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Tasks and Task List

Tasks and Task List

4 Must-Do’s

1. Problem Description: Have you clearly defined the user problem(s) you intend to solve, and what value this creates? Write down a story, user insight, or quote about this problem (this is important because (1) this will motivate your team, and (2) without this your problem might not actually be a big problem for the users themselves).
2. User Stories: Have you clearly written at least 3 user stories and use cases? 
3. Market Analysis: Have you surveyed what the market is doing here (e.g. comparison to other EMRs, or paper approaches; and don’t forget about learning from historic/existing OMRS instances)? Have you written down any possible gaps in your understanding of your users or their workflows? Have you reviewed the topic in FHIR to see what requirements or fields the global community references? (Eg if working on insurance, should look here)
4. Technical Considerations & Dependencies: Have you outlined what you need from cross-functional areas for success of the feature? E.g. do you need the platform to support a new API call? Have you explained how you’ve addressed dev concerns, such as designs that may not be feasible, or will be extra time-intensive to implement? 

Optional/Encouraged

Sketches: Have you added a drawing or description of how the feature could work to solve the problem at hand? (Pictures of sketches are ok!) 
Project Management: Have you created the Epic and JIRA tasks so you can share work clearly? Roll-out plan: Do you have an idea whether this will be an experiment, gradual roll out, and when? Have you added this to the timeline view? Have you planned how you will promote and/or work with communications folks in order to help this feature reach the widest audience and have the biggest impact it can?

Later but should do

QA Plan: Have you mentioned the plan for QA, such as how you will discover and address edge cases? Does your team/squad have a plan for automated tests to be added to new components (unit tests) or workflows (e2e tests)?
Safety & Tech Risks: Is there any reason you could regret rolling out this feature? (e.g. possible patient harm, heavy tech debt like introducing an unsupported library) Have you thought through the risks for this particular solution? And, how to reduce/address those? 

This checklist was inspired by this article. Additional Business Analyst Resources here.

Status: In Progress

Technical Complexity: Manual: Medium Engine/Rule-Driven: Hard / Complex FHIR/Drools/Java/React

Summary:

  • Task Lists are like Checklists for an individual Patient. These can help with communication accross providers, shift changes, and specialties; and, can leverage CDS rules/reminders to generate suggested tasks to help ensure a patient gets ideal care (e.g. “due for mammogram”).

  • History: In 2023 we created designs and UI patterns for Tasks and Task Lists as part of the ANC DAK / SMART Guidelines project. This work needs to be actualized: from the frontend, to the backend storage, to actually leveraging a CDS engine.

  • MVP: Getting started with manual task creation is a great first step!

Handy Links:

DS2_Tasks-Open.png

1. Problem & User Stories

Currently, there is no structured task management within the OpenMRS clinician user experience. In the past many implementers have used the Sticky Note as a simple free-text way for staff to leave reminders and task ideas; or, users could add such text to visit notes in forms or the Visit Note text box, but action requests / tasks are unlikely to be dug-up/found by subsequent staff.

Many sites have requested a more structured Task List. This will allow:

  • Allows for more organized task tracking per-patient, so it’s clear what has been done vs not done

  • Give a UI for showing more advanced CDS-based task suggestions (e.g. “It has been 1 year since last diabetic foot exam → task gets triggered by CDS engine to show “Perform Annual Diabetic Foot Exam”, for example).

Example Use Cases:

  • Custom Content Examples:

    • Notes/Reminders for “The Next Clinician”:

      • I’m an OPD clinician seeing a patient, and I’ll be on vacation next time they come to the clinic. I want to leave a task behind for my replacement to remember to re-order a drug for this patient, or perhaps to ask the patient about how a referral went to a specialist.

      • Remind the next Mental Health counsellor to do a PHQ-9 follow-up/re-assessment.

      • Shift Change: Notes for the next shift, e.g. due for dressing change; flag “review nutrition complications, maybe have doctor modify food intake prescription” because previous nurse i.d.'d concerns about nutrition.

    • Cross-Specialty/Department Communication: Ask the Psychiatrist who next sees the patient to do the prescription because that’s out of my scope.

