So to add on to what Ben has described...

What we are looking for is something like the the active problem list 
functionality to carry the current recommendations for immunizations. Right now 
we are stuck in having to save this information as OBS. To do this, we either 
append an OBS to a current encounter with the recommendation in a concept, or 
we create a new encounter to hold the OBS. The issue is that we expect to run 
the recommendation algorithm nightly or weekly. This would create a ton of 
unwanted encounters if each time we created a new encounter from the procedure. 
If we update the OBS for an existing encounter then we have the issue of the 
encounter date either not matching the OBS date, or by changing the encounter 
we break a rule of EHRs but essentially deleting the old encounter and creating 
a new one with the current information.

The last quirk has to do with the xforms module and the past medical history 
display. If we decide to just keep appending the OBS to an existing (older) 
encounter... will the obs display in reverse chronological order in ODK display 
or will it look only at the encounter date (not the obs datetime) and display 
all the OBS for that encounter on the first page (not workable).

Thanks for the advice!
Andy (and Ben)
 
-------------------- 
Andrew S. Kanter, MD MPH 

- Director of Health Information Systems/Medical Informatics
Millennium Villages Project, Earth Institute, Columbia University
- Asst. Prof. of Clinical Biomedical Informatics and Clinical Epidemiology
Columbia University

Email: [email protected] 
Mobile: +1 (646) 469-2421
Office: +1 (212) 305-4842
Skype: akanter-ippnw
Yahoo: andy_kanter



>________________________________
> From: benjamin rukundo <[email protected]>
>To: [email protected] 
>Sent: Friday, April 27, 2012 4:14 PM
>Subject: [OPENMRS-DEV] what could be the best scenario for saving patient 
>cohors observation ?
> 
>
>Hi all,
>
>I'm working on the immunization module, and the module provides immunization 
>recommendation for patients, currently we have expanded the immunization 
>recommendation to be accessible on mobile phone so the immunization 
>recommendations are saved as text data type in obs table and these 
>immunization recommendations are downloaded from a mobile phone to be viewed. 
>The idea is to save the immunization recommendation for a cohort of patient eg 
>children < 5 years old.
>
>instead of saving new encounter for each audit date on a daily or weekly basis 
>to get the latest immunization recommendations which will create many 
>encounters for one patient
>2 options are proposed
>
>Option 1) we create an "immunization recommendation" encounter if not already 
>there. If one exists, we append a new obs with the date of the audit.
>as new audits are
 done, we simply append new OBS to the same old encounter but save 
(obs_datetime) with the audit date as the OBS date
>
>Option 2)  we do the same as option 1 but change the encounter date to the 
>current audit date.
>
>On the phone, we should only view OBS information (the historical information) 
>for a given concept not sure if this sorts by OBS datetime or encounter date 
>time ?
>
>Thanks
>
>
>
>Benjamin RUKUNDO
>EMR Programmer
>
>MVP-Rwanda
> 
>________________________________
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