How to create a Patient Clinical Summary using Reporting Module

There are been various approaches to creating Patient Summaries (Patient Summary Module) or Clinical Summaries (Clinical Summary Module) in the past. Unfortunately, these modules are not compatible with the latest versions of OpenMRS but the need to create patient-centric summary reports still exists. As a workaround, you can create a patient summary using the Reporting Module.

Creating the Patient Clinical Summary

1. Build a Data Set Definition (or multiple data sets) to contain all of the data for the fields you want to include on your patient summary. You should specify a parameter to pass the person into the Data Set. For example, you could create an SQL Data Set backed by an SQL query. This example SQL uses the CIEL Concept Dictionary concept ID's.

   SQL Data Set Definition Example Expand source

   SELECT `patient_identifier`.`identifier`, 
   CONCAT(UPPER(`family_name`), ', ',`given_name`) as patient_name,
   `admission_encounter`.`encounter_datetime` as admission_datetime, 
   `discharge_encounter`.`encounter_datetime` as discharge_datetime, 
   CONCAT(`admission_encounter`.`encounter_id`, ', ', `discharge_encounter`.`encounter_id`) as encounter_id, 
   (SELECT CONCAT(`provider_name`.`family_name`, ', ', `provider_name`.`given_name`) as provider FROM `person_name` as `provider_name` WHERE `provider_name`.`preferred` = 1 AND `provider_name`.`voided` = 0 AND `provider_name`.`person_id` = (SELECT `person_id` FROM `provider` WHERE `provider_id` = (SELECT provider_id FROM encounter_provider WHERE voided = 0 AND encounter_id = `discharge_encounter`.`encounter_id` LIMIT 1) LIMIT 1 ) LIMIT 1) as provider,
   (SELECT CONCAT_WS(', ',(SELECT `name` FROM `concept_name` WHERE `voided` = 0 AND `locale` IN ('en','fr') AND `concept_id` = `value_coded`  AND `concept_name_type` = 'FULLY_SPECIFIED' ORDER BY `locale` DESC LIMIT 1),(SELECT GROUP_CONCAT(`value_text` SEPARATOR ', ')  FROM `obs` WHERE `concept_id` = 160531 AND `obs`.`encounter_id` = `discharge_encounter`.`encounter_id` AND `voided` = 0))  FROM `obs` WHERE `concept_id` = 5219 AND `obs`.`encounter_id` = `admission_encounter`.`encounter_id` AND `voided` = 0) as chief_complaint,
   (SELECT CONCAT_WS(', ',(SELECT name FROM concept_name WHERE voided = 0 AND locale in ('en','fr') AND concept_id=`value_coded` ORDER By locale DESC LIMIT 1),(SELECT GROUP_CONCAT(`value_text` SEPARATOR ', ')  FROM `obs` WHERE `concept_id` = 162879 AND `obs`.`encounter_id` = `discharge_encounter`.`encounter_id` AND `voided` = 0)) as concept_name  FROM `obs` WHERE `concept_id` = 1655 AND `obs`.`encounter_id` = `admission_encounter`.`encounter_id` AND `voided` = 0) as admission_reason,
   (SELECT CONCAT_WS(', ', GROUP_CONCAT(UPPER((SELECT `name` FROM `concept_name` WHERE `voided` = 0 AND `locale` IN ('en','fr') AND `concept_id` = `diags`.`value_coded`  AND `concept_name_type` = 'FULLY_SPECIFIED' ORDER BY `locale` DESC LIMIT 1)) SEPARATOR ', '),(SELECT GROUP_CONCAT(UPPER(`diags`.`value_text`) SEPARATOR ', ') FROM `obs` as diags, `obs` as diag_type WHERE `diags`.`concept_id` = 161602 AND `diags`.`encounter_id` = `discharge_encounter`.`encounter_id` AND `diag_type`.`encounter_id` = `discharge_encounter`.