Diagnoses list in use in Haiti

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(Dimitri R) #1

Hi Haiti community!

As we are starting our new hospital implementation in Northern Haiti, we are wondering what is going to be the best approach about maintaining a comprehensive list of diagnoses

I look into Haiti Core and there isn’t any bundle of diagnoses in there, therefore I was wondering what was used at both Mirebalais and in iSantéPlus? Is it simply the diagnoses out of the CIEL dictionary?

Cc: @nathaelf @ball @mogoodrich

(Ellen Ball) #2

@mksd The Haiti implementation includes concepts for diagnosis (1589), symptom (23), symptom/finding (38), and finding (282). These are all included in github (mds package).

These are a subset of the CIEL concepts since we limit to diagnoses that are possible in our health facilities (health clinic -> tertiary/teaching hospital) without overloading the users with choices.


(Dimitri R) #3

Ah! That’s amazing, thanks @ball for pointing me so quick to your metadata resources, super useful. We will certainly check that MDS package out in the next week or two.

Do you know from the top of your head about how many diagnoses this is?

The reason I’m asking is because “usually” we would maintain this kind of metadata as a CSV that is then loaded with the Initializer module (example here). Unless its thousands of diagnoses of course…

(Cc @mksrom )

(Mike Seaton) #4

@mksd, I’ll let @ball clarify the number, but @mogoodrich and I are definitely interested in seeing if we can start leveraging Initializer more in general.


(Ellen Ball) #5

1589 diagnoses + symptom (23), symptom/finding (38), and finding (282)

(Dimitri R) #6

Cool, thanks @ball. Ok, that’s a lot of diagnoses… :slight_smile:

@mseaton great, we have been really happy with it. We have used it in 4 implementations/distributions (1 Ref App + 3 x Bahmni), applying its underlying logic of the OpenMRS config strictly separated from the binaries. However this one is precisely a tricky case.

The thing is, it could work to load 2,000 concepts line by line with the Initializer but the initial loading would probably be painfully slow. You probably remember the base idea, such CSV will not reload until its checksum has changed. So everything is fine, until you decide to correct one typo in a diagnosis name in some locale.

This can be worked around by introducing a second CSV that would be used to bring changes and additions. But that would mean that the overall diagnoses are kept as two (or more) files. We could live with that, but that is not an amazing format to share and maintain a list of diagnoses across implementing teams. I guess.

On the other hand maybe those ~1,600 diagnoses hardly ever change, and all is fine. I wanted to look at the file history to get an idea about this but it seems that it was brought from elsewhere recently?

(Andrew Kanter) #7

Remember, that patients have more diagnoses than just the number of ICD-10 codes. :slight_smile: I would be sure to use links to CIEL in those concepts, however, as although the medical concepts do not change (usually) the underlying codes DO change over time.