Observations with anatomy concept

Implementing
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1

After a while working on other projects I’m back to attempting to setup an implementation of OpenMRS for evaluation, and as such I’m currently attempting to recreate one of the more common forms we use. Although not the exact form (yet to be finalised), NHS East Lancashire has published the form and full procedure for completing a Foot Screening for Diabetic Patients. I’m specifically looking to recreate the second level screening as the first level is triaged before it reaches our clinic.

I’m now struggling to work out what should be a concept, and what class of concepts they should be, then how to combine those into the form. This is what I have determined so far:

  • There are in-fact multiple forms on the paper form which could be completed individually if appropriate to non diabetic patients. These should be separate forms to allow reusability.
  • Taking the Vascular Assessment as an example I would have the following concepts:
    • Test set: Vascular assessment of the foot
      • Test set: Pulse examination of the foot
        • Test set: Dorsalis Pedis Pulse
          • Test (coded): Vascular assessment by palpitation
            • Finding: Palpable
            • Finding: Non-palpable
          • Test (coded): Vascular assessment by Doppler
            • Finding: Triphasic
            • Finding: Biphasic
            • Finding: Monophasic
        • Test set: Posterior Tibial Pulse
          • Test (coded): Vascular assessment by palpitation…
          • Test (coded): Vascular assessment by Doppler…

I shall avoid listing any more than necessary here, but I think I have the assessment concepts sorted for a single foot. The problem then is how to replicate this for both the left and right foot within the form, or how to reuse the assessment concepts for both the Dorsalis and Posterior sites.

In my head this should be done through a few more anatomy concepts:

  • Left
  • Right
  • Dorsalis Pedis
  • Posterial Tibial

I can’t however in the HTML form docs see a way to specify this extra metadata to the form. Any help would be appreciated, especially if I’m barking up completely the wrong tree with my concept design.

2

I am surprised that there are not more contributions, here… but perhaps it is the specificity of the post… There are technical questions about implementing forms and having the right information model and concepts… but there are larger issues about provider workflow and whether forms should be just made electronic or not. This one form is quite intimidating from a clinician point of view, and I can’t imagine how having all this information in granular format helps the provider or the patient. However, there are some best practices which are documented elsewhere on talk or the wiki (in terms of form generation and modeling). Might be better if an implementation that has done something similar contribute their experience (In this case with Diabetic Foot Exam).

3

I’ve just been asked to look into this again after being reassigned for a while, and I guess a more abstract way of asking the question would be:

How do you layout the concepts for a yes/no test that is performed on multiple areas of the body?

Any help would still be appreciated.

4

@ball, do you have anything like this in your form bank?

5

Partners In Health does not use anatomy on any of our forms.

Since you asked about foot screening, including this section of an NCD form used in Haiti for diabetic patients. Maybe it’s of interest (but no anatomy):

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PS - For a female, it includes a choice for gestational diabetes.

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