`encounter_id` AND `diags`.`voided` = 0 AND `diag_type`.`voided` = 0 AND `diags`.`obs_group_id` = `diag_type`.`obs_group_id` AND `diag_type`.`concept_id` = 159394 AND `diag_type`.`value_coded` = 159393))  FROM `obs` as diags, `obs` as diag_type WHERE `diags`.`concept_id` = 1284 AND `diags`.`encounter_id` = `admission_encounter`.`encounter_id` AND `diag_type`.`encounter_id` = `discharge_encounter`.`encounter_id` AND `diags`.`voided` = 0 AND `diag_type`.`voided` = 0 AND `diags`.`obs_group_id` = `diag_type`.`obs_group_id` AND `diag_type`.`concept_id` = 159394 AND `diag_type`.`value_coded` = 160250) as ddx_diags,
   (SELECT GROUP_CONCAT(`value_text` SEPARATOR ', ')  FROM `obs` WHERE `concept_id` = 163104 AND `obs`.`encounter_id` = `discharge_encounter`.`encounter_id` AND `voided` = 0) as treatment_description,
   (SELECT GROUP_CONCAT(`value_text` SEPARATOR ', ')  FROM `obs` WHERE `concept_id` = 163046 AND `obs`.`encounter_id` = `discharge_encounter`.`encounter_id` AND `voided` = 0) as cardio,
   (SELECT GROUP_CONCAT(`value_text` SEPARATOR ', ')  FROM `obs` WHERE `concept_id` = 159573 AND `obs`.`encounter_id` = `discharge_encounter`.`encounter_id` AND `voided` = 0) as bedside_echo,
   (SELECT GROUP_CONCAT(`value_text` SEPARATOR ', ')  FROM `obs` WHERE `concept_id` = 160689 AND `obs`.`encounter_id` = `discharge_encounter`.`encounter_id` AND `voided` = 0) as resp,
   (SELECT CONCAT('Hémaglobine:',`value_numeric`,' g/dL - ',`comments`) as heme  FROM `obs` WHERE `concept_id` = 21 AND `encounter_id` = `discharge_encounter`.`encounter_id` AND `voided` = 0) as heme,
   (SELECT CONCAT('Créatine kinase:',`value_numeric`,' IU/L') as heme FROM `obs` WHERE `concept_id` = 21 AND `obs`.`encounter_id` = `discharge_encounter`.`encounter_id` AND `voided` = 0) as creatine,
   (SELECT GROUP_CONCAT(`value_text` SEPARATOR ', ')  FROM `obs` WHERE `concept_id` = 160983 AND `obs`.`encounter_id` = `discharge_encounter`.`encounter_id` AND `voided` = 0) as renal,
   (SELECT GROUP_CONCAT(`comments` SEPARATOR ', ')  FROM `obs` WHERE `concept_id` = 1284 AND `value_coded` = 151673 AND `obs`.`encounter_id` = `discharge_encounter`.`encounter_id` AND `voided` = 0) as infectious_disease,
   (SELECT GROUP_CONCAT(`value_text` SEPARATOR ', ')  FROM `obs` WHERE `concept_id` = 160951 AND `obs`.`encounter_id` = `discharge_encounter`.`encounter_id` AND `voided` = 0) as gastro,
   (SELECT GROUP_CONCAT(`comments` SEPARATOR ', ')  FROM `obs` WHERE `concept_id` = 1284 AND `value_coded` = 142089 AND `obs`.`encounter_id` = `discharge_encounter`.`encounter_id` AND `voided` = 0) as endocrine,
   (SELECT GROUP_CONCAT(`value_text` SEPARATOR ', ')  FROM `obs` WHERE `concept_id` = 163109 AND `obs`.`encounter_id` = `discharge_encounter`.`encounter_id` AND `voided` = 0) as neuro,
   (SELECT GROUP_CONCAT(`value_text` SEPARATOR ', ')  FROM `obs` WHERE `concept_id` = 163108 AND `obs`.`encounter_id` = `discharge_encounter`.`encounter_id` AND `voided` = 0) as social,
   (SELECT (SELECT `name` FROM `concept_name` WHERE `voided` = 0 AND `locale` IN ('en','fr') AND `concept_id` = `value_coded`  AND `concept_name_type` = 'FULLY_SPECIFIED' ORDER BY `locale` DESC LIMIT 1) as concept_name  FROM `obs` WHERE `concept_id` = 163105 AND `obs`.`encounter_id` = `discharge_encounter`.`encounter_id` AND `voided` = 0) as disposition,
