A visit to a health facility is most often remembered for the time spent in waiting. This is at best a waste of patient time and at worst an extended period of discomfort or deterioration in a medical condition.
OpenMRS can provide the mechanisms to minimize waiting and improve the deployment of services towards better patient outcomes.
Effective triage of patients at each node in an encounter.
Improve throughput of patients by identifying service bottlenecks and monitoring improvement programs
Background and strategic fit
Every health facility is in a constant conflict between service quality and available resources.
OpenMRS should provide the information and tools to help resolve the conflict by ensuring efficient and effective use of resources while objectively measuring key aspects of service quality.
- Workflow management would be integrated into each step of the the patient encounter.
- The workflow and service definition and relationships would be independent of facility type.
|1||Workflow within OpenMRS|
The long term goal would be to be able to (ideally graphically) describe the workflow associated with each patient encounter type. The workflow would have to support conditional branches and iterations.
Initially this may be implemented in a more basic form by the extension of the concept of location.
At the start an encounter a patient would enter a workflow path by being assigned to a service (currently this is location). A user would be responsible for the management of one or more services and have visibility of all patients currently assigned to the service with time of assignment and other encounter attributes like urgency.
The intersection of patient encounter with service would have an associated status eg waiting initial consultation, in process, waiting secondary service, reassigned, complete, discharged. A status change would be time-stamped.
While "in process" a number of secondary assignments could be made eg lab request, radiology with similar facilities to manage the the patient encounter queue and status.
Historical data should be available to report maximum and average number (and/or service time) of patient encounters and for a given service and status over a given time period e.g. what is the maximum waiting time for a lab test between the hours of 18.00 and 06.00.
I would imagine that a number of workflow management tools contain these facilities and may form a model for more detailed technical design.
User interaction and design
Below is a list of questions to be addressed as a result of this requirements document: