Handling inpatient and outpatient medication orders within Bahmni

In a related note to @grace’s recent post on handling medications within Bahmni, are there cases where Bahmni is managing medication orders across inpatient and outpatient settings?

We introduced the CareSetting within the OpenMRS order service to discriminate between these contexts, but haven’t (yet) fully leveraged it within the OpenMRS order service.

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AFAIK, Bahmni does not leverage “care_setting” model, other than to store the ref. e.g if order was made in IPD settings, orders.care_setting will reference Inpatient care settings. (actually there is a bug that exists wrt to mapping of care settings from Visit types in Bahmni).

In Bahmni, we do not have dangling encounters, and encounters are always associated/grouped under a visit (usually Emergency, OP, IP, Fields etc) . So in terms of traceability, whether drug was ordered in OPD or IPD setting, that is easily discoverable. Don’t know if this is relevant, but Bahmni does store some info in visit attributes - mainly “Admission” status and if I am not wrong, we once thought of assigning a IPD admission specific tracking/identifier number. (but that was never merged I think).

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Is there a notion of active medications (a med list) in Bahmni? Just curious, since these are typically handled independently across contexts (a patients medications in the hospital are usually different than what they take outside of the hospital).

Yes. active medications are indicated so. Its determined by the date/period the med requests are for.

Bahmni also groups by dates and indicates whether active visit.

Regarding “patients meds being different outside” - absolutely. I have often raised the need for supporting “Medication Statement” - and this has been requested quite a few times over by the hospitals.

A “Medication Statement” model to represent that can provide a better view of medications that are being consumed by a patient will help a lot.

A “Med administration” may be even better for IP/day-care settings … but with minimal info from visit type and care settings, we can do without for sometime…