During the implementation, the implementation team, which consists of the Doctors also, soon realized that, due to the flexibility in the HTMLForms and Concept Dictionary, any type of data can be captured very effectively using multiple modularized forms. But, as the patient data entered using multiple forms will span across multiple encounters, a Consultant Doctor needs to look up each of the forms to get an idea of the Patients medical condition. The Doctor has only few minutes to go over each patient record in an already crowded public health domain. It will increase the Doctors work several fold. As a result, it seems, currently in several OpenMRS implementations there is a tendency of creating one long form with multiple sections and data is entered retroactively for a period of time, so that the patient record is viewed at once.
We are proposing a Patient Clinical Summary Module to be developed in this project
a) To realize the true potential of encounter concept, so that a Patients medical history is time-stamped and b) the data entry is easier with multiple form based encounter
As OpenMRS implementation can be very different from one site to another, so the Patient Clinical Summary View will be different from one implementation to another. So, it is important that the Clinical Summary need to be configured based on concept dictionary and encounters chosen.
Implementation: MissionArogya - ArogyaNet
A. Clinical Summary Template function :
Users (Doctors) should be able to select concepts to define the template for a clinical summary.
It can be implemented as
a) Tag in HTMLForm (example: A tag to display a table of lab results)
b) A wizard like tool , where the user can choose the different concepts and ordering of the concepts in the form
c) An ideal solution will be to have a WYSIWYG editor, which combines the wizard concept as well as the formatting concept
The doctor may decide to include specific "Encounters" that are important to create a final template of clinical summary
The doctor may save this template , so that it can be used by other doctors.
(I am not sure if these nice to have can be implemented easily)
Some specific Requirements (from Joaquin):
1. There should be a button to print the summary which shows just the summary and not the entire page
2. Should be able to show observations that have been entered for the patient
a. Can choose whether it's the first or last chronologically, the lowest or highest, or all, as is done in the reporting and reporting compatibilty module
3. Should be able to select to view or not view the last 5 to 10 encounters a. Should be able to select how many are displayed b. Should have an option to choose if the encounter name is a link that takes you to the form
4. Should be able to place graphs of any numeric concept as in the Graphics tab in the Patient Page
5. Should be able to show patient flags (https://modules.openmrs.org/modules/view.jsp?module=patientflags)
6. Should be able to select to show which program the patient is in (as in the Description tab in the Patient page)
7. This should be an additional tab in the patient page, and not a link in the patient summary as in the current Patient Summary Module
8. There should be a default view which should be able to be set depending on the user's role, though if the user has the modify clinical summary privilege they should be able to change it. This change should only affect their view.
a. If the user is able to edit the clinical summary, they should also be able to save it in a template which another user can upload to their page to have the same view. This assumes that it would be a system with the same data dictionary