New Ophthalmology zForm

OpenEMR Development
1

medfetch wrote on Friday, November 14, 2014:

I am making a first stab at an ophthalmology form. Hope others find it useful and can comment on the code. It is forked on github as “ophthal” and the form name is eye_mag.

2

fsgl wrote on Friday, November 14, 2014:

All of the Ophthalmologists in these Fora are physicians primarily.

If you wish to have our feedback, a Wiki article & link would be helpful.

3

medfetch wrote on Friday, November 14, 2014:

The link to the form on github is:

https://github.com/ophthal/openemr/tree/master/interface/forms/eye_mag

Like real life, an ophthalmology record can be a foreign document for non-eye docs, and I apologize for this. I plan to create a “human” readable report for export from this form but all in good time. The form is hopefully intuitive to any ophthalmologist/optometrist who uses it and is meant as a start point.

My problem is my coding abilities :frowning: , how to integrate this into openEMR and how to incorporate all the functionality that already exists from all your hard work to date. I am new to this process and am not sure what you wish to see in the wiki? Is this where ideas, suggestions etc occur in the review process? Is it meant to explain why each feature does what it does? I tried to write the form so it would be intuitive and usable without a manual, which makes users very happy… It looks a lot like the paper forms one might use in the office today, with some of the nicer features CSS and JS offer.

If the form has legs and is “usuable”, perhaps there will be more eyedocs in these Fora!

4

fsgl wrote on Friday, November 14, 2014:

It is impossible for the Eye folks to look at the codes & offer an opinion because we don’t know what we are looking at. For everyone else, php may be familiar, but Ophthalmic terminology is a foreign language.

If the form is a Layout Based Visit form, life would be simple with the import of a .sql file. But that is not the case.

In the meantime reviewers will offer suggestions. When the form becomes “tangible”, we will be happy to pitch in.

5

blankev wrote on Saturday, November 15, 2014:

WIKI example might be:

The total and complete Form any eye related specialty ever wanted to use. (Or something more appropriate, remember you want to get attention for your efforts to get USERS involved, something convincing)

Followed by some screen shots of the different stages your form can take. Sometimes you need to go in depth, sometimes it is better to skip because some parts are irrelevant to a sub-type of patients.

If the USERS are able to see the way you go, the coding might become obvious.

Give here in this part of the forum, some attachments that show the forms you want to include in OpenEMR. Chances you might get the right people involved with the correct answers.

6

bradymiller wrote on Saturday, November 15, 2014:

Hi,

It looks very nice on the demo.

Can demo this on the following “up for grabs” demo:
http://www.open-emr.org/wiki/index.php/Development_Demo#192.168.1.130

I’ll rebase it into one commit in near future for a code review (note that MU2 items are taking precedence now, so the review may take some time).

thanks,
-brady
OpenEMR

7

fsgl wrote on Saturday, November 15, 2014:

Absolutely brilliant!

Comprehensive with a capital C!

Great features:

Auto-save.
5 options Amsler Grid.
Defaults/Quick Picks for the non-typist.
Draw in color.
Gross Visual Fields.

Questions:

  1. Can a stylus be used in lieu of mouse in Draw?
  2. What is in Settings?

Suggestions:

  1. It is not obvious that History appears with clicking “Toggle construction zones”.
  2. A section for non-Ophthalmic signs; e.g., Carotid bruit, absent Temporal Arterial pulse.
  3. Small cosmetic change in layout, see attachment 1.
  4. Form should persist, especially after locking; see attachment 2.

We look forward to the eye_mag Wiki article.

Congratulations, very well done.

8

medfetch wrote on Sunday, November 16, 2014:

Thanks for looking at the Ophthalmology form. It is a work in progress like most of these I guess. I changed the font as you suggested since it did not fit in your browser. There are still lots of cosmetic tweaks to do, like the CC/HPI/PMSFHx areas. Feedback is warmly welcomed!

The second point 2.png I think has to do with the report feature. I have not written the report.php yet - that will summarize the eye hieroglyphics into a human readable digestible prose. We’ll see.

I will work to get the base demo Brady created pre-populated with one patient who has two visits. There are “Easter Eggs” which pop-up when there is more than one visit - you can scroll through old records side-by-side with the current record. For now to see this in action, you’d need to add a patient and create two encounters on separate days. A Pull-forward feature is not implemented yet.

Your feedback is much appreciated!

9

medfetch wrote on Sunday, November 16, 2014:

I do not have a stylus but I imagine it can. I will get one and test it out.

We eyedocs are totally handicapped in that we are overly driven by visual stimuli and how we chart is no exception. With HTML5 and CSS3, I think we are beginning to see an alternative to the current tab driven field based process. It will be interesting to see how the developers integrate these approaches.

The other problem in ophthalmology is our high degree of dependence on our toys - and these toys need to interact with our EMRs, dumping their data into the EMR programs. There are DICOM and IHE/Eyecare standards to interconnect these machines into an EMR but I do not know how that works on a granular level. If someone can direct me I’d like to take a look at how to make that happen with openEMR since this capability will make this EMR quite desirable to the “eye world”.

