for chronic
care starting with HF. Does this sounds like something you would be
interested in? If so do let me know. Hope this helps,

Maros


On Sun, Nov 30, 2008 at 10:03 AM, Andrew Kanter <[hidden email]> wrote:

> Ghislain,
> I would be interested in taking more of a look at this problem module. Are
> you also using the Program section to manage problems, or was this just an
> example in the screenshots? I especially like the timeline for problems,
> although one year might be too short for chronic problems and too long for
> acute ones. I still cannot see how an infopath form can be used to identify
> reattendance, so if anyone else has any ideas or is currently using a form
> which results in a report where new diagnoses are separated out from repeat
> visits I would really be interested in that.
> Thanks!
> Andy
>
> --------------------
> Andrew S. Kanter, MD MPH
>
> - Director of Health Information Systems/Medical Informatics
> Millennium Villages Project Earth Institute, Columbia University
> - Asst. Prof. of Clinicaral Biomedical Informatics and Clinical Epidemiology
> Columbia University
>
> Email: [hidden email]
> Mobile: +1 (646) 469-2421
> Office: +1 (212) 305-4842
> Skype: akanter-ippnw
> Yahoo: andy_kanter
>
> ________________________________
> From: "Kouematchoua, Ghislain" <[hidden email]>
> To: [hidden email]
> Sent: Tuesday, November 25, 2008 4:30:37 AM
> Subject: [OPENMRS-IMPLEMENTERS] AW: [OPENMRS-IMPLEMENTERS] Flagging a
> diagnosis as a repeat visit
>
> Hi Andy,
>
>
>
> for our test installation in Goettingen, we have developed a medical problem
> module, which allows a problem-oriented aggregation of patient data stored
> in OpenMRS. In our approach, each problem has a duration (opened date and
> closed date) and a description. To each new problem, you can add related
> existing problems of the patient. For example a diabetes patient who has
> hypertension or renal failure. Also, relevant existing encounters, programs,
> and observations records can be mapped to the new problem.
>
> Take a look at the screenshots attached.
>
>
>
> - Ghislain.
>
>
>
>
>
> Ghislain B. Kouematchoua Tchuitcheu, MSc.
>
> Medical Informatics Department
>
> University of Goettingen
>
> Robert-Koch-Str. 40
>
> 37075 Goettingen -Germany-
>
> Phone: +49-(0)551-3922842
>
> Fax:      +49-(0)551-3922493
>
>
>
> ________________________________
>
> Von: [hidden email] [mailto:[hidden email]] Im Auftrag
> von Darius Jazayeri
> Gesendet: Dienstag, 25. November 2008 06:58
> An: [hidden email]
> Betreff: Re: [OPENMRS-IMPLEMENTERS] Flagging a diagnosis as a repeat visit
>
>
>
> Hi Andy,
>
> Would it solve your problem if there were a portlet on the patient dashboard
> that showed active problems? Or do you need this to show in the infopath
> forms?
>
> In the old user-configurable patient summary I wrote an
> <openmrs:activeList/> tag, and that's still in the codebase. It would take
> 10 minutes to wrap it in a portlet and add it to the dashboard.
>
> You would basically specify which concept means problem added, which means
> concept removed, and a few other optional settings, and you get a table
> like:
>
> Active Problem
>
> Date added
>
> Recurring?
>
> Diabetes
>
> 08/02/2008
>
>
>
> Malaria
>
> 25/11/2008
>
> Yes
>
> It would probably be trivial to add the optional "recurring" column, which
> would be checked if the problem has been "added" more than once.
>
> You wouldn't be able to add problems from this interface. Or that would take
>>10 minutes of work.
>
> -Darius
>
> Andrew Kanter wrote:
>
> This is the same way we are using it. However, it is a bit confusing for
> actually documenting the reason for the current visit and it does not
> capture whether it is truly a new problem added or just added for today (and
> the patient has had this problem before... as in chronic).  I think primary
> care might have a different requirement than AMPATH in this case....
>
>
>
> -Andy
>
>
>
> --------------------
> Andrew S. Kanter, MD MPH
>
> - Director of Health Information Systems/Medical Informatics
> Millennium Villages Project Earth Institute, Columbia University
> - Asst. Prof. of Clinical Biomedical Informatics and Clinical Epidemiology
> Columbia University
>
>
>
> Email: [hidden email]
> Mobile: +1 (646) 469-2421
> Office: +1 (212) 305-4842
> Skype: akanter-ippnw
> Yahoo: andy_kanter
>
>
>
>
>
> ________________________________
>
> From: Burke Mamlin <[hidden email]>
> To: [hidden email]
> Sent: Monday, November 24, 2008 1:09:23 PM
> Subject: Re: [OPENMRS-IMPLEMENTERS] Flagging a diagnosis as a repeat visit
>
> Andy,
>
>
>
> We record PROBLEM ADDED and PROBLEM RESOLVED observations for diagnoses.
>  When we need the list of active problems (in the clinical summary module,
> for example), we create a list of all PROBLEM ADDED without a later PROBLEM
> RESOLVED.  So, duplicates of either (added or resolved) have no effect on
> the final list.
>
>
>
> Eventually, we hope to have active lists within OpenMRS, so these problem
> added/resolved observations can be supplemented with a trigger to add or
> remove items from an active list of diagnoses.  In essence, this is just
> doing the work at the time data are received instead of deferring it to the
> time of retrieval... but it would undoubtedly be more efficient/easier in
> the long run.
>
>
>
> -Burke
>
>
>
> On Nov 24, 2008, at 11:43 AM, Andrew Kanter wrote:
>
> Has anyone properly tagged their diagnoses on the form as being a new
> visit/returned visit? We have been struggling over this for awhile and I
> don't think it is properly recorded on the MOH forms either. However, if we
> add a data element to the problem_added array for repeat visit
> (reattendance) then the javascript function which calls the task pane has to
> be redone. If we add a new array to keep track of those diagnoses which are
> repeats, then we have to subtract them each time. Any other ideas here?
>
> It seems that best way to have done this would be to dynamically generate
> the form so that it already included prior diagnoses on a list. Then they
> could be checked as a reattendance, or even checked if they became resolved
> (rather than clicking the remove problem button).
>
> Thanks!
> Andy
>
>
>
> --------------------
> Andrew S. Kanter, MD MPH
>
> - Director of Health Information Systems/Medical Informatics
> Millennium Villages Project Earth Institute, Columbia University
> - Asst. Prof. of Clinical Biomedical Informatics and Clinical Epidemiology
> Columbia University
>
>
>
> Email: [hidden email]
> Mobile: +1 (646) 469-2421
> Office: +1 (212) 305-4842
> Skype: akanter-ippnw
> Yahoo: andy_kanter
>
>
>
> ________________________________
>
> Click here to unsubscribe from OpenMRS Implementers' mailing list
>
>
>
> ________________________________
>
> Click here to unsubscribe from OpenMRS Implementers' mailing list
>
> ________________________________
>
> Click here to unsubscribe from OpenMRS Implementers' mailing list
>
> ________________________________
> Click here to unsubscribe from OpenMRS Implementers' mailing list
> ________________________________
> Click here to unsubscribe from OpenMRS Implementers' mailing list
> ________________________________
> Click here to unsubscribe from OpenMRS Implementers' mailing list

