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The Issue

This is a weekly clinical report that will automatically be sent via email to clinicians and data team from all PIH-support HCs in Rwanda. These reports will provide patient details for patients falling into several high risk categories, assisting the clinical team in being able to intervene rapidly for patients at high risk.

Indicators are being finalized but will include :

  1. Suspected immunological failure
  2. Declining CD4 and due to present this week (% to be determined by clinical team)
  3. Any patients with a new CD4 count below 100
  4. Following patients with a new CD4 count below 350
  5. Patients on TB treatment awaiting AR start (with anticipated ART start date listed)
  6. Patients newly meeting lost to followup criteria

I will send through a document with these definitions

of course Justin challenged me to recreate the whole user interface for the reporting framework

this is work in progress but your feedback would be highly appreciated....

My approach

The issue was to create reports for High Risk patients

ART monitoring is needed
• to determine when to start therapy
• to monitor adverse events and
• to monitor response to treatment

For me, the main indicators that were uniform and could be applied on all patients fall into 3 main categories...

  1. Cd4 count
  2. Viral load(abbreviated as VL)
  3. Clinical staging based on the WHO classification of disease.

To tackle the above issue, I divided the queries into two groups….

  1. Monthly high risk report
  2. Weekly high risk report
    The difference between the two reports is that for the monthly report we will be generating a monthly summary and for these patients we may not have necessarily be due to attend to them in the coming clinic week….
    For the weekly high risk report is just for patients that were seen in the past(irrespective if this falls within the month of seeing them) but are due to attend the scheduled clinic in the coming week……

Below are flowcharts to expound further on the two……

Monthly High Risk Report flow chart

  1. Select * patients from database
  2. Select patients attended over the last 1 month
  3. Check user criteria(CD4 count/ WHO count/ Viral Load )---for the example I will use CD4 count
  4. Check CD4 count at present(a)
  5. Check CD4 count previous(b)
  6. If a<b
  7. Calculate % drop
  8. b-a/a X100
  9. get other details to show in the dataset
  10. save record
  11. loop for all patients meeting the criteria..

Weekly High Risk Report

  1. Select all patients
  2. Check the date of the next appointment
  3. If between week 1 and week 2
  4. Check selected user criteria(CD4 count/ WHO staging/ Viral Load)---I will use CD4 count to show this example
  5. Check cd4 count at present=a
  6. Check previous cd4 count=b
  7. If a<b
  8. Calculate % drop
  9. b-a/a X100
  10. get other details to show in the dataset
  11. save record
  12. loop for all patients meeting the criteria..

Main User Interface

Monthly High Risk Report

Weekly High Risk Report

Create Your Own Patient Report

Dataset Examples

View the final appearance of the datasets after running the reports