  • CDS Content Examples: The WHO’s ANC DAK contains a bunch of examples of decision support rules that should trigger in a pregnant woman’s chart given certain inputs. Most up-to-date file is here under “Annex B: Decision Support Logic”. See especially the sheet named “Check Symptoms” for examples. A screenshot is here:

    image-20251024-080445.png
    Screenshot of sample CDS rules for pregnant patients, per the WHO ANC DAK.

Types/Levels of Tasks:

  • Simplest: Custom Tasks (PRIORITY): On-the-Fly, Manually-Created Tasks (This is what MSF wants the most, though no use cases provided)

  • Medium: System Tasks: Pre-Configured Tasks: Choosing from a list of sample/common tasks from a “Task Library” so I don’t have to type the whole task (e.g. “Refer to [Specialty ABC]”

  • Complex/Hard: CDS-Powered / Rule-Driven: Tasks that only show up based on some logic being triggered (e.g. female + positive HCG test → triggers “Refer to MCH Clinic” etc)

  • Sub-Tasks: Mini-tasks within a bigger set/task.

    • e.g. from MSF: General task for “Give this drug”; then sub tasks include tasks required to make that happen, e.g.: Get it ordered; Nursing tasks around when to give it; follow-up requirements. (Grace note: I suppose many common blood thinners fall into a category like this, where they need careful lab monitoring so as to make sure the doseage is not making the blood too thin; however, this is a slightly unusual example.)

    • e.g. from Pelvic Physio example: Many pelvic physio tasks require multiple training steps before the task can be correctly performed. E.g. a pregnant patient should be trained first on pelvic relaxation before kegels, because of the concern around too much tension. In this example, the order of the sub-tasks matters as well as the fact that they are together. So in total it could look something like:

      • Task: Assign Pelvic Floor Exercises

        • Sub-Task #1: Train in pelvic relaxation

        • Sub-Task #2: Train in kegels (pelvic tension)

    • Here are some more examples, though admittedly GPT-generated. But these are reasonable and show a good example of how much per-site or per-department configuration people are likely to need/want!

🏥 Example 1: Discharge Planning

Main task: Prepare patient for discharge.
Sub-tasks:

  • Review inpatient medication list and reconcile with home meds.

  • Generate discharge summary and send to primary care provider.

  • Educate patient on wound care and follow-up appointments.

  • Confirm transportation home.

  • Schedule follow-up visit within 7 days.

  • Print and review discharge instructions with patient.

💊 Example 2: Start Antiretroviral Therapy (ART) (HIV program)

Main task: Initiate ART for newly diagnosed patient.
Sub-tasks:

  • Verify HIV diagnosis and confirm baseline labs (CD4, viral load).

  • Screen for TB symptoms and other co-infections.

  • Check for contraindicated medications or allergies.

  • Provide adherence counselling.

  • Select and prescribe ART regimen per guidelines.

  • Document next refill and follow-up visit date.

💉 Example 3: Diabetes Management Review

Main task: Conduct quarterly diabetes care review.
Sub-tasks:

  • Check and document HbA1c result (<3 months old).

  • Review blood pressure and weight.

  • Review current medications (including insulin).

  • Confirm foot exam completed.

  • Order eye screening if due.

  • Provide lifestyle counselling (diet, exercise).

  • Update care plan and patient goals.

🤰 Example 4: Antenatal Visit (ANC) Task

Main task: Complete second-trimester antenatal visit.
Sub-tasks:

  • Record vital signs (BP, weight, fundal height).

  • Perform urine dipstick for protein and glucose.

  • Update fetal movement and heart rate.

  • Screen for anemia (Hb test).

  • Review lab results from last visit.

  • Provide iron/folate supplements.

  • Document counselling (nutrition, danger signs, birth plan).

🧪 Example 5: Lab Result Follow-Up

Main task: Review and act on abnormal lab result.
Sub-tasks:

  • Review result (e.g., elevated potassium).

  • Contact patient or caregiver for follow-up.

  • Document intervention or repeat test ordered.

  • Notify supervising physician if required.

  • Close the loop (mark result reviewed + action taken).

💬 Example 6: Depression Management Plan

Main task: Manage patient with PHQ-9 ≥10.
Sub-tasks:

  • Confirm diagnosis and rule out bipolar disorder.

  • Start antidepressant or refer to counselling.

  • Schedule follow-up in 2 weeks.

  • Document safety plan for suicidal ideation.

