Make patients active, inactive, active again

david_r_whiting wrote on Sunday, February 20, 2011:

Hi,

I’m helping someone set up openemr. In their setting they have patients who become inactive (i.e. they stop seeing them) who then may become active later, inactive again, active later, and so on. At the moment with their paper system they record the dates the patient becomes inactive and active again. What’s the best way to represent/store this in openemr? Conceptually would this be an encounter (e.g. an inactivation encounter, a reactivation encounter) or perhaps a transaction? Or something else? They will want to be able to filter reports on active/inactive patients, by date.

Thanks.

David

sunsetsystems wrote on Sunday, February 20, 2011:

Are you sure such an indicator is necessary?  Information as to when the patient was last seen is already in OpenEMR, and it would be simple to create reports of patients that were seen or not seen within the past 12 months or whatever.

I understand that paper charts might be moved to a storage area for patients that are deemed inactive, but that’s not necessary with electronic records.

Rod
www.sunsetsystems.com

julialongtin wrote on Sunday, February 20, 2011:

Pardon me while I Re-state some assumptions, in an attempt to make sure I’m understanding this right, and try to supply a possible solution (with major issues)

You’re using the ‘active’ flag of a patient to determine whether a patient is currently being seen by your organization. specifically, you turn them inactive when you no longer expect to see this client.

You are currently using the reports system, and using its built in filters to only show active clients, when you do reports.

You are wanting to do reports based on clients which were active at a given point, not just the current state of the world.

You are also wanting to track when you started seeing a client, and when you stopped.

Now, if i were trying to solve the problem of '“i need to know whether a client is active or not, track when they became active, and track when i think i’m done with them”, this is what I would do:

To model the data, i would create an encounter form. this encounter form would become authoratative when signed per my signaures system, so it would show as the default activity page for this user (think how history works, only strting from an encounter, getting signed, then being all visible). when a close date is entered, a new encounter form would have to be filed for the new activity period.

I would then make my world a living pain, while I tell the report system to do reports on this. not-trivial. getting the behavior out of an encounter form that you want is pretty simple. getting the reports to work against it would take real work.

Now that i’ve made things as clear as mud…

Julia Longtin

bradymiller wrote on Monday, February 21, 2011:

Julia,
Please get the signature table in the main codebase before recommending its use. :slight_smile:
-brady

david_r_whiting wrote on Monday, February 21, 2011:

Thanks. @Rod: I think that looking at last visit make a lot of sense. I won’t be seeing the person I’m helping for another week so will discuss with them then.

aethelwulffe wrote on Tuesday, March 22, 2011:

The flag might not be necessary, but it would be REALLY NICE.

  Once you have a grand pile of records in the EMR, and you are trying to do large scale record review it is quite nice.  We might have 300 “active” patients, and 1200 total.  It is far easier to say “I’m gonna review all the active patients imported documents today” if you can easily pull up the active/valid patients list again and again just by hitting the name box with an empty name and getting only the “real” ones.  Better yet, a “monthly review” feature would be even better, so you can flag a patient as active, and indicate that they have been reviewed within the last 30 days, thereby cycling through a list.  Perhaps a different report could do this, other than the search screen, but hey…
  Our solution (in a MH clinic) is to give other demographics tags to the patients.  These consist of “Counselor”, “Counseling Supervisor”, and “Program”.  If a client is not in a program, they are not “active”.  I would still prefer that the active flag be a primary global search filter that requires an exception, rather than being a search perameter every time we bring up a client list.
  Perhaps simply having a setting in globals that allows you to select what search filters to display on the main sidebar, and saving the last chosen filters to the session variables would be quite enough to get this behavior.

Hi,
I would like to resurrect this thread. I have been carrying this mod for a few years now and now that I am working on integrating it into the newest code base. I wanted to ask if this would be a good time to share this mode?

The practice that I am working with is a pain management clinic. They wanted this very feature. So, it was built and they have relied on it for years. I see this is not in the code base yet. And because they have two facilities, they wanted a way to see which facility the patient was seen at last in the report.