   (SELECT GROUP_CONCAT(UPPER((SELECT `name` FROM `concept_name` WHERE `voided` = 0 AND `locale` IN ('en','fr') AND `concept_id` = `meds`.`value_coded`  AND `concept_name_type` = 'FULLY_SPECIFIED' ORDER BY `locale` DESC LIMIT 1)) SEPARATOR ', ')  FROM `obs` as meds, `obs` as stop_date WHERE `meds`.`concept_id` = 1282 AND `meds`.`encounter_id` = `discharge_encounter`.`encounter_id` AND `stop_date`.`encounter_id` = `discharge_encounter`.`encounter_id` AND `meds`.`voided` = 0 AND `stop_date`.`voided` = 0 AND `meds`.`obs_group_id` = `stop_date`.`obs_group_id` AND `stop_date`.`concept_id` = 1191 AND date(`discharge_encounter`.`encounter_datetime`) = `stop_date`.`value_datetime`) as meds_discontinued,
   (SELECT GROUP_CONCAT(UPPER((SELECT name FROM concept_name WHERE voided = 0 AND locale in ('en','fr') AND concept_id=`value_coded` AND `concept_name_type` = 'FULLY_SPECIFIED' ORDER By locale DESC LIMIT 1)) SEPARATOR ', ') FROM `obs` WHERE `concept_id` = 162692 AND `obs`.`encounter_id` = `discharge_encounter`.`encounter_id` AND `voided` = 0) as meds_on_discharge,
   (SELECT `value_text`  FROM `obs` WHERE `concept_id` = 163106 AND `obs`.`encounter_id` = `discharge_encounter`.`encounter_id` AND `voided` = 0) as instructions,
   (SELECT CONCAT_WS(', ', GROUP_CONCAT(UPPER((SELECT `name` FROM `concept_name` WHERE `voided` = 0 AND `locale` IN ('en','fr') AND `concept_id` = `diags`.`value_coded`  AND `concept_name_type` = 'FULLY_SPECIFIED' ORDER BY `locale` DESC LIMIT 1)) SEPARATOR ', '),(SELECT GROUP_CONCAT(UPPER(`diags`.`value_text`) SEPARATOR ', ') FROM `obs` as diags, `obs` as diag_type WHERE `diags`.`concept_id` = 161602 AND `diags`.`encounter_id` = `discharge_encounter`.`encounter_id` AND `diag_type`.`encounter_id` = `discharge_encounter`.`encounter_id` AND `diags`.`voided` = 0 AND `diag_type`.`voided` = 0 AND `diags`.`obs_group_id` = `diag_type`.`obs_group_id` AND `diag_type`.`concept_id` = 159394 AND `diag_type`.`value_coded` = 160250))  FROM `obs` as diags, `obs` as diag_type WHERE `diags`.`concept_id` = 1284 AND `diags`.`encounter_id` = `discharge_encounter`.`encounter_id` AND `diag_type`.`encounter_id` = `discharge_encounter`.`encounter_id` AND `diags`.`voided` = 0 AND `diag_type`.`voided` = 0 AND `diags`.`obs_group_id` = `diag_type`.`obs_group_id` AND `diag_type`.`concept_id` = 159394 AND `diag_type`.`value_coded` = 160250) as final_diags
   FROM `person_name`,`patient_identifier`, `encounter` as discharge_encounter, `encounter` as admission_encounter WHERE `person_id` = :person AND `person_name`.`person_id`= `patient_identifier`.`patient_id` AND `patient_identifier`.`patient_id` = `discharge_encounter`.`patient_id` AND `patient_identifier`.`voided`=0 AND `person_name`.`voided`=0 AND `patient_identifier`.`preferred`=1 AND `person_name`.`preferred`=1 AND `patient_identifier`.`identifier_type`=3 AND `discharge_encounter`.`voided` = 0 AND `admission_encounter`.`encounter_type` = 4 AND `discharge_encounter`.`encounter_type` = 3 AND `admission_encounter`.`visit_id` = `discharge_encounter`.`visit_id` AND `admission_encounter`.`location_id` = `discharge_encounter`.`location_id` ORDER BY `discharge_encounter`.`encounter_datetime` DESC LIMIT 1