  • Reassess PHQ-9 score at follow-up.

🫁 Example 7: TB Treatment Initiation

Main task: Begin TB treatment.
Sub-tasks:

  • Verify sputum test or GeneXpert result.

  • Record weight and calculate drug doses.

  • Dispense medications for 2 weeks.

  • Educate patient on adherence and side effects.

  • Schedule DOT (directly observed therapy) follow-up.

  • Record treatment start date in registry.

🧍 Example 8: Chronic Disease Follow-Up (NCD Clinic)

Main task: Monthly hypertension follow-up.
Sub-tasks:

  • Measure BP and pulse.

  • Review adherence to antihypertensives.

  • Screen for side effects.

  • Adjust medication if BP uncontrolled.

  • Provide lifestyle counselling.

  • Schedule next follow-up date.

👩‍⚕️ Example 9: Post-Operative Care

Main task: Monitor patient after surgery.
Sub-tasks:

  • Check wound site and document healing.

  • Monitor temperature and vital signs.

  • Review pain score and adjust analgesics.

  • Check for signs of infection.

  • Remove sutures/staples if due.

  • Educate patient on wound care.

🧠 Example 10: Pediatric Immunization Visit

Main task: Complete 6-month vaccination visit.
Sub-tasks:

  • Verify child’s ID and vaccination record.

  • Confirm absence of contraindications (fever, allergies).

  • Administer vaccines (e.g., DTP-HepB-Hib, Polio, PCV).

  • Record lot numbers and dates in EMR.

  • Provide caregiver education and schedule next visit.

 

2. Designs

Thorough design work has already been done for Tasks by Sonder Design UX experts as part of the ANC DAK project funded by Digital Square in ~2023. The resources that resulted from research and design time are available at:

3. Technical Considerations & Dependencies

Ideally this should integrate with the existing FHIR-compliant data model, potentially leveraging Care Plans or Tasks resources to ensure interoperability. This addresses the current gap in structured task management within OpenMRS while maintaining platform consistency.

Back in ~2023 under the ANC DAK project, there was initial prototype work done just in the frontend (not currently included in the RefApp today), but overall, these designs were not fully implemented because the project ended before data model design or a rule-engine were completed.

  • Past frontend work: _____ (Contact: Hadijah)

  • Past backend work (goal was to use fhir tasks): ____ (Contact: Mozzy)

Overall Requirements from MSF

Category

Requirement

Description

Category

Requirement

Description

Task Creation

Create new task

I would like to create tasks for self.

Task Creation

Assign task

I would like to assign to colleagues (nurses, residents, or other doctors).

Task Creation

Set priority

I would like to set priority levels (high, medium, low) with color coding.

Task Creation

Set due date

I would like to assign due dates and deadlines.

Task Details

Add description

I would like to write Task title + notes.

Task Management

Edit/reassign

I would like to change ownership of tasks.

Subtasks Creation

Create subtasks

I would like to create a subtask under a main patient task.

Subtasks Creation

Multiple subtasks

I would like to add multiple subtasks to a single main task.

Subtasks Creation

Set due date

I would like to set due dates for subtasks, independent of the main task.

Task Management

Time critical icons

Highlight with icons soon overdue and overdue tasks.

Subtasks Creation

Independent tracking

I would like to track completion of each subtask separately.

Subtask Management

Set priority

I would like to set priority levels (high, medium, low) for each subtask.

Subtask Management

Audit trail

I would like to see who completed which subtask and when.

Collaboration

Shared visibility

All providers in the care team can see patient tasks.

Collaboration

Role-based access

Only authorized staff can view/act on certain tasks.

Others

Expand/ collapse

I would like to see subtasks displayed under main task in collapsible view.

Phases and Timeline for MSF & Madiro in Q4 2025

Phase

Timeline

Owner(s)

FHIR Data Model & API 

Weeks 1-4

Madiro (Brandon)

Frontend Development

Weeks 1-4

Madiro (Brandon)

Testing and Documentation

Weeks 3-6

MSF (Lime Team)

Revisions and Validation

Weeks 3-6

Madiro (Brandon)

Sign-off

Weeks 6-7

MSF (Lime Team)

Community Merge

Weeks 7-8

Madiro (Brandon) + Community

Time Estimate: 40 hours