The hospital i am working for is using the lab test result report in Bahmni to proactively call up patients to inform them if they have been detected with some serious illnesses for which treatment should be started as early as possible.
The designated person looks up the report which shows only abnormal results, checks treatment started and then calls up the patients whose treatment is not started. To know the patients phone number he has to go to registration module and then search the patient and then look up his phone number.
If the number is not reachable then he is supposed to send postcard to the patient, for which he needs to know the patients address.
To simplify his work, its required that the Lab Test Result Report have the ability to configure and show patient attributes (Telephone number,etc) and address attributes (village, pin code, etc).
( Ideally it would be awesome if we can somehow show in the same report whether the patient already started on treatment or not. But i know thats going to be tricky. So that for sometime later may be. )
Similarly, the canned report DateConceptValuesPatientsList is used for similar purpose. The report is configured to show up patients with their follow up dates. Same patient attributes and address attributes are required there as well.
This is an interesting request and has privacy concerns that I hope your hospital is aware of. Not only are lab tests hard to interpret totally on their own, but access to medical record information exposes information to the lab result that normally would not be allowed. Also, it is quite possible that this is the first abnormal test result and that the clinician has not yet determined the best course of treatment. I think it might be improper for the lab/hospital to contact the patient prior to the primary caregiver. Just some thoughts…
These lab tests happen at the same hospital only.
For certain tests, it usually happens that patients give the sample and go back home. The results come after they are gone.
In one such case in past a patient was brought to hospital in a very serious condition and she eventually died. On looking through the records it was found that the abnormality was detected a year back, but because the patient never returned back to hospital, no one acted on the abnormal report. Had the treatment started on time, she could have been alive.
So the the proactive communication that i mentioned in previous post is to mitigate such situations. The patient is just asked to come back to the hospital soon, collect his report and consult the doctor.
The hospital wants to take the responsibility that the lab test result and the abnormality is at least conveyed to the patient.
I see. So it really is just that they need to consult with their doctor, and they don’t want to send the letter to patients already on treatment. I think the way that this is done in the US is to simply assume that all patients need to consult with their doctors about abnormal results and that everyone gets the letter (and the letter also goes to the doctor so that they know too). I just think you put yourself at some risk if you try to get too smart about who gets the letter and who doesn’t since you don’t know for sure if the treatment they are on is effective, appropriate for the lab result, etc. Better to be safer than sorry…
Bahmni is being used to check for “unacted” lab results and then communicate to the patients and suggest visiting the JSS hospital.
I had briefly mentioned about that in this Bahmni blog post
The NMJI article raises some interesting questions about responsibilties of hospital in an area. Would this be the right forum to know the thoughts of various health facilities, especially the ones in similar social and economic context ?
(May be a separate thread if the answer is yes)