International Patient Summary Support in OpenMRS

Owned by Grace Potma
Last updated: Aug 10, 2024 by Casey Iiams-Hauser
3 min read

Lead by ITECH DIGI

The following is a brainstorming roadmap for the development of support for FHIR based IPS ingestion, viewing, and generation in OpenMRS O3. This is being used as a guide for how we view the baseline requirements for both the MVP 1 and MVP 2 versions of the work, and for how to conduct the initial development cycle for those.

The work is being initially developed by a small squad of folks including @Reagan patrick Makoba @Samuel Male @Christopher Miiro @Ian Bacher @Piotr Mankowski @Casey Iiams-Hauser @Jan Flowers.

User Stories

  1. I have a patient seen in a single facility A, who moves to another facility B with OpenMRS. Providers in facility B need to be able to view records from facility A in the facility B OpenMRS EMR.

  2. I have a patient seen in a single facility A with OpenMRS, who moves to another facility B. I need to send records for my patient from the facility A OpenMRS EMR to be consumed/displayed by providers at facility B.

Breakdown MVP requirements:

  1. Ingesting (Consume) and Saving IPS - MVP 1

    1. identification of correct patient to request patient summary records

    2. No storage of historical data within the medical record, but simply as a single JSON object to be displayed (read-only summary)

    3. For MVP - can we make an assumption about the identification of the patient and request for the IPS?

      1. assume user is manually going into patient record and requesting record correctly

      2. likely need some display functionality of showing potential summaries/matches and accepting the summary to be attached to the patient - human adjudication of the summary

      3. assume the ID from OMRS is managed well and is NOT going to be adjudicated from the IPS view feature.

      4. assume the “client registry” could be internal or external - need rules around the processing based on that client registry use

  2. Display IPS - MVP 1

    1. In test format only (read-only)

    2. Add a visual component to the patient chart.

  3. Generate IPS from OMRS data within a Single Instance - MVP 2

    1. Pros to internal generation - more advanced out of the box functionality

    2. Cons - become maintainers of the IPS generation, instead of outsourcing this to experts in IPS

    3. Decision: to work with HAPI to make sure the IPS generation meets our needs

    4. Document how to stand this up locally and how to centralize using an HIE

    5. Focus in OpenMRS is to make sure the necessary bundle of data is sent to whatever will generate the IPS? (or maybe we can utilize/package within OpenMRS a library or something from HAPI or otherwise that we don’t necessarily “own/maintain” to generate within?)

  4. How do we generate an IPS from a golden record ID (Combine multiple records from multiple OMRS facilities) - FUTURE Scope

    1. How do we leverage the SHR to combine data properly

    2. How does OMRS sync to the CR and SHR?

    3. Test and document the workflow

Prior work to leverage

  • Haiti - data model is ugly and very specific

    • might shift this idea out to HAPI or something that fx as the SHR

  • HAPI IPS generation via SHR model we use

    • Needs to be made generic

    • Right now the module builds the IPS, not well designed.

  • Check with Palladium, METS, NigeriaMRS?

Current Gaps

  1. ID the gaps in the OMRS data model / collection-generation

    1. Meds summary needs to be done - REQUIRED MVP 2

      1. Samuel Male - has explored this for O3

    2. History of procedures need to be done - Good to have

  2. Showcase ingesting the IPS from multiple facilities

    1. SHR can generate this