All this feedback has been helpful… I definitely would be interested additional thoughts on Mike’s point about a “Provider Role” in his previous email… we are likely to model CHWs as Providers in the system. However, there are different CHW roles that define what kind of services the CHW could provide. We could track the role(s) a CHW has by creating a ProviderAttributeType of “CHW Role”, or, possibly, a more generic “Provider Role”, and it sounds like this may be the preferred approach. But associating a role with a provider seems like a standard enough need that relegating it to a custom attribute type seems like the wrong (at least long-term) solution.
Thoughts? Mark From: [email protected] [mailto:[email protected]] On Behalf Of Burke Mamlin Sent: Wednesday, March 14, 2012 10:02 AM To: [email protected] Subject: Re: [OPENMRS-DEV] Modelling Provider Types and Provider Services in OpenMRS Sorry, didn't mean to be glib. I was in clinic, so could only throw out some thoughts. Probably should've mentioned that. Jonah created a household module that we should cultivate. I would like to see OpenMRS evolve to have more robust cohorts along with cohort-level observations that would subsume much of what Jonah has created in his module. But that will take some design conversations & some time to get in place. OpenMRS core will be unlikely to meet all the needs of any specific CHW program out of the box, since the personnel management, scheduling needs, etc. for a CHW program are likely to go beyond the scope of an EMR. I believe what PIH folks are trying to do (and I applaud them for it) is to try to tease out the common needs across CHW programs so that efforts can leverage OpenMRS in a consistent way and go toward a single, shared module instead of everyone creating their own. -Burke On Tue, Mar 13, 2012 at 10:45 PM, Friedman, Roger (CDC/CGH/DGHA) (CTR) <[email protected]<mailto:[email protected]>> wrote: Burke, I think this reply is a little glib for the CHW situation. CHWs tend to be household-based or geography-based, making the relationship model a little bit gimpy. CHWs also tend to be program oriented, so the CHW needs to be a provider of program services for programs in which they have been trained. Also, their encounters tend to be group-oriented, for which we don’t have easy data entry mechanisms. I think it would be useful to convene a brainstorming session around CHWS, maybe Andy Kanter could make happen. From: [email protected]<mailto:[email protected]> [mailto:[email protected]<mailto:[email protected]>] On Behalf Of Burke Mamlin Sent: Tuesday, March 13, 2012 12:26 PM To: [email protected]<mailto:[email protected]> Subject: Re: [OPENMRS-DEV] Modelling Provider Types and Provider Services in OpenMRS 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 to track what services are being provided to what patients. Additionally, we need to track the dates over which a CHW provided 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
