Visits in OpenMRS 1.9


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for the OpenMRS University Forum on 20-Jun-2012

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Visits in OpenMRS 1.9

  1. 1.
  2. 2. From the upcoming version of the OpenMRS Guide at A Visit in OpenMRS represents exactly what it sounds like: a time period when a patient is actively interacting with the healthcare system, typically at a location. The metadata differentiating different types of visits is a Visit Type. Visit Types are displayed in the user interface, and can be searched against. A visit containsEncounters, which store more granular data about treatments or services. Historical note: Encounters were supposed to be what Visits are, but we got them wrong…
  3. 3.  Visit  Encounter ◦ Patient ◦ Patient ◦ Visit Type ◦ Encounter Type ◦ Location (optional) ◦ Location (optional) ◦ Start DateTime ◦ DateTime ◦ End DateTime  i.e. a single instant  i.e. a duration ◦ Providers ◦ Contains Encounters ◦ Contains Obs Think of an Encounter as a “data collection transaction” or a “clinical transaction”
  4. 4.  A big improvement in our information model ◦ Especially if you’re doing point-of-care work If you already have workflows and forms built around encounters, shifting to visits may require significant work and reconfiguration. Disabling visits lets you continue with the old model
  5. 5.  Visit Types Assigning Encounters to Visits Auto-closing Visits Visit Attributes
  6. 6.  To categorize Visits Displayed in the UI Make them granular enough for meaningful use: Outpatient Primary Care is better than just Outpatient Just a Name and Description ◦ In the future Visit Type may drive which encounters are allowed/expected in a visit
  7. 7.  Reporting and Reporting Compatibility don’t let you search on them ◦ If you want this, create a ticket or vote for it! HTML Form Entry and XForms don’t explicitly support visits ◦ thus you need to configure automatic assignment of encounters to visits
  8. 8.  Choose one of the two “Assign …” options As each encounter is created (assuming it doesn’t have a visit specified explicitly) it will be assigned to a visit with: ◦ encounter location is visit.location or a sublocation ◦ visit start <= encounter datetime<= visit end “Create New” option also requires you to set “Encounter Type to Visit Type Mapping” GP This is all very new. Let us know how it works out. Tickets welcome!
  9. 9.  HTML Form Entry works fine with Visits if you configure your forms right!Bad:<encounterDate default=“today”/>Good:<encounterDate default=“now” The UI creates visits showTime=“true”/> starting “now.” An encounter at 00:00 today cannot be assigned to a visit started at 9:15.
  10. 10.  ??? ◦ I haven’t used XForms in OpenMRS 1.9. ◦ I assume it works. ◦ Can someone comment?
  11. 11.  Outpatient visits typically do not have an official check-out Need to auto-close outpatient visits, or they If you’re building a custom UI, you will never get closed. probably want something like this: Inpatient visits typically have a real-life discharge workflow.
  12. 12.  Custom attributes, Recorde d for each visit Virtual “columns” in the visit table Arbitrary use cases. I can’t think of any good examples. :-)
  13. 13.  Data collected pre-1.9 doesn’t have visits We need to improve this UI a bit ◦
  14. 14.  Start Visit defaults to “now”. Add Visit asks you to enter the date Billing code should be shown as required. We have some UI issues to work out.
  15. 15. Avoid these in productionat the moment…
  16. 16.  Encountersgrouped byvisit Active Visits highlighted
  17. 17.  Entering a form adds an encounter to the visit ◦ With the correct setup (note the ugly time widget)
  18. 18.  Header shows encounters in active visit Visits tab shows encounters grouped by visit
  19. 19.  Close a visit from the dashboard header ◦ In 1.9.1 a popup will let you confirm the datetime on “End Visit Now” ◦ Otherwise, “Edit Visit”, set end datetime, and save.
  20. 20.  Allowed to have simultaneous visits (intentionally)
  21. 21.  Manually assigning encounters to visits is tedious (partly due to poor UI) ◦ ◦ Won’t actually let you do the obvious wrong thing
  22. 22. 20-Jun-2012 djazayeri@pih.orgAny Questions?