_________________________________________

To unsubscribe from OpenMRS Implementers' mailing list, send an e-mail to [hidden email] with "SIGNOFF openmrs-implement-l" in the  body (not the subject) of your e-mail.

[mailto:[hidden email]?body=SIGNOFF%20openmrs-implement-l]

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Darius Jazayeri Darius Jazayeri
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Re: Flagging a diagnosis as a repeat visit

Hi Andy,

We're not actually intending to do that. The clinicians are filling out
a paper chart that looks like a flowsheet. The data clerks are going to
enter that into a computer interface that looks like the same flowsheet.

-Darius

Andrew Kanter wrote:

> This is interesting, but we don't think we are going to be able to
> support online entry for providers in the short term. We had hoped to
> have a more dynamic form approach which would allow for printed forms
> with prior data. Building something in Infopath would be cool, but
> doesn't have the longevity requirement since we want to get off of
> infopath. Having an X-forms approach to this would be great, so it is
> possible that we could move easily to provider-entry when time was right.
>
> The flowsheet approach has been tossed around lately, and I think it
> is a good idea for several reasons: 1) it reduces data entry, 2) it
> provides historical data easily, and 3) it help group data for the
> provider to act on. I am sure there are lots of other good reasons to
> do it... but we just can't expect a computer on each providers table
> at the moment.
>
> Thanks again,
> Andy
>  
> --------------------
> Andrew S. Kanter, MD MPH
>
> - Director of Health Information Systems/Medical Informatics
> Millennium Villages Project Earth Institute, Columbia University
> - Asst. Prof. of Clinical Biomedical Informatics and Clinical Epidemiology
> Columbia University
>
>
> Email: [hidden email]
> Mobile: +1 (646) 469-2421
> Office: +1 (212) 305-4842
> Skype: akanter-ippnw
> Yahoo: andy_kanter
>
>
> ------------------------------------------------------------------------
> *From:* Maros Cunderlik <[hidden email]>
> *To:* [hidden email]
> *Sent:* Sunday, November 30, 2008 12:08:57 PM
> *Subject:* Re: [OPENMRS-IMPLEMENTERS] Flagging a diagnosis as a repeat
> visit
>
> Andrew,
>
> I am in a process of helping to support management of data in openMRS
> for chronic care, starting with heart failure. One of the first issues
> from usability perspective is lack of longitudinal view in infopath
> data entry for visits, labs,  meds, hospitalizations and diagnoses. We
> are starting with just normal intake and follow up visit infopath
> forms however what we are looking at next is replacing follow-up form
> with an online flowsheet-style representation of data; this is what
> the clinicians use on paper and having it online appears essential to
> effective use of the system, especially for HF patients where
> management of disease often requires frequent adjustments in regimen.
> We looked at expanding infopath to be able to do this (i.e.
> pre-populate infopath with existing diagnoses, hospitalizations, and
> meds) however it wold be non-trivial amount of work and we feel like
> if we are going to put some effort into it we may as well put it into
> making online flowsheet-style pages as opposed to investing into
> infopath. In mid-tem, what I imagine we will end up with is something
> similar to what Dave T. did for PIH with MDR-TB module but for chronic
> care starting with HF. Does this sounds like something you would be
> interested in? If so do let me know. Hope this helps,
>
> Maros
>
>
> On Sun, Nov 30, 2008 at 10:03 AM, Andrew Kanter <[hidden email]
> <mailto:[hidden email]>> wrote:
> > Ghislain,
> > I would be interested in taking more of a look at this problem
> module. Are
> > you also using the Program section to manage problems, or was this
> just an
> > example in the screenshots? I especially like the timeline for problems,
> > although one year might be too short for chronic problems and too
> long for
> > acute ones. I still cannot see how an infopath form can be used to
> identify
> > reattendance, so if anyone else has any ideas or is currently using
> a form
> > which results in a report where new diagnoses are separated out from
> repeat
> > visits I would really be interested in that.
> > Thanks!
> > Andy
> >
> > --------------------
> > Andrew S. Kanter, MD MPH
> >
> > - Director of Health Information Systems/Medical Informatics
> > Millennium Villages Project Earth Institute, Columbia University
> > - Asst. Prof. of Clinicaral Biomedical Informatics and Clinical
> Epidemiology
> > Columbia University
> >
> > Email: [hidden email] <mailto:[hidden email]>
> > Mobile: +1 (646) 469-2421
> > Office: +1 (212) 305-4842
> > Skype: akanter-ippnw
> > Yahoo: andy_kanter
> >
> > ________________________________
> > From: "Kouematchoua, Ghislain" <[hidden email]
> <mailto:[hidden email]>>
> > To: [hidden email]
> <mailto:[hidden email]>
> > Sent: Tuesday, November 25, 2008 4:30:37 AM
> > Subject: [OPENMRS-IMPLEMENTERS] AW: [OPENMRS-IMPLEMENTERS] Flagging a
> > diagnosis as a repeat visit
> >
> > Hi Andy,
> >
> >
> >
> > for our test installation in Goettingen, we have developed a medical
> problem
> > module, which allows a problem-oriented aggregation of patient data
> stored
> > in OpenMRS. In our approach, each problem has a duration (opened
> date and
> > closed date) and a description. To each new problem, you can add related
> > existing problems of the patient. For example a diabetes patient who has
> > hypertension or renal failure. Also, relevant existing encounters,
> programs,
> > and observations records can be mapped to the new problem.
> >
> > Take a look at the screenshots attached.
> >
> >
> >
> > - Ghislain.
> >
> >
> >
> >
> >
> > Ghislain B. Kouematchoua Tchuitcheu, MSc.
> >
> > Medical Informatics Department
> >
> > University of Goettingen
> >
> > Robert-Koch-Str. 40
> >
> > 37075 Goettingen -Germany-
> >
> > Phone: +49-(0)551-3922842
> >
> > Fax:      +49-(0)551-3922493
> >
> >
> >
> > ________________________________
> >
> > Von: [hidden email] <mailto:[hidden email]>
> [mailto:[hidden email] <mailto:[hidden email]>] Im
> Auftrag
> > von Darius Jazayeri
> > Gesendet: Dienstag, 25. November 2008 06:58
> > An: [hidden email]
> <mailto:[hidden email]>
> > Betreff: Re: [OPENMRS-IMPLEMENTERS] Flagging a diagnosis as a repeat
> visit
> >
> >
> >
> > Hi Andy,
> >
> > Would it solve your problem if there were a portlet on the patient
> dashboard
> > that showed active problems? Or do you need this to show in the infopath
> > forms?
> >
> > In the old user-configurable patient summary I wrote an
> > <openmrs:activeList/> tag, and that's still in the codebase. It
> would take
> > 10 minutes to wrap it in a portlet and add it to the dashboard.
> >
> > You would basically specify which concept means problem added, which
> means
> > concept removed, and a few other optional settings, and you get a table
> > like:
> >
> > Active Problem
> >
> > Date added
> >
> > Recurring?
> >
> > Diabetes
> >
> > 08/02/2008
> >
> >
> >
> > Malaria
> >
> > 25/11/2008
> >
> > Yes
> >
> > It would probably be trivial to add the optional "recurring" column,
> which
> > would be checked if the problem has been "added" more than once.
> >
> > You wouldn't be able to add problems from this interface. Or that
> would take
> >>10 minutes of work.
> >
> > -Darius
> >
> > Andrew Kanter wrote:
> >
> > This is the same way we are using it. However, it is a bit confusing for
> > actually documenting the reason for the current visit and it does not
> > capture whether it is truly a new problem added or just added for
> today (and
> > the patient has had this problem before... as in chronic).  I think
> primary
> > care might have a different requirement than AMPATH in this case....
> >
> >
> >
> > -Andy
> >
> >
> >
> > --------------------
> > Andrew S. Kanter, MD MPH
> >
> > - Director of Health Information Systems/Medical Informatics
> > Millennium Villages Project Earth Institute, Columbia University
> > - Asst. Prof. of Clinical Biomedical Informatics and Clinical
> Epidemiology
> > Columbia University
> >
> >
> >
> > Email: [hidden email] <mailto:[hidden email]>
> > Mobile: +1 (646) 469-2421
> > Office: +1 (212) 305-4842
> > Skype: akanter-ippnw
> > Yahoo: andy_kanter
> >
> >
> >
> >
> >
> > ________________________________
> >
> > From: Burke Mamlin <[hidden email]
> <mailto:[hidden email]>>
> > To: [hidden email]
> <mailto:[hidden email]>
> > Sent: Monday, November 24, 2008 1:09:23 PM
> > Subject: Re: [OPENMRS-IMPLEMENTERS] Flagging a diagnosis as a repeat
> visit
> >
> > Andy,
> >
> >
> >
> > We record PROBLEM ADDED and PROBLEM RESOLVED observations for diagnoses.
> >  When we need the list of active problems (in the clinical summary
> module,
> > for example), we create a list of all PROBLEM ADDED without a later
> PROBLEM
> > RESOLVED.  So, duplicates of either (added or resolved) have no
> effect on
> > the final list.
> >
> >
> >
> > Eventually, we hope to have active lists within OpenMRS, so these
> problem
> > added/resolved observations can be supplemented with a trigger to add or
> > remove items from an active list of diagnoses.  In essence, this is just
> > doing the work at the time data are received instead of deferring it
> to the
> > time of retrieval... but it would undoubtedly be more
> efficient/easier in
> > the long run.
> >
> >
> >
> > -Burke
> >
> >
> >
> > On Nov 24, 2008, at 11:43 AM, Andrew Kanter wrote:
> >
> > Has anyone properly tagged their diagnoses on the form as being a new
> > visit/returned visit? We have been struggling over this for awhile and I
> > don't think it is properly recorded on the MOH forms either.
> However, if we
> > add a data element to the problem_added array for repeat visit
> > (reattendance) then the javascript function which calls the task
> pane has to
> > be redone. If we add a new array to keep track of those diagnoses
> which are
> > repeats, then we have to subtract them each time. Any other ideas here?
> >
> > It seems that best way to have done this would be to dynamically
> generate
> > the form so that it already included prior diagnoses on a list. Then
> they
> > could be checked as a reattendance, or even checked if they became
> resolved
> > (rather than clicking the remove problem button).
> >
> > Thanks!
> > Andy
> >
> >
> >
> > --------------------
> > Andrew S. Kanter, MD MPH
> >
> > - Director of Health Information Systems/Medical Informatics
> > Millennium Villages Project Earth Institute, Columbia University
> > - Asst. Prof. of Clinical Biomedical Informatics and Clinical
> Epidemiology
> > Columbia University
> >
> >
> >
> > Email: [hidden email] <mailto:[hidden email]>
> > Mobile: +1 (646) 469-2421
> > Office: +1 (212) 305-4842
> > Skype: akanter-ippnw
> > Yahoo: andy_kanter
> >
> >
> >
> > ________________________________
> >
> > Click here to unsubscribe from OpenMRS Implementers' mailing list
> >
> >
> >
> > ________________________________
> >
> > Click here to unsubscribe from OpenMRS Implementers' mailing list
> >
> > ________________________________
> >
> > Click here to unsubscribe from OpenMRS Implementers' mailing list
> >
> > ________________________________
> > Click here to unsubscribe from OpenMRS Implementers' mailing list
> > ________________________________
> > Click here to unsubscribe from OpenMRS Implementers' mailing list
> > ________________________________
> > Click here to unsubscribe from OpenMRS Implementers' mailing list
>
> _________________________________________
>
> To unsubscribe from OpenMRS Implementers' mailing list, send an e-mail
> to [hidden email] <mailto:[hidden email]>
> with "SIGNOFF openmrs-implement-l" in the  body (not the subject) of
> your e-mail.
>
> [mailto:[hidden email]
> <mailto:[hidden email]>?body=SIGNOFF%20openmrs-implement-l]
> ------------------------------------------------------------------------
> Click here to unsubscribe
> <mailto:[hidden email]?body=SIGNOFF%20openmrs-implement-l>
> from OpenMRS Implementers' mailing list

