Where to put provider credentials

Where in open emr do I specify whether a user is a MD, RN, PA, FNP? The add/edit user frame doesn’t have a spot for it (unless i’ve gone blind) and the users database table doesn’t seem to have a spot for it either. I noticed that some of the users from an older version put their credentials after their last name in the lname field of the users table.

Is that still the only place to put that?

thanks in advance for any info.

hi @bearzillasquatch , it could be classified by taxonomy, https://taxonomy.nucc.org/

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Hi @bearzillasquatch
I’m not sure what the use of the taxonomy field is; I myself have never seen any professional credentials appended to the provider’s name no matter what the taxonomy value is.

In my time supporting OpenEMR I’ve seen that appending the credentials to the user’s last name is the most common method used to display them. However, that method does conflict with some 3d party external services e.g., NewCrop eRx, which authenticates a user using their correct last name, and will break if passed the name + credentials.

However, thanks to your question I learned something today! The Address Book (main menu: Admin/ Address Book’) when properly used should contain full background and professional information on all the people and business entities which interact with the practice’s EMR in any manner, including being staff employees of the practice. The Address Book has a free-text field called ‘Valedictory’ which officially is intended to contain whatever the user wants to show as their title.

The OpenEMR wiki has a small mention of it in the docs for OpenEMR 4.2; look about 1/2 way down the page in the section ’ 4. Enter contact information’:
https://www.open-emr.org/wiki/index.php/New_Clinic_OpenEMR_Setup_4.2.0

That note links the reader to a discussion in a thread in the OLD OpenEMR forum (i.e., don’t try to post to it)
https://sourceforge.net/p/openemr/discussion/202505/thread/175f9084/

That forum post, despite devolving into an amusing discussion of the etiology of the word ‘valedictory’ and other terms, still does not tell where the valedictory title is displayed. So if you play with this and find out how this works, it’d be really cool to post back here!

Best- Harley

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Hi @htuck. That taxonomy field is used when billing with electronic claims and the HCFA. Looks like it won’t be helpful for the valedictory :slight_smile: although it could describe what type of provider it is if we brought in the corresponding text that relates to the code.

The address book is more suited for external providers. Most likely there will need to be a separate field for a valedictory added to the users table to support safely adding.

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I have now retired and no longer am actively tending to my database but my recollection is that I added an extra “degree” field to the users database (and an extra associated entry field into the Add/Edit User dialog into which I inserted MD, DO, FNP and the like. I used the “valedictory” field to hold the Dear “So and So” section of my outgoing communications to referral sources. As such, it could could be filled with a familiar name (i.e., “John”) or a title (i.e., “Dr. Smith”) which could then be used to automatically make outgoing letters a little more personal.

The advantage I found in treating my users list in this fashion is that I could then more easily streamline automating the way outgoing letters (specifically, the address block at the top of the letter) were formatted. I had also created my own “Letter” form that just held the block of text for any outgoing letters. Automated date, address and salutation blocks were added to the top of the letter text and an automated Sincerely (with signature) block was added to the end. All that need to be done then was to print out the form and a nicely formatted letter was produced.

All right, this is all a little geeky and probably exceeds the needs of most practices, but it can be done with a little planning. Sorry about the wordiness of the post. Good luck.

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Thanks to all who responded.

The reason that I asked the question is, during a recent audit by an insurance company, they said the reports that we generated from oemr for the encounters needed to have the providers “MD or PA etc” in the esignature by their name. So I went looking as to where to add this info and couldn’t find it.

Before now it hasn’t been an issue.

@stephenwaite i now know what the taxonomy field is. I see it’s usefulness but i don’t think it will solve this specific problem.
@htuck we only use the address book for external individuals. I never thought about also putting the employees in there. That might be a good idea too. However, like the taxonomy i don’t think that will solve this specific issue.
@Mouse55 i will probably add a column in the users table as you suggested. Then i can have the reports concatenate that info to the name in the reports.

I learned something and found a solution. That’s a win-win. Thanks everyone.

If this is a requirement that insurance companies require, we should look at opening an Issue on the github repo and get this functionality added to core OpenEMR. I’m wondering if this is something specific to this one insurance company or an industry wide expectation.

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So far this is the only time the creds have been asked for. Maybe it’s something new, maybe they just wanted to complain about something.

Is there a signature for the encounter in an associated form like a soap form or speech dictation?

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Many times professionals that work very hard to earn their credentials like to see that associated with their titles. I kind of get it it also lends some credibility to whatever they’re attaching their name to.
This is something we perhaps should add whenever someone gets a minute.

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@stephenwaite in our situation we use a custom soap note and the speech dictation note. The notes have an esignature and the encounter has an esignature too. The provider who makes the note signs the note. At the end of the day the Dr who is the medical director signs the encounter.

here’s the PR in progress

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Taxonomy is a HL7/FHIR reference. Ideally the codes here should be added to codes table to let selection be based on description rather than raw key. Although it would appear to be convenient to just create another list, this is an industry standard code and as such should rarely be maintained by installations.

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I would suggest any change should move the code towards interoperability standards. If ‘Provider’ in this EMR is expected to be human and not IBM Watson , the name structure is described here including an example.

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I think more and more the “provider” ends up being the insurance company. But that’s a topic for another time.

In the meantime, until (and if) it’s ultimately added to the code, here’s what I did. You will need to do two things. First, add a “degree” field to the users table. From within the mysql database run the following code:

ALTER TABLE users ADD COLUMN degree VARCHAR(20) NOT NULL;

20 characters seemed more than enough to handle all of my needs but this could be altered as needed. Second, after saving a backup copy replace openemr\interface\usergroup\addrbook_edit.php with the attached file of the same name. For those who are paranoid I’ve remarked all the altered lines with my initials (DRH). Examine them at your leisure. Also, if you’ve elected to allot more than 20 spaces to the degree field in step 1 you may for consistency need to make minor alterations to addrbook_edit.php as well.

Extracting the information from the database and actually using it is left to you. At least it’s there in a fashion that can be added, edited or deleted.

addrbook_edit.php (26.8 KB)

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@Mouse55 Thanks for the info and file. I’ll look that over.

hi, the PR was merged and brought back to the current release to go out in the next patch

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@stephenwaite awesome!

Wow, lots of action since I posted yesterday! This is FOSS in action :slight_smile:
But this is still slightly relevant to the discussion: I had always thought the Address Book was only for external contacts but then I looked in the OpenEMR demos, in the the unmodified state that they are reset to daily, and all the pre-configured provider users are in there! They each have an asterisk in the ‘Local’ column so I figured that in-house providers belong in there.
Though like I say I don’t know how ‘Local’ providers are handled by the Addr Bk differently from external providers.

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