Inpatient Care Module User Guide

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Last updated: Aug 18, 2010Version comment
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<html><head><title></title></head><body>h1. Overview
For an overview visit the module homepage.

Installation

The Medical Problem Module must be running prior to installing this module.

Location Management

This module extends the locations (e.g. a hospital) of OpenMRS with three new hierarchy levels – department, specialty and room. Each of these new types has been given an own administration page (Administration → Manage Departments/Encounters/Rooms). Their administration is analogous to that of regular locations. Unlike other types, rooms contain some additional data, therefore their administration will be explained in detail.

The page shown in Figure 1 contains a list of currently existing rooms. Each room will be listed with its details, such as its parent specialty, department and location, as well as its bed capacity. The 'Current Patients' column will list the number of patients currently occupying a bed in that room. Clicking on that number will take you to the list of these patients (given you have the 'View Patients' privilege). Clicking on the room name, as well as the 'Add Room' link (1) will open a form for room creation/editing (Figure 2). To delete a room, check the box to the left of its name (2) and press the delete button (4).

Note: Deleting a record of any type will also delete all of its children (e.g. deleting a hospital location record will also delete all of its departments, as well as their specialties and rooms). Also, you cannot delete a room that has been used in an existing encounter record.

The room creation/editing form (Figure 2) contains the following elements:

  1. In the 'Specialty' drop down menu you have to select the specialty record that will be the parent of the room.
  2. The room name (or room number) is the name that will be displayed in encounter records.
  3. The room capacity expresses the total number of beds in a room. This number will be used to calculate the vacancy for this room. If this room is not a bedroom, you can leave this field blank or set it to '0'.
  4. You can write (optional) notes for this room, such as a possible quarantine status or maintenance requirements.

Management of departments and specialties is very similar (although they lack the 'Capacity' fields) and will not be explained in detail.

Patient Dashboard Functions

This module adds new content to the OpenMRS patient dashboard. This includes an 'Inpatient Care' tab (Figure 4), which is a specialized version of the regular 'Encounters' tab. It will list inpatient care (parent) encounters, as well as their child encounters (a parent encounter will be listed using a regular sized font, while its child encounters will have a smaller font, see Figure 3). Clicking on one of the 'Edit' icons (1) will open the corresponding record details on the encounter management page (see “Encounter Management†below). In addition, there is a link for creating a new encounter record (2) for this patient, which will also take you to the encounter management page.

Note: The core OpenMRS application cannot differ between outpatient and inpatient care encounters, so be careful when using the regular 'Encounters' tab, as all encounters (outpatient, inpatient parent and inpatient child) will be listed there without further identification. It is therefore recommended to use 'INPATIENTCARE' encounter types (added by this module) when creating inpatient care encounters (for better visual identification).

A new box has also been added to the 'Overview' tab. It displays a time line of encounters for the last 12 months (see Figure 3), with a visible difference between outpatient and inpatient care encounters (as well as their child encounters). A list of of these encounters will be displayed underneath for individual access (press the “Toggle Encounter List†button to display the list).

Encounter Management

The 'Manage Encounters' section on the OpenMRS administration panel (Administration → Manage Encounters) will take you to an extended encounter management section (Figure 5).

This page has been extended by several new items.

  1. The 'Inpatient Care?' check box will let you select whether you wish the new encounter to be an inpatient care parent. For existing encounters, it will either display “true†if this is a parent encounter or a link to the parent encounter (if it is a child encounter). Note: Once the encounter has been saved, the value of this check box can no longer be modified!
  2. You must choose the level of the location hierarchy to be used for this encounter (location, department, specialty or room, see Location Management).
  3. Afterwards, select the location from the list (the list changes depending on the selected level). If the selected location type is 'Room', the listed items will show their available capacity (vacant beds/total beds). Rooms with no vacant beds will be highlighted red (this, however, is just a warning, and it is still possible to place a patient in that room).
  4. An additional date record that expresses the date of discharge. Leave blank if the patient has not been discharged yet.
  5. If a discharge date has been recorded, you are given the option generate a discharge letter.
  6. The list of child encounters will contain all child encounters of an inpatient care parent encounter (and only if this is a parent encounter!), from which the individual pages for each child encounter can be accessed. Previously recorded (non-parent) encounters can be added by selecting one from the drop down menu and using the 'Save' button (Note: Only encounters that lie within the time frame of the parent encounter will be listed). The 'Add New Child Encounter' link will open a new encounter creation page, with the current encounter already assigned as its parent.
  7. Finally, there is the usual list of observations for the encounter (both parent and child encounters can have observations). For example, a parent encounter could have observations with data that describes the inpatient care stay in general (e.g. admission notes), while child encounter observations could record the tests, orders and procedures.

Discharge Letters

When a discharge date has been set on an encounter, you are given the option to generate a PDF discharge letter (Figure 6). The generated letter is an XML message adhering to the Belgian KMEHR standard (Kind Messages for Electronic Healthcare Records), which is in return used to generate the PDF document. In the future, these message could be made available electronically, provided the appropriate service are available in OpenMRS.

  1. First, you must select a recipient. The recipient can be any Person defined in the system.
  2. You can optionally uncheck any data items you want excluded from the discharge letter (items that are declared mandatory by KMEHR cannot be unchecked).
  3. When all adjustments are made, press the 'Update' button.
  4. The PDF icon appears. Click on it to generate and download the PDF document.

Note: Habits and allergies are currently not supported.

More on the KMEHR discharge letter message format

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