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HIV Clinic Workflows to Support: Ampath, PIH Mexico, UgandaEMR

HIV Clinic Workflows to Support: Ampath, PIH Mexico, UgandaEMR

Goal

The goal is to create a packaged release to prove the feasibility of MFE from an implementation perspective, starting with a pilot in HIV Outpatient Clinic(s). 

Live Requirements Spreadsheet

https://docs.google.com/spreadsheets/d/1PwivnnDUWHVSHQkEATzmTDlZSil9lymf9mzrUnoMmJg/edit#gid=0

HIV Clinic Workflow Requirements

Ampath

Step

User

Description

Why

Part of AMRS POC needed

Part of MFE Proof of Concept MVP scope?

Step

User

Description

Why

Part of AMRS POC needed

Part of MFE Proof of Concept MVP scope?

Patient check-in

Registration clerk

Patient checks-in and issues clinic card at the registration desk.
Patient is searched either by name or identifier indicated on the card.

Ensure that the patient is well identified and add relationships (in case they have any - e.g. a spouse).
It is also at this point that the patient contacts are verified/updated.





Start Visit

Registration clerk

After patient search, today's visit is started by the registration clerk in the HIV Program that the patient is enrolled into e.g. HIV standard program.
Patient is then sent to the triage nurse's desk.

By starting the visit, the patient is marked as checked-in



Triage

Nurse

Patient is triaged by capturing the vitals which are filled in a triage form within the visit that was started. Vitals captured are: BP, Pulse, RR, Temp, Weight, Height, Sp02, BMI (Auto calculated from weights vs height), MUAC.
Patient is then sent to the Clinicians desk.

To find out if the patient is suffering from any other ailments e.g. high blood pressure.



View HIV summary

Clinician

Patient is reviewed by the clinician where they first get a review of the patient HIV summary and today's' vitals which are displayed below the patient header.

  • View historical medications that the patient is taking from the summary.

  • Check patient adherence to medications.



View clinical notes

Clinician

Clinician reviews the clinical notes of the patient which is accessible on the side drawer menu within the HIV program.

View previous notes that a clinician/nurse had written about the patient that might need action.



View historical lab results

Clinician

Clinician reviews historical lab data results of the patient. This can go up to the date the patient was enrolled into HIV care. The most recent results will display on the first column.

Check if the patient is responding well to the medications administered by lowering their viral load and improving their immunity (CD4 count)



View lab orders

Clinician

Check to see if the patient has had any blood works ordered recently and if there is any pending lab orders whose results have not been received yet.

To determine whether to order a new test as required by the HIV guidelines.



Fill clinical encounter

Clinician

The clinician will then open a return clinical encounter which they would fill by asking the patient a number of specific questions that have been coded in the form.
NB: Its also within the clinical encounter that medication orders, test orders and appointments are captured.

  • Patient is reviewed and clinical judgements made for the patient e.g. changing medications if they are not responding well to the current meds.

  • By filling the clinical encounter, a number of concepts are captured in the form which are used for reporting purposes.



Order medications

Clinician

Medications are ordered on the form in the medication history page.
There is a use value button (to use previous values) in case the current medication orders are not changing to a new one.
We are currently capturing the orders through the form and the concepts are saved as observations