We've bounced up against it for a while. I've been warning of the potential conflict between organizational roles & application roles for a while. One of the themes coming out of implementation feedback is for improvements to roles & permissions, so this might get "rolled" into that effort. Historically, I've pictured organizational roles distinct from the application roles (our roles & permissions tables) to ensure that application roles are explicitly distinct from the permissions system. In any case for CHW roles, using a "Provider Role" provider attribute type would probably meet your short-term needs and easily translate when/if a better solution comes along.
-Burke On Wed, Mar 14, 2012 at 1:31 PM, Mark Goodrich <[email protected]> wrote: > I hadn’t heard of “Organizational Role” but I just glanced at the wiki > page and it looks interesting… if it existed now, I think we’d consider > using it to model CHW Roles… is Organizational Role something that is on > the roadmap, or just in the brainstorming stage now? **** > > ** ** > > Mark**** > > ** ** > > ** ** > > *From:* [email protected] [mailto:[email protected]] *On Behalf Of *Darius > Jazayeri > *Sent:* Wednesday, March 14, 2012 12:47 PM > > *To:* [email protected] > *Subject:* Re: [OPENMRS-DEV] Modelling Provider Types and Provider > Services in OpenMRS**** > > ** ** > > The other relevant point is "Organizational Role", which is something we > intend to attach to Person.**** > > ** ** > > Perhaps we'd use the same thing for providers in the long run?**** > > ** ** > > -Darius**** > > On Wed, Mar 14, 2012 at 9:24 AM, Burke Mamlin <[email protected]> > wrote:**** > > I would use a provider attribute type of "Provider Role", as you suggest. > It's likely that this could be rolled into the provider table and making > that change should be relatively straightforward.**** > > ** ** > > It's worth noting that provider, like user, is itself a role, not a > distinct person. This means that we'd allow for a single person to have > multiple entries in the provider table (e.g., a doctor who practices in two > subspecialties) linked to the same person. So, I wouldn't worry about > allowing multiple provider roles for a single provider record; rather, make > separate provider entries when multiple provider roles are needed for the > same person.**** > > ** ** > > Our long-term goal is for the effort of representing distinct individuals > to happen at the person level. While we all know that data always can get > messy, our assumption is that an individual shouldn't be more than one > person (that's why we created a merge feature for persons). Users, > providers, and – eventually, probably only with a major API version change > – even patient could/should be allowed (at the API level) to be many-to-one > to person.**** > > ** ** > > -Burke**** > > ** ** > > On Wed, Mar 14, 2012 at 12:01 PM, Mark Goodrich <[email protected]> wrote: > **** > > **** > > 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]> 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]] *On Behalf Of *Burke > Mamlin > *Sent:* Tuesday, March 13, 2012 12:26 PM**** > > > *To:* [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]> 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]] *On Behalf Of *Ben Wolfe > *Sent:* Tuesday, March 13, 2012 11:39 AM > *To:* [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]> 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<[email protected]?body=SIGNOFF%20openmrs-devel-l>from > OpenMRS Developers' mailing list > **** > > **** > ------------------------------ > > Click here to > unsubscribe<[email protected]?body=SIGNOFF%20openmrs-devel-l>from > OpenMRS Developers' mailing list > **** > > ** ** > ------------------------------ > > Click here to > unsubscribe<[email protected]?body=SIGNOFF%20openmrs-devel-l>from > OpenMRS Developers' mailing list > **** > > ** ** > ------------------------------ > > Click here to > unsubscribe<[email protected]?body=SIGNOFF%20openmrs-devel-l>from > OpenMRS Developers' mailing list > **** > ------------------------------ > Click here to > unsubscribe<[email protected]?body=SIGNOFF%20openmrs-devel-l>from > OpenMRS Developers' mailing list > _________________________________________ To unsubscribe from OpenMRS Developers' mailing list, send an e-mail to [email protected] with "SIGNOFF openmrs-devel-l" in the body (not the subject) of your e-mail. 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