_________________________________________

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Maros Cunderlik Maros Cunderlik
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Re: Flagging a diagnosis as a repeat visit

Right, I was just writing that :) ...paper flowsheets are used during
the clinic visits. What happens next is that the new data entered on
the flowsheet (it has EMR? checkbox) gets put into infopath. The
infopath form looks like the paper flowsheet but it doesn't have all
the historical data which makes it particularly tedious for the data
entry officers -- making this easier and more consistent with the
paper flowsheet that implicitly provides the historical view is the
need we are planning to address by online flowsheet. One potential
side benefit is that we are hoping to be able to print out
new/replament flowsheets using the same mechanism.

As far as having providers do direct data entry, personally, I feel
like with proper hardware (i.e. medical grade tablet) certain types of
encounters can be handled directly by providers but that is not on the
radar screen at this point (at least not on mine).

Maros


On Sun, Nov 30, 2008 at 11:36 AM, Darius Jazayeri <[hidden email]> wrote:

> Hi Andy,
>
> We're not actually intending to do that. The clinicians are filling out a
> paper chart that looks like a flowsheet. The data clerks are going to enter
> that into a computer interface that looks like the same flowsheet.
>
> -Darius
>
> Andrew Kanter wrote:
>>
>> This is interesting, but we don't think we are going to be able to support
>> online entry for providers in the short term. We had hoped to have a more
>> dynamic form approach which would allow for printed forms with prior data.
>> Building something in Infopath would be cool, but doesn't have the longevity
>> requirement since we want to get off of infopath. Having an X-forms approach
>> to this would be great, so it is possible that we could move easily to
>> provider-entry when time was right.
>>
>> The flowsheet approach has been tossed around lately, and I think it is a
>> good idea for several reasons: 1) it reduces data entry, 2) it provides
>> historical data easily, and 3) it help group data for the provider to act
>> on. I am sure there are lots of other good reasons to do it... but we just
>> can't expect a computer on each providers table at the moment.
>>
>> Thanks again,
>> Andy
>>  --------------------
>> Andrew S. Kanter, MD MPH
>>
>> - Director of Health Information Systems/Medical Informatics
>> Millennium Villages Project Earth Institute, Columbia University
>> - Asst. Prof. of Clinical Biomedical Informatics and Clinical Epidemiology
>> Columbia University
>>
>>
>> Email: [hidden email]
>> Mobile: +1 (646) 469-2421
>> Office: +1 (212) 305-4842
>> Skype: akanter-ippnw
>> Yahoo: andy_kanter
>>
>>
>> ------------------------------------------------------------------------
>> *From:* Maros Cunderlik <[hidden email]>
>> *To:* [hidden email]
>> *Sent:* Sunday, November 30, 2008 12:08:57 PM
>> *Subject:* Re: [OPENMRS-IMPLEMENTERS] Flagging a diagnosis as a repeat
>> visit
>>
>> Andrew,
>>
>> I am in a process of helping to support management of data in openMRS
>> for chronic care, starting with heart failure. One of the first issues
>> from usability perspective is lack of longitudinal view in infopath
>> data entry for visits, labs,  meds, hospitalizations and diagnoses. We
>> are starting with just normal intake and follow up visit infopath
>> forms however what we are looking at next is replacing follow-up form
>> with an online flowsheet-style representation of data; this is what
>> the clinicians use on paper and having it online appears essential to
>> effective use of the system, especially for HF patients where
>> management of disease often requires frequent adjustments in regimen.
>> We looked at expanding infopath to be able to do this (i.e.
>> pre-populate infopath with existing diagnoses, hospitalizations, and
>> meds) however it wold be non-trivial amount of work and we feel like
>> if we are going to put some effort into it we may as well put it into
>> making online flowsheet-style pages as opposed to investing into
>> infopath. In mid-tem, what I imagine we will end up with is something
>> similar to what Dave T. did for PIH with MDR-TB module but for chronic
>> care starting with HF. Does this sounds like something you would be
>> interested in? If so do let me know. Hope this helps,
>>
>> Maros
>>
>>
>> On Sun, Nov 30, 2008 at 10:03 AM, Andrew Kanter <[hidden email]
