The aim of this project
OpenMRS is used by a "group" of clinics and medical practices. These clinicis and medical practices are able to share information following an information sharing protocol for purposes of treatment and-or research.
Medical clinician is granted access via a referral letter by an existing medical clinician with access rights, or by being assigned the patient by medical record administrator during registration. Patients may request access be granted to a clinician by asking a clinician with access rights write a referral letter to their nominated clinician.
All patients are identified by universal ID. (Citizen ID)
Clinicians are identified by universal ID. (Provider ID)
Medical and Medical Research institutions are identified by universal ID. (Institution ID)
Patient presents to their General Practitioner (GP).
In the OpenMRS system used by the GP, any GP working in this GP clinic has read-write-edit permissions, on this patient record. All access, including simple viewing, will be logged.
GP uses OpenMRS to write a referral letter to specialist, selects specialist from a list with Ids attached. The creation and transmission of the referral letter allows specialist to view-copy the patient records of the referred patient held on GP System.
The specialist will not be using the same OpenMRS system as is used by the GP. The specialist was assigned the patient during the patient record creation process on the system used by the specialist. The specialist has full read-write-edit access to records they create, view-copy access to records created by the GP.
The geographic separation of the OpenMRS systems may be substantial.
Specialist may use OpenMRS to write a referral letter to second specialist. Second specialist may now view first specialist records for this patient and the patient records held in the GP OpenMRS system for this patient. Permissions follow the referral letter "chain" no matter how long the chain becomes. The geographic distance between specialists may be substantial.
Patient may advise GP they allow their records to be used in medical research. A research institution may then follow the referral letter permissions path to collect data in from all contributing clinicians.
Clinicians may flag, should their patient data be used in research, they wish to be provided with a copy of the report of the research findings.
Special Note: To complete the example, and more fully explain the permission path, say the GP refers a patient with a form of cancer to an Oncologist in an Oncology Department of a large Hospital. After accepting the referral the Oncologist realises a Colleague may well be better suited to assist this patient. There is little point in having the GP write a second referral, the Oncologist deemed better suited will simply "take over" patient care. As they have full access on the oncology OpenMRS System they can view the patient information on the GP OpenMRS, as the two OpenMRS sytems "recognise" each other.
Research Clarification: Where patient data is used anonymously then data maybe used at the clinicians discretion. Clinician may flag they wish to ahve a report of findings. Where the patient maybe contacted, ie identified, then a referral will be written with patient consent by the clinician to the Research Institute. Referral permissions then follow.
Research example questions:
- incidence of cancers; planning of transportation services for cancer patients
- the geographical distribution of cancers (mine, power line, or occupational proximity)
- the change in depression measures with economic /political events
- change in diabetes control with exercise levels
Documentation / How-To
In design phase.
This module is being developed by a group of students of the University of Wollongong as part of their degree programme.
It is expected the subject will be undertaken in second half 2012, beginning July, 2012.