2. Create a Custom Report (Advanced) which calls the Data Set (or data sets) you created in step 1. This will also need to have a parameter of type 'person'. The person parameter in the report should be mapped to the person parameter in the data set. For example...
   
   

3. Create an 'HTML/Text-based Template' type of Report Renderer (sometimes referred to as an Output Design Template or a Report Design). From the report, click the down arrow under the Output Designs section. Choose 'HTML/Text-based Template and click Add Another. Enter a name and description.  Then write some HTML to format your report. The Report Definition and Script Type can remain unchanged. In your definition, variables can be labeled with pound sign before and after like #patient_name#.

   A sample HTML definition which works with the SQL example above would be like...

   Report Template Definition Expand source

   <!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Frameset//EN" "http://www.w3.org/TR/html4/frameset.dtd">
   <html>
   <head>
   <meta charset="UTF-8">
   <title>Note d'Exeat de l'ICU</title>
   <style>
     .summarytable {
     width:670px;
     border:2px solid black;
     border-collapse:collapse;
     padding:5px;
     }
     .summarytable th {
     border:1px solid black;
     padding:1px;
     background:azure;
     text-align:left;
     font-family:tahoma;
     }
     .summarytable td {
     border:1px solid black;
     padding:1px;
     text-align:left;
     font-family:tahoma;
     }
   </style>
   </head>
   <body>
   <table class="summarytable">
   <tr>
     <th colspan="2"><center><h1>Note d'Exeat de l'ICU</h1></center></th>
   </tr>
   <tr>
     <td><b>NOM DU PATIENT:</b></td>
     <td>#patient_name#</td>
   </tr>
   <tr>
     <td><b>IDENTIFICATEUR:</b></td>
     <td>#identifier#</td>
   </tr>
   <tr>
     <td><b>MÉDECIN:</b></td>
     <td>#provider#</td>
   </tr>
   <tr>
     <td><b>DATE/HEURE D'ADMISSION:</b></td>
     <td>#admission_datetime|dd/MMM/yyyy HH:mm#</td>
   </tr>
   <tr>
     <td><b>DATE/HEURE D'ÉXEAT:</b></td>
     <td>#discharge_datetime|dd/MMM/yyyy HH:mm#</td>
   </tr>
   <tr>
     <td><b>NUMÉRO DE RENCONTRE:</b></td>
     <td>#encounter_id#</td>
   </tr>
   <tr>
     <td><b>PLAINTE PRINCIPALE:</b></td>
     <td>#chief_complaint#</td>
   </tr>
   <tr>
     <td><b>RAISON DE L'ADMISSION EN ICU:</b></td>
     <td>#admission_reason#</td>
   </tr>
   <tr>
     <td><b>DDX:</b></td>
     <td>#ddx_diags#</td>
   </tr>
   <tr>
     <th colspan="2"><b>BRÈVE DESCRIPTION DE SÉJOUR EN ICU:</b></th>
   </tr>
   <tr>
     <td colspan="2">#treatment_description# </td>
   </tr>
   <tr>
     <th colspan="2"><b>CARDIOVASCULAIRE:</b></th>
   </tr>
   <tr>
     <td colspan="2">#cardio# </td>
   </tr>
   <tr>
     <th colspan="2"><b>BEDSIDE ÉCHO:</b></th>
   </tr>
   <tr>
     <td colspan="2">#bedside_echo# </td>
   </tr>
   <tr>
     <th colspan="2"><b>RESPIRATOIRE:</b></th>
   </tr>
   <tr>
     <td colspan="2">#resp# </td>
   </tr>
   <tr>
     <th colspan="2"><b>HEME:</b></th>
   </tr>
   <tr>
     <td colspan="2">#heme# </td>
   </tr>
   <tr>
     <th colspan="2"><b>CREATINE:</b></th>
   </tr>
   <tr>
     <td colspan="2">#creatine# </td>
   </tr>
   <tr>
     <th colspan="2"><b>MALADIES INFECTIEUSES:</b></th>
   </tr>
   <tr>
     <td colspan="2">#infectious_disease# </td>
   </tr>
   <tr>
     <th colspan="2"><b>ENDOCRINE:</b></th>
   </tr>
   <tr>
     <td colspan="2">#endocrine# </td>
   </tr>
   <tr>
     <th colspan="2"><b>NEUROLOGIQUE:</b></th>
   </tr>
   <tr>
     <td colspan="2">#neuro# </td>
   </tr>
   <tr>
     <th colspan="2"><b>DERNIÈRES DISPOSITIONS:</b></th>
   </tr>
   <tr>
     <td colspan="2">#disposition# </b></td>
   </tr>
   <tr>
     <th colspan="2"><b>MÉDICAMENTS PRÉSCRITS AU PATIENT AU MOMENT DE L'ÉXEAT:</b></th>
   </tr>
   <tr>
     <td colspan="2">#meds_on_discharge# </td>
   </tr>
   <tr>
     <th colspan="2"><b>EDUCATION DU PATIENT; INSTRUCTIONS À LA FAMILLE:</b></th>
   </tr>
   <tr>
     <td colspan="2">#instructions# </td>
   </tr>
   <tr>
     <th colspan="2"><b>DIAGNOSTIC FINAUX:</b></th>
   </tr>
   <tr>
     <td colspan="2">#final_diags# </td>
   </tr>
   </table>
   </body>
   </html>

Running the Patient Summary

It would be ideal to be able to click to run the report directly from the patient dashboard. That functionality is requested at 

    {
        "id": "referenceapplication.legacyRunICUReport",
        "label": "Run Legacy ICU Report",
        "description": "Run the ICU Discharge Summary through legacy UI",
        "extensions": [
            {
                "id": "referenceapplication.legacyRunICUReportLink",
                "extensionPointId": "org.openmrs.referenceapplication.homepageLink",
                "type": "link",
                "label": "Imprimer ICU Décharge Résumé",
                "url": "module/reporting/run/runReport.form?reportId=76cfc87a-9e88-4d39-acc7-ed68d4beb1f7",
                "icon": "icon-print",
                "order": 20,
                "requiredPrivilege": "Task: referenceapplication.simpleDischarge"
            }
        ]
    }

The interface to run the report looks like this. Choose the patient (by name or identifier), and select the "Output To:" to reflect the HTML/Text renderer you created. Then click Request Report.

Note: The user will need to open the generated report of extension 'null' in their web browser.

The final report example using the SQL and HTML template above would look like ICU_Discharge_Sum.pdf that was printed to PDF from the web browser.

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