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STATUS:  Proposal for Comments

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Written Summary of Applications Structure

The OpenMRS Flow application is divided into two primary areas: HOME and PATIENT FILE.

1.  HOME

The HOME section is designed to be highly flexible. 

It can be customized to a user based on their User Role / Location / and Clinic Type. When a user loads the application, they can be prompted to select their user role, location, and clinic type. How often and which of these variables a user can set is a configurable setting.

The purpose of the HOME screen is to help the user know which patient they need to see as fast as possible. It also can show important information: such as key report metrics, or organization notifications.

Users can select their next patient via:

  • Search
  • Worklists 
    • Patient lists
      • Auto-generated by parameter. Example
        • Lab result
        • New consult
        • Missed clinic 
        • Recent Patients
        • By Location
        • By User Name
      • User maintained lists
    • Clinic Queue / appointments
    • To-Do lists

Selecting a patient from HOME opens that the PATIENT FILE

2.  PATIENT FILE

The patient file contains both the PATIENT WORKSPACE and the PATIENT CHART.

2a. PATIENT WORKSPACE 

The PATIENT WORKSPACE helps the user quickly start a new visit and workflow. Examples of workflows may be Follow Up Standard HIV Visit, or New Diabetes Visit, or Mental Health Screening, or General Clinic Visit.

The workflow brings together in one place (ideally even one page), all the information a clinicians requires for that workflow. Such as,

  1. Patient information to be displayed (e.g. Active medications, recent vitals).
  2. Patient information to be captured (e.g. questionnaire)
  3. The actions that need to be performed for that patient (e.g. book appointment, order medication)

The goal is to have a large library of pre-build components that can be assembled into this type of a workflow builder. The goal is to greatly simplify the clinician's experience of the EHR, improve the clinician's efficiency and increase the flexibility to build new unique OpenMRS deployments.

Note: The term 'form' is not used, because a form typically does not have all three of these functions. Until a new workflow builder is build that works across all OpenMRS implementations, an organization's existing forms can be placed in the space of the application reserved for the Workflows.

2b. PATIENT CHART

The PATIENT CHART is available if information the user requires is not displayed part of the workflow. This contains

  1. A set of tabs a clinician would expect to find in the patient file, such as Biography, Notes, Therapy, Results.
  2. A Timeline tab, where users can see a history of the patient's Appointments/Encounters, Orders, and any information in the chart they want sorted by time.
  3. An Issues tab, that contains both past medical history, and active issues.
  4. A series of flex tab(s), that are auto-inserted based on the workflow the clinician was in when they switched from the WORKSPACE to the PATIENT CHART. For instance, if the user was in an HIV follow up appointment, when they opened the PATIENT CHART, they would first see the HIV Summary tab that was inserted as the flex tab.

Users can enter information directly into the patient chart section if they like; however, most of the time this data capture will occur within the WORKSPACE section.


Advantages of separating the patient workspace and the patient chart.

  1. It enables multi-tasking on mobile, tablet, and desktop. The ability to switch between documentation/orders, and reviewing clinical information is a highly requested user feature. 
  2. It has a highly flexible area: WORKSPACE. This enables organizations to easily customize the application based on their users, care settings and workflows using off the shelf components.
  3. It has a well build PATIENT CHART. It's design will follow best practice for the display of clinical information. This chart is flexible enough that it can be used across a wide variety of clinical settings and users. The flexible-tab insertion, enables a customized tab to be inserted into the patient chart based on the workflow (or user, or location type). This enables organizations to focus on building workflows and a single clinical summary page and not have to spend redundant time building generic patient charts.

Patient Identify

Patient Banner: information required to identify the patient

Patient Cover: when the patient banner is clicked, the patient cover opens fullscreen. It contains additional key information that has to be at a clinician's fingertips. Such as ID numbers that are frequently written on paper. In theory, the patient cover could be configured based on User Role / Location / Clinic. 



Simple Diagram of Application's Major Regions

The following simple diagrams show the PATIENT FILE, and how the user can move between the WORKSPACE and PATIENT CHART, and even view both of these at the same time.


Mobile


Tablet


Alternative way to split screen (side-by-side). May be option for larger tablets. For smaller tablets a bottom drawer works better.


Desktop


On desktop, there is the possibility of having multiple 'tabs' of the patient chart open at once.



Flow Chart of App Navigation



References

Further background on this navigational structure.


Overview of EHR Layout

The 3 (+1) essential tasks of an EHR

Simple EHR workflow: only 2 screens

HOME

Primary Purpose of the EHR HOME screen

Ways to search for a patient in the EHR

PATIENT FILE

What is the Patient File? - EHR UX

The Patient Workflow: it's not just a form.

PATIENT FILE: major UX regions

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