FEATURE REQUEST: Simplify Diagnosis Tab

The behaviour of Diagnoses and Conditions is confusing on the Diagnosis tab, Diagnoses are “recorded” (will be saved with SAVE button) as soon as all required fields are entered, whereas Conditions require the extra step of clicking the ADD button, which is not consistent.

I would find it more logical getting rid of the Condition entry section below, and just entering both of them as Diagnoses with a checkbox to indicate if it’s a Condition.

1 Like

Thanks @ouiliam.

@darius & @angshuonline this could be discussed over Wed’s PAT call.

Thanks for the helpful feedback!

This was discussed on today’s Product Architecture Team call. Some notes are here: https://docs.google.com/document/d/1-E37h5O9QN6-ckGCgevN_9EXfqpvu4oM5kfe8dTVvrQ/edit?usp=sharing

Ok so subsequently to Wed’s PAT call we would like to advocate for the below minor change.

When the top condition has been keyed in (diagnosis selected, activity status ticked, date chosen or not) and that the user clicks on ‘Save’ at the top of the screen, like here:

Then we would like this one condition to be saved as well, rather than ignored silently as it is happening now.
Thoughts?

Cc: @sanjayap @angshuonline @akhilmalhotra @arjun

Your proposal probably makes sense as a quick-fix, but I’d like to hear from those actively using this feature how it would impact them. (@sanjayap)

Personally I don’t like the currently design/flow and I’d like to at least discuss what a bigger enhancement might look like. (@jteich, @burke, @terry, also interested in your feedback here.)

You can test out the flow on a Bahmni demo by doing Clinical -> choose a patient -> Consultation -> Diagnosis tab, but I’ll paste a bunch of screens here:

The blank screen looks like this:

I can fill out the condition fields, and then I need to click Add (which is the workflow complaint from Liam at the start of this thread):

After clicking Add, this is added to the active conditions (it’s not written to the DB until you click Save in the top right):

If I save this condition, then start filling out a consultation in a new visit for this patient, the condition will be displayed active, and I have the option to indicate that this visit is a Followup for that condition:

My first thought at a not-too-large change is that instead of having a Condition panel, we should always show the Active, History Of, and Inactive Conditions panels, even if there are no conditions. And you should have a blank row at the start of each of panels where you can enter a new condition for the given status. This would be more consistent with how Diagnosis works, where you have a blank line, and when you fill that out it automatically creates another blank row for you to fill another if you with.

2 Likes

I agree it’s good to always show all the Condition panels, each with a blank row to enter new conditions, which behaves as in the Diagnosis entry.

I’d like to state a couple of principles (many on this thread will probably already know these), then consider what they mean for the UI.

  1. Diagnosis is the diagnosis you made or used for the current encounter. It is a data element of the encounter. My diagnosis for today’s encounter may be “sore throat”, even though that isn’t important enough to be on the condition list.

  2. Conditions are permanent patient status (until explicitly changed). My condition list may include “diabetes”, even though that has nothing to do with today’s diagnosis.

  3. When I was helping design condition lists and diagnoses for Bahmni (and OpenMRS) the intended interaction between the two was:

  • When you document today’s encounter, you always need to have a diagnosis (sometimes one primary and one or more secondary diagnoses). You don’t have to interact with the condition list at every encounter
  • If desired, the user could add today’s diagnosis to the condition list with a button push
  • If desired, the user could select a condition from the condition list and make it today’s diagnosis with a button push (typical for follow-up encounters)

Given that, I’d support the idea that there should be a separate Condition panel where you can add additional new conditions, change and delete existing conditions, etc. I’d also support a button near the Diagnosis field to add it to the Condition list. And for convenience, you could optionally show the Condition list (without a whole table — perhaps a list control) on the Diagnosis page with the only operation being to select one and have it populate the Diagnosis field.

Jonathan

BTW, I’m not sure that it makes sense for today’s diagnosis to be Inactive, given that it is clearly an active part of today’s encounter.