Hi Darius,Thanks for the feedback. I didn't mean to imply that one "provider type" per Provider is necessarily correct (though since you could have multiple providers per person, this is yet another way one could design it, with a person filling multiple provider roles by being linked to multiple provider entries, each with a different type - thus my call for some best practice guidance).
I also feel like I recall some discussion around a "provider role" extension to Provider once upon a time, which maybe was shelved for the first pass at Provider. A many-to-many mapping between a Provider and a set of job-titles / functional roles would seem to be a decent solution to consider.
I didn't actually know that EncounterRole existed. It doesn't seem like it ties into Providers at all, so although you can say that Person X was the "Nurse" for this Encounter, you can't easily configure which Providers in your system can take on the "Nurse" EncounterRole. Or am I not seeing this? I think that adding this link would be more appropriate than tagging, as it would provide a direct utility to help drive user interfaces by limiting the Providers to an appropriate subset for a given question like "What Nurse / Lead Surgeon / CHW was involved in this encounter?"
The more we can flesh out whether there are patterns in what we are trying to do for our CHW Management / Dashboard, and what a generic set of requirements that many implementations will have around Provider Management (including roles, services able to perform, HR structure / supervisory roles, etc), as well as the best practices for how to track services performed (Relationships vs. Encounters vs. Visits vs. Obs vs. Mythical Episodes of Care), then the more we will be able to make this module something that will be of broader use to the community. It will also vastly increase the chance of some of this getting contributed to OpenMRS trunk, rather than buried in our CHW module...
Thanks, Mike On 03/13/2012 11:08 PM, Darius Jazayeri wrote:
I think that being able to tag providers is more useful than giving them a single type. Nobody is both a Surgeon and a CHW, but I can imagine other provider categorizations where you'd want someone to have >1 of them.We definitely discussed (and opted to delay) letting encounter metadata specify minOccurs/maxOccurs constraints for the number of providers they'd need for given encounter roles. And if we're going to do that we'd want a mechanism for saying what types of providers could fill which encounter roles.Seems like you could start off by creating a "Provider Type" attribute, with minOccurs = 0, maxOccurs=infinity, and plan to eventually migrate that to a tag when that gets added.-DariusOn Tue, Mar 13, 2012 at 5:58 PM, Michael Seaton <[email protected] <mailto:[email protected]>> wrote:Thanks Ben and Burke, One thing Mark brings up is the notion that we want to be able to model Types of Providers, as well as the types of services that they can provide. Is there any notion of this built into the 1.9 Provider model or the future road map for Provider? Is the intention that ProviderAttribute is meant to provide sufficient flexibility to encapsulate either Provider Types or Provider Services (or Provider anything else) as needed? If so, I get that, but want to confirm that this is the direction intended. I could see a case for modeling one or both of these explicitly, as it would seem that ProviderType is something we are going to frequently want to support (eg. show a list of all Surgeons on form X, or all Community Health Workers on page Y). Mike On 03/13/2012 12:26 PM, Burke Mamlin wrote:The encounter represents a clinical transaction in our model, so as Ben suggests, a provider providing clinical services for a patient would fall into an encounter, which (eventually) could generate any number of observations, orders, notes, or form data. For denoting ongoing relationships between persons (e.g., providers & patients), we would use the relationship model. To connect multiple encounters over time, you could use the visit model (created to group encounters, but usually representing a series of contiguous encounters) or the yet-to-be-implemented episodes of care, which are designed to connect encounters related to a treatment program across multiple, possibly non-contiguous, visits (e.g., pregnancy). FWIW, I believe we added (or planned to add) date ranges to relationships; however, if you want to track "service" (possibly for billing purposes), then I would suggest using visits, since that's where an account number would go. Note that these aren't mutually exclusive. For example, you could create relationships to track relationships between accompagnateurs and their patients and still record encounters +/- visits for clinical transactions between the provider and their patient. -Burke On Tue, Mar 13, 2012 at 11:59 AM, Mark Goodrich <[email protected] <mailto:[email protected]>> wrote: Ben, Hmm… that may be the way to do it generically, but I don’t know if it works for us since we need to model this over time. Mark *From:*[email protected] <mailto:[email protected]> [mailto:[email protected] <mailto:[email protected]>] *On Behalf Of *Ben Wolfe *Sent:* Tuesday, March 13, 2012 11:39 AM *To:* [email protected] <mailto:[email protected]> *Subject:* Re: [OPENMRS-DEV] Modelling Provider Types and Provider Services in OpenMRS Would you be able to store these as the encounterrole for that CHW for each encounter? Ben On Tue, Mar 13, 2012 at 11:21 AM, Mark Goodrich <[email protected] <mailto:[email protected]>> wrote: I’ve been looking at the new Provider model in 1.9, and I was wondering if thought has been put into modeling provider types (Cardiologist, PCP) and specific provider services, and how to record that a provider provided a specific service to a patient. Do we have a vision as to how we may want to model this going forward? The reason I’m asking is that I’m currently working on determining how PIH wants to model Community Health Workers within our system, and I’m considering how they may fall into a more generic provider structure. We want to be able to handle various types of CHWs (Accompagnateurs, Pallative care workers, Community Health Nurses) that provide various services (HIV accompaniment, end-of-life care, etc) that we’d like to be able to model, and then we’d like to be able totrack what services are being provided to what patients. Additionally, we need to track the dates over which a CHWprovided such a service, ie: “Accompagnateur A provided HIV accompaniment to Patient B from 1/2/2010 to 3/4/2011” At first, it seems like Relationships would be the way to model this kind of interaction, since a relationship defines a relationship between two people, and (as of 1.9) can have a start date and an end date. However, it doesn’t quite seem to be the right way to do this, primarily because a relationship is a Person-to-Person relationship, when what we are modeling is a Provider-to-Patient relationship. It seems like this is an archetypical relationship in an EMR that it may make sense to model in a different manner than general relationships. Take care, Mark ------------------------------------------------------------------------ Click here to unsubscribe <mailto:[email protected]?body=SIGNOFF%20openmrs-devel-l>from OpenMRS Developers' mailing list------------------------------------------------------------------------ Click here to unsubscribe <mailto:[email protected]?body=SIGNOFF%20openmrs-devel-l> from OpenMRS Developers' mailing list ------------------------------------------------------------------------Click here to unsubscribe <mailto:[email protected]?body=SIGNOFF%20openmrs-devel-l> from OpenMRS Developers' mailing list
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