10

fsgl wrote on Sunday, November 16, 2014:

Integration between EHR’s and devices has been hampered by manufacturers’ reticence to share their proprietary codes.

This impression was gleaned from posts here and at the AAO website. No one is holding his breath for this to change any time soon.

We just upload the perimeter’s printouts as .jpeg files & attach them to each encounter. Cumbersome, but it gets the job done.

11

bradymiller wrote on Monday, November 17, 2014:

Hi Ray,

I rebased all your code into one commit and reviewed it here(start from the top and search for bradymiller to see the comments; I tried to do it in a tutorial fashion with more descriptions near the top):

I recommend that you continue to work on your current github branch.

Looking forward to next revision.

thanks,
-brady
OpenEMR

12

kodusote wrote on Monday, November 17, 2014:

Impressive on the demo site. A wiki would definitely help in understanding how all the different input widgets work.

13

medfetch wrote on Monday, December 08, 2014:

As I delve into making this form, I get a glimpse of how much work has been done on the back end. You guys really do rock! I hope to add a useful module and look forward to the first commit. The code should be up to snuff after much hand holding by Brady - I really appreciate your approach.

You can always use the “up for grabs” demo server to play around with this form but as it is reset daily, you have to add the form, then a patient, then multiple visits to see some of the more advanced features like how the carry-forward feature works. I’ll try to figure out how to put demo data that updates visits too in the sql file.

As Brady finds time in his day to review the code, I put together 2 screencasts from a sandbox server so you can get an idea of where it is going. I think this will be the start of a Wiki; we’ll see…

https://sourceforge.net/u/medfetch/wiki/Home/

Ray

14

blankev wrote on Monday, December 08, 2014:

May be the weekly restore Demo is the solution? Somewhere in the top three Demos.

15

fsgl wrote on Monday, December 08, 2014:

Hi Ray,

Brady’s help is needed to make Eye Exam registered permanently. The same should happen for the Encounter Form & test patient.

The 2107 Demo has patients, Encounters & contributed forms which are not ephemeral. The same can be done for the 2104 Demo.

Those of us without a YouTube account are unable to view your videos.

In the event that you are unfamiliar with the Formatting Help section, it is located in the left sidebar. Here is the link for embedding YouTube videos.

16

robertjtownley wrote on Wednesday, December 10, 2014:

Youtube says “This video is private”.

On Mon, Dec 8, 2014 at 6:29 AM, fsgl fsgl@users.sf.net wrote:

Hi Ray,

Brady’s help is needed to make Eye Exam registered permanently. The same
should happen for the Encounter Form & test patient.

The 2107 Demo has patients, Encounters & contributed forms which are not
ephemeral. The same can be done for the 2104 Demo.

Those of us without a YouTube account are unable to view your videos.

In the event that you are unfamiliar with the Formatting Help section, it
is located in the left sidebar. Here is the link for embedding YouTube
videos
https://sourceforge.net/p/openemr/discussion/markdown_syntax#md_ex_video
.

New Ophthalmology zForm
https://sourceforge.net/p/openemr/discussion/202506/thread/78bb9974/?limit=25#7589

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17

fsgl wrote on Wednesday, December 10, 2014:

Thanks, Robert. I did see that message & thought that a YouTube account was needed to get into the club.

Ray needs to change the setting of his videos from private to public, to enable viewing by Forum members.

18

medfetch wrote on Thursday, December 11, 2014:

Sorry 'bout that. There are 2 now marked as Public:
[[embed url=https://www.youtube.com/watch?v=0pBulU5BF2Y]]

[[embed url=https://www.youtube.com/watch?v=_oGvRBV3qUs]]

There is one more but I think this is a good start and the next parts will be better off in segments for the wiki.
Ray

19

fsgl wrote on Thursday, December 11, 2014:

Thanks for changing the video settings.

Is it possible to use a stylus with Draw?

20

medfetch wrote on Thursday, December 11, 2014:

Yes I have used a stylus but… This HTML5 canvas function is evolving. I plugged in a cheap Wacom stylus/pad and it worked like a mouse would. Drawing with a mouse is no fun. Maybe there are people out there who have better drawing pads/stylus that work better with HTML5 drawing programs?

I cannot get the draw function to work properly on my iPad (1 or 3). No idea of how it works on a Droid or the new Windows machines where you can draw directly on the screen.

Essentially the HTML5 canvas is separate from the graphics - the canvas accepts the drawing input and the image you see is actually a background image - which you can swap if you like. As you draw on a segment, you are drawing on a canvas “layer” in front of the background - it is sent to the server (on a mouseup or blur event) and merged with your background into a new image for that section of the encounter. The background however is not refreshed on screen without a reload. This is not a problem when as you draw all that you draw stays visible on the canvas – on the ipads, each new event (like mouseup/blur etc) the drawn elements ARE sent to the server BUT then the canvas is cleared! Not sure how to fix this canvas problem - any ideas?

BTW, this html5 canvas can be used in any form and should be in the library after the first commit. It is sketch.js and on github:

http://intridea.github.io/sketch.js/

Ray