>> <mailto:[hidden email]>> wrote:
>> > Ghislain,
>> > I would be interested in taking more of a look at this problem module.
>> > Are
>> > you also using the Program section to manage problems, or was this just
>> > an
>> > example in the screenshots? I especially like the timeline for problems,
>> > although one year might be too short for chronic problems and too long
>> > for
>> > acute ones. I still cannot see how an infopath form can be used to
>> > identify
>> > reattendance, so if anyone else has any ideas or is currently using a
>> > form
>> > which results in a report where new diagnoses are separated out from
>> > repeat
>> > visits I would really be interested in that.
>> > Thanks!
>> > Andy
>> >
>> > --------------------
>> > Andrew S. Kanter, MD MPH
>> >
>> > - Director of Health Information Systems/Medical Informatics
>> > Millennium Villages Project Earth Institute, Columbia University
>> > - Asst. Prof. of Clinicaral Biomedical Informatics and Clinical
>> > Epidemiology
>> > Columbia University
>> >
>> > Email: [hidden email] <mailto:[hidden email]>
>> > Mobile: +1 (646) 469-2421
>> > Office: +1 (212) 305-4842
>> > Skype: akanter-ippnw
>> > Yahoo: andy_kanter
>> >
>> > ________________________________
>> > From: "Kouematchoua, Ghislain" <[hidden email]
>> > <mailto:[hidden email]>>
>> > To: [hidden email]
>> > <mailto:[hidden email]>
>> > Sent: Tuesday, November 25, 2008 4:30:37 AM
>> > Subject: [OPENMRS-IMPLEMENTERS] AW: [OPENMRS-IMPLEMENTERS] Flagging a
>> > diagnosis as a repeat visit
>> >
>> > Hi Andy,
>> >
>> >
>> >
>> > for our test installation in Goettingen, we have developed a medical
>> > problem
>> > module, which allows a problem-oriented aggregation of patient data
>> > stored
>> > in OpenMRS. In our approach, each problem has a duration (opened date
>> > and
>> > closed date) and a description. To each new problem, you can add related
>> > existing problems of the patient. For example a diabetes patient who has
>> > hypertension or renal failure. Also, relevant existing encounters,
>> > programs,
>> > and observations records can be mapped to the new problem.
>> >
>> > Take a look at the screenshots attached.
>> >
>> >
>> >
>> > - Ghislain.
>> >
>> >
>> >
>> >
>> >
>> > Ghislain B. Kouematchoua Tchuitcheu, MSc.
>> >
>> > Medical Informatics Department
>> >
>> > University of Goettingen
>> >
>> > Robert-Koch-Str. 40
>> >
>> > 37075 Goettingen -Germany-
>> >
>> > Phone: +49-(0)551-3922842
>> >
>> > Fax:      +49-(0)551-3922493
>> >
>> >
>> >
>> > ________________________________
>> >
>> > Von: [hidden email] <mailto:[hidden email]>
>> > [mailto:[hidden email] <mailto:[hidden email]>] Im
>> > Auftrag
>> > von Darius Jazayeri
>> > Gesendet: Dienstag, 25. November 2008 06:58
>> > An: [hidden email]
>> > <mailto:[hidden email]>
>> > Betreff: Re: [OPENMRS-IMPLEMENTERS] Flagging a diagnosis as a repeat
>> > visit
>> >
>> >
>> >
>> > Hi Andy,
>> >
>> > Would it solve your problem if there were a portlet on the patient
>> > dashboard
>> > that showed active problems? Or do you need this to show in the infopath
>> > forms?
>> >
>> > In the old user-configurable patient summary I wrote an
>> > <openmrs:activeList/> tag, and that's still in the codebase. It would
>> > take
>> > 10 minutes to wrap it in a portlet and add it to the dashboard.
>> >
>> > You would basically specify which concept means problem added, which
>> > means
>> > concept removed, and a few other optional settings, and you get a table
>> > like:
>> >
>> > Active Problem
>> >
>> > Date added
>> >
>> > Recurring?
>> >
>> > Diabetes
>> >
>> > 08/02/2008
>> >
>> >
>> >
>> > Malaria
>> >
>> > 25/11/2008
>> >
>> > Yes
>> >
>> > It would probably be trivial to add the optional "recurring" column,
>> > which
>> > would be checked if the problem has been "added" more than once.
>> >
>> > You wouldn't be able to add problems from this interface. Or that would
>> > take
>> >>10 minutes of work.
>> >
>> > -Darius
>> >
>> > Andrew Kanter wrote:
>> >
>> > This is the same way we are using it. However, it is a bit confusing for
>> > actually documenting the reason for the current visit and it does not
>> > capture whether it is truly a new problem added or just added for today
>> > (and
>> > the patient has had this problem before... as in chronic).  I think
>> > primary
>> > care might have a different requirement than AMPATH in this case....
>> >
>> >
>> >
>> > -Andy
>> >
>> >
>> >
>> > --------------------
>> > Andrew S. Kanter, MD MPH
>> >
>> > - Director of Health Information Systems/Medical Informatics
