Dear Faustin,
Sorry I did not get back to you after Implementers Conference as promised,
got involved with raxa-jss lab module which hopefully will reach a decent state
soon.
I think you need to be concerned about the fact that what the doctor
orders is typically a panel of tests, e.g. whole blood count, and there are
many results, e.g. white blood count, platelet count, leukocyte number,
hemogloblin. So the order will reference a set and the observations will be of
set members. Note that even things that might not look like a set may turn out
to be one -- CD4 count and CD4 percent as results from a CD4 test; HIV rapid
test result, initial test kit lot number, confirmatory test kit lot number from
an HIV test.
You also need to take care because OpenMRS allows only one test and one
accession number per order. This is not always the case -- TB diagnosis
requires 2 or 3 sputum specimens, depending on the protocol.
Dave is certainly right in noting 3 different steps -- the order, the
specimen collection and the testing. Note that at order time, there is no
specimen ID/accession number (unless you are dealing with a specimen collected
by the doctor, like a skin snip or a pus specimen).
Also note that you can have an encounterless observation. That is, the
result would be linked back to the lab order and not to a third-step encounter.
So your statuses become:
* pending -- order exists with no accession number, no discontinued date and no
linked obs
* discontinued -- order exists with discontinued date
* collected -- order exists with accession number, no discontinued date, and no
linked obs
* completed -- order exists with no discontinued date and linked obs
From: [email protected] [mailto:[email protected]] On Behalf Of Dave Thomas
Sent: Tuesday, February 07, 2012 7:13 PM
To: [email protected]
Subject: Re: [OPENMRS-DEV] How to assign exams results to one Lab encounter
when the exams are ordered on the same date?
Hi Faustin. For Openmrs1.6, you should add the obs with the test results to
the original encounter. They shouldn't be added as just Obs with no encounter
associated with them. The model should be that the result obs are saved
inside the original encounter, and each result obs should have its 'order'
property set to the Order for that test.
And, accession_number is the sample/specimen Id. And autoExpireDate is really
mostly for drugOrders -- it says that an order will be stopped on that day (in
the future).
d
On Tue, Feb 7, 2012 at 12:16 AM, Maniragena faustin
<[email protected]<mailto:[email protected]>> wrote:
Hi Dave,
Just realized you didn't understand very well the question.So, allow me to
explain in details the work flow of Lab module.
1Step:On patient dashboard I created a new tab called " Lab order".When you
click on this tab you get a list of all oderable exams at Health Center or
Hospital.By asking the patient relevant questions,the clinician will be able
to select exams to be ordered for more diagonisis. When the selected Lab exams
are ordered ,the Encounter between the patient and Clinician is created.
Note:This page with Lab order is intended for Physician/Clinician ordering Lab
exams.
2nd Step:After the clinician orders lab exams,the patient leaves for Laboratory
to give the sample of those ordered exams in first step.On the basis of patient
name or identifier the laboratory technician automatically loads all ordered
tests from the system for that specific patient and ordered tests are dis
played as it looks like below:
Number
OrderId
Test Name
Ordered on
Status
1
4560
hemoglobin
02/02/2012
incomplete
2
4561
CD4
02/02/2012
incomplete
3
4562
Malaria Smear
02/02/2012
incomplete
4
4562
Stool exam
02/02/2012
incomplete
The result will be added later in next step.
Note:This table above is viewed by Laboratory tecnician when he is checking the
orders for a specific patient
3rd step:When results are available ,the next step is to add the results.The
Lab technician click on incomplete status and get the form below from it the
result will be filled in.
Patient
Benz Jean
Observation date
Location
Test
Hemoglobin
Results
SAVE
When this form is Saved,the encounter whose encounter type is Laboratory
encounter type is created.Now the key challenge I 'm facing is to add results
for all exams and links them to this Last Lab encounter that created at this
3rd step.
Note;This forms is saved as obs.
For further information on your Lab entry,How do u manage the sample and
specimen number of exams?In which table are the specimen number saved?What
does autoExpireDate, AccessionNumber (from Order properties) mean?
I think the work flow can make you the logic we are using.
Faustin.
On Tue, Feb 7, 2012 at 3:01 AM, Dave Thomas
<[email protected]<mailto:[email protected]>> wrote:
Hi Faustin. I don't totally understand the question, but if you nemed to say
what test results correspond to what Obs, there's the property Obs.orderId that
lets you explicitly join an Obs (the test result) to the Order.
If you mean, 'should there be different Encounters for 1) the physician
ordering the lab test 2) the sample collection and 3) the test result becoming
available', the answer is this:
In newer version of openmrs, there's a Visit object, that is a parent object to
Encounter, that allows you to group multiple Encounters into a Visit.
However, for openmrs1.6, i would only use one Encounter, and then use an Obs to
ask all the questions that need to be added, like:
Encounter (primary care provider, date, location)
Order (the lab order) (during the primary care visit)
Obs: Specimen collection date, specimen collection time, specimen
collected by, specimen ID, etc... (during sample collection)
Obs: test result, test result date, test result time, test performed
by... (while recording the test result)
And, test results can be linked back to the Order by Obs.setOrder(Order
order)
d
On Sun, Feb 5, 2012 at 12:51 PM, Maniragena faustin
<[email protected]<mailto:[email protected]>> wrote:
Hi All;
I'm working on Laboratory orders and results managements.With this Lab
module,I've to create one encounter when the clinician is ordering laboratory
orders for a specific Patient.Another encounter of type Laboratory encounter
type need to be created when the Laboratory Technician is adding the results
to ordered tests by the clinician and this is where I'm facing the challenge of
creating one encounter that has those results as observations.If the ordered
tests are ordered on the same date must be have one Lab encounter.So,to make
you understand this questions,below is an example of Patient DAIHATSU and
Clinician TOYOTA till the exams results are available:
* The clinician/physician(TOYOTA) orders laboratory order for DAIHATSU
patient and save them into the system :The first Encounter between the patient
and clinician is created.
* After being consulted,the DAIHATSU leaves for Laboratory to give
specimen.
* When DAIHATSU arrives in Laboratory ,the Lab technician A loads the
ordered lab exams from the system and collects the specimen based on the
laboratory orders assigned to that Patient.
* When the results are available,the Lab technician click on incomplete
status and add add results relevant to the ordered exams(below are listed exams
and their status)
Number
OrderId
Test Name
Ordered on
Status
1
4560
hemoglobin
02/02/2012
incomplete
2
4561
CD4
02/02/2012
incomplete
3
4562
Malaria Smear
02/02/2012
incomplete
4
4562
Stool exam
02/02/2012
incomplete
The table above is given by the following code; for (Order order :
labOrders){
String orderStrDate=df.format(order.getStartDate());
if (orderStrDate.equals(labEncounterDateStr)) {
if (order.getAutoExpireDate()==null) {
incompleteLabOrders.add(order);
}
}
}
Is there any way to create one encounter for all those exams when we want to
add the results as observations?
I'm waiting to hear from you.
Thanks
--
MANIRAGENA Faustin
MOH/EMR DEVELOPER
Phone:0788670135
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--
MANIRAGENA Faustin
MOH/EMR DEVELOPER
Phone:0788670135
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