>> > Millennium Villages Project Earth Institute, Columbia University
>> > - Asst. Prof. of Clinical Biomedical Informatics and Clinical
>> > Epidemiology
>> > Columbia University
>> >
>> >
>> >
>> > Email: [hidden email] <mailto:[hidden email]>
>> > Mobile: +1 (646) 469-2421
>> > Office: +1 (212) 305-4842
>> > Skype: akanter-ippnw
>> > Yahoo: andy_kanter
>> >
>> >
>> >
>> >
>> >
>> > ________________________________
>> >
>> > From: Burke Mamlin <[hidden email]
>> > <mailto:[hidden email]>>
>> > To: [hidden email]
>> > <mailto:[hidden email]>
>> > Sent: Monday, November 24, 2008 1:09:23 PM
>> > Subject: Re: [OPENMRS-IMPLEMENTERS] Flagging a diagnosis as a repeat
>> > visit
>> >
>> > Andy,
>> >
>> >
>> >
>> > We record PROBLEM ADDED and PROBLEM RESOLVED observations for diagnoses.
>> >  When we need the list of active problems (in the clinical summary
>> > module,
>> > for example), we create a list of all PROBLEM ADDED without a later
>> > PROBLEM
>> > RESOLVED.  So, duplicates of either (added or resolved) have no effect
>> > on
>> > the final list.
>> >
>> >
>> >
>> > Eventually, we hope to have active lists within OpenMRS, so these
>> > problem
>> > added/resolved observations can be supplemented with a trigger to add or
>> > remove items from an active list of diagnoses.  In essence, this is just
>> > doing the work at the time data are received instead of deferring it to
>> > the
>> > time of retrieval... but it would undoubtedly be more efficient/easier
>> > in
>> > the long run.
>> >
>> >
>> >
>> > -Burke
>> >
>> >
>> >
>> > On Nov 24, 2008, at 11:43 AM, Andrew Kanter wrote:
>> >
>> > Has anyone properly tagged their diagnoses on the form as being a new
>> > visit/returned visit? We have been struggling over this for awhile and I
>> > don't think it is properly recorded on the MOH forms either. However, if
>> > we
>> > add a data element to the problem_added array for repeat visit
>> > (reattendance) then the javascript function which calls the task pane
>> > has to
>> > be redone. If we add a new array to keep track of those diagnoses which
>> > are
>> > repeats, then we have to subtract them each time. Any other ideas here?
>> >
>> > It seems that best way to have done this would be to dynamically
>> > generate
>> > the form so that it already included prior diagnoses on a list. Then
>> > they
>> > could be checked as a reattendance, or even checked if they became
>> > resolved
>> > (rather than clicking the remove problem button).
>> >
>> > Thanks!
>> > Andy
>> >
>> >
>> >
>> > --------------------
>> > Andrew S. Kanter, MD MPH
>> >
>> > - Director of Health Information Systems/Medical Informatics
>> > Millennium Villages Project Earth Institute, Columbia University
>> > - Asst. Prof. of Clinical Biomedical Informatics and Clinical
>> > Epidemiology
>> > Columbia University
>> >
>> >
>> >
>> > Email: [hidden email] <mailto:[hidden email]>
>> > Mobile: +1 (646) 469-2421
>> > Office: +1 (212) 305-4842
>> > Skype: akanter-ippnw
>> > Yahoo: andy_kanter
>> >
>> >
>> >
>> > ________________________________
>> >
>> > Click here to unsubscribe from OpenMRS Implementers' mailing list
>> >
>> >
>> >
>> > ________________________________
>> >
>> > Click here to unsubscribe from OpenMRS Implementers' mailing list
>> >
>> > ________________________________
>> >
>> > Click here to unsubscribe from OpenMRS Implementers' mailing list
>> >
>> > ________________________________
>> > Click here to unsubscribe from OpenMRS Implementers' mailing list
>> > ________________________________
>> > Click here to unsubscribe from OpenMRS Implementers' mailing list
>> > ________________________________
>> > Click here to unsubscribe from OpenMRS Implementers' mailing list
>>
>> _________________________________________
>>
>> To unsubscribe from OpenMRS Implementers' mailing list, send an e-mail to
>> [hidden email] <mailto:[hidden email]> with
>> "SIGNOFF openmrs-implement-l" in the  body (not the subject) of your e-mail.
>>
>> [mailto:[hidden email]
>> <mailto:[hidden email]>?body=SIGNOFF%20openmrs-implement-l]
>> ------------------------------------------------------------------------
>> Click here to unsubscribe
>> <mailto:[hidden email]?body=SIGNOFF%20openmrs-implement-l> from
>> OpenMRS Implementers' mailing list
>
> _________________________________________
>
> To unsubscribe from OpenMRS Implementers' mailing list, send an e-mail to
> [hidden email] with "SIGNOFF openmrs-implement-l" in the  body
> (not the subject) of your e-mail.
>
> [mailto:[hidden email]?body=SIGNOFF%20openmrs-implement-l]
>

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Kouematchoua, Ghislain Kouematchoua, Ghislain
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AW: [OPENMRS-IMPLEMENTERS] Flagging a diagnosis as a repeat visit

In reply to this post by Andrew Kanter

Andy,

 

We are using existing Program, observation, and encounter in our manage problem section. The idea here is to make relevant information accessible from the problem section. I will send you access data to our installation.

 

Regards,

Ghislain

 

Ghislain B. Kouematchoua Tchuitcheu, MSc.

Medical Informatics Department

University of Goettingen

Robert-Koch-Str. 40

37075 Goettingen -Germany-

Phone: +49-(0)551-3922842

Fax:      +49-(0)551-3922493

 


Von: [hidden email] [mailto:[hidden email]] Im Auftrag von Andrew Kanter
Gesendet: Sonntag, 30. November 2008 17:04
An: [hidden email]
Betreff: Re: [OPENMRS-IMPLEMENTERS] Flagging a diagnosis as a repeat visit

 

Ghislain,

I would be interested in taking more of a look at this problem module. Are you also using the Program section to manage problems, or was this just an example in the screenshots? I especially like the timeline for problems, although one year might be too short for chronic problems and too long for acute ones. I still cannot see how an infopath form can be used to identify reattendance, so if anyone else has any ideas or is currently using a form which results in a report where new diagnoses are separated out from repeat visits I would really be interested in that.

 

Thanks!

Andy

 

--------------------
Andrew S. Kanter, MD MPH

- Director of Health Information Systems/Medical Informatics
Millennium Villages Project Earth Institute, Columbia University
- Asst. Prof. of Clinicaral Biomedical Informatics and Clinical Epidemiology
Columbia University

 

Email: [hidden email]
Mobile: +1 (646) 469-2421
Office: +1 (212) 305-4842
Skype: akanter-ippnw
Yahoo: andy_kanter

 

 


From: "Kouematchoua, Ghislain" <[hidden email]>
To: [hidden email]
Sent: Tuesday, November 25, 2008 4:30:37 AM
Subject: [OPENMRS-IMPLEMENTERS] AW: [OPENMRS-IMPLEMENTERS] Flagging a diagnosis as a repeat visit

Hi Andy,

 

for our test installation in Goettingen, we have developed a medical problem module, which allows a problem-oriented aggregation of patient data stored in OpenMRS. In our approach, each problem has a duration (opened date and closed date) and a description. To each new problem, you can add related existing problems of the patient. For example a diabetes patient who has hypertension or renal failure. Also, relevant existing encounters, programs, and observations records can be mapped to the new problem.

Take a look at the screenshots attached.

 

- Ghislain.

 

 

Ghislain B. Kouematchoua Tchuitcheu, MSc.

Medical Informatics Department

University of Goettingen

Robert-Koch-Str. 40

37075 Goettingen -Germany-

Phone: +49-(0)551-3922842

Fax:      +49-(0)551-3922493

 


Von: [hidden email] [mailto:[hidden email]] Im Auftrag von Darius Jazayeri
Gesendet: Dienstag, 25. November 2008 06:58
An: [hidden email]
Betreff: Re: [OPENMRS-IMPLEMENTERS] Flagging a diagnosis as a repeat visit

 

Hi Andy,

Would it solve your problem if there were a portlet on the patient dashboard that showed active problems? Or do you need this to show in the infopath forms?

In the old user-configurable patient summary I wrote an <openmrs:activeList/> tag, and that's still in the codebase. It would take 10 minutes to wrap it in a portlet and add it to the dashboard.

You would basically specify which concept means problem added, which means concept removed, and a few other optional settings, and you get a table like:

Active Problem

Date added

Recurring?

Diabetes

08/02/2008

 

Malaria

25/11/2008

Yes


It would probably be trivial to add the optional "recurring" column, which would be checked if the problem has been "added" more than once.

You wouldn't be able to add problems from this interface. Or that would take >10 minutes of work.

-Darius

Andrew Kanter wrote:

This is the same way we are using it. However, it is a bit confusing for actually documenting the reason for the current visit and it does not capture whether it is truly a new problem added or just added for today (and the patient has had this problem before... as in chronic).  I think primary care might have a different requirement than AMPATH in this case....

 

-Andy

 

--------------------
Andrew S. Kanter, MD MPH

- Director of Health Information Systems/Medical Informatics
Millennium Villages Project Earth Institute, Columbia University
- Asst. Prof. of Clinical Biomedical Informatics and Clinical Epidemiology
Columbia University

 

Email: [hidden email]
Mobile: +1 (646) 469-2421
Office: +1 (212) 305-4842
Skype: akanter-ippnw
Yahoo: andy_kanter

 

 


From: Burke Mamlin [hidden email]
To: [hidden email]
Sent: Monday, November 24, 2008 1:09:23 PM
Subject: Re: [OPENMRS-IMPLEMENTERS] Flagging a diagnosis as a repeat visit

Andy,

 

We record PROBLEM ADDED and PROBLEM RESOLVED observations for diagnoses.  When we need the list of active problems (in the clinical summary module, for example), we create a list of all PROBLEM ADDED without a later PROBLEM RESOLVED.  So, duplicates of either (added or resolved) have no effect on the final list.

 

Eventually, we hope to have active lists within OpenMRS, so these problem added/resolved observations can be supplemented with a trigger to add or remove items from an active list of diagnoses.  In essence, this is just doing the work at the time data are received instead of deferring it to the time of retrieval... but it would undoubtedly be more efficient/easier in the long run.

 

-Burke

 

On Nov 24, 2008, at 11:43 AM, Andrew Kanter wrote:

 

Has anyone properly tagged their diagnoses on the form as being a new visit/returned visit? We have been struggling over this for awhile and I don't think it is properly recorded on the MOH forms either. However, if we add a data element to the problem_added array for repeat visit (reattendance) then the javascript function which calls the task pane has to be redone. If we add a new array to keep track of those diagnoses which are repeats, then we have to subtract them each time. Any other ideas here?

It seems that best way to have done this would be to dynamically generate the form so that it already included prior diagnoses on a list. Then they could be checked as a reattendance, or even checked if they became resolved (rather than clicking the remove problem button). 

Thanks!
Andy

 

-------------------- 
Andrew S. Kanter, MD MPH 

- Director of Health Information Systems/Medical Informatics
Millennium Villages Project Earth Institute, Columbia University
- Asst. Prof. of Clinical Biomedical Informatics and Clinical Epidemiology
Columbia University

 

Email: [hidden email] 
Mobile: +1 (646) 469-2421
Office: +1 (212) 305-4842
Skype: akanter-ippnw
Yahoo: andy_kanter

 


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