Understanding Observations, Diagnosis, and Consultation tabs

I have the feeling that I don’t fully understand the differences and intentions of the tabs Observations, Diagnosis, and Consultation of the clinical module.

The observations tab is most clear to me and I know how to add additional forms to it. The Diagnosis and Consultation tab seem less configurable and in theory I think the observations can capture the same data. Are they mainly designed for convenience/usability purpose?

Diagnosis is stored as observation in backend, so in theory it can be captured in Obs template. But there are few specific requirements, like marking a diagnosis as Primary/Secondary or Presumed/Confirmed etc, which are unique to Diagnosis. Also providers need not care if diagnosis is stored in backend as an obs. Having it in separate tab gives that abstraction.

In Consultation tab, providers can review data they have added in other tabs, all in one page If needed, they can add consultation note if something they want to capture but not sure where to enter.

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OK. This is helpful. Thanks Vinkesh.

Then for a clinical provider the ‘workflow’ is to first enter any Observations applicable for the patient, then switch to the Diagnosis tab and in case for additional notes go to the Consultation tab?

And is the Diagnostic tab meant to be customisable similar to the Observations tab?

Most common workflow I have seen is to first enter “Observation”, then go to “Orders” to order some lab test/radiology tests (if needed), then enter “Diagnosis” (maybe in next encounter) according to test results, then advice some “Treatment”. Before saving, providers can review data in Consultation tab and add “Consultation Notes” if required.

Diagnosis tab is not as customizable as observation page. Do you have any customization for diagnosis tab in mind that you are looking for?

Hi Vinkesh,

Is it safe to say that the separation of “Observations”, “Diagnosis”, and “Consultation” is more due to the technical detail of how this data is stored in the backend, and less about the logical grouping of functionality? Or was it a user request to have separate “Observations” and “Diagnosis” tabs?

Saying “providers need not care if diagnosis is stored in backend as an obs. Having it in separate tab gives that abstraction” implies that users actually care or have knowledge about the distinction between data stored in the obs table vs. some other data structure, and want their UI divided up to represent this. Is this true?

Like Christian, I have also found the “Observations” tab as distinct from the “Diagnosis” tab as more of a reflection of our data modeling and a convenience to developers, than as the optimal clinical UI. But this is just my impression - I’d love to hear more about how this has evolved with JSS and other hospitals that you originally designed this for.

Thanks! Mike

Hi Mike, Christian,

I actually meant to say that users would not care or have knowledge about how data is stored in the backend.

I don’t think we separated them into different tabs because of technical complexities. We felt that Observations & Diagnosis were two different things in a Doctor’s mind and thats why we have them in different tabs. Tabs in Bahmni mostly reflect a doctor’s normal workflow. Having them separate makes it easier for doctors to know where they should go if they want to enter some Diagnosis vs. entering some observation.

Others might be able to give better explanation of the actual thought process though :smile:


In addition to someone giving the thought process behind Bahmni’s implementation of this (it would be great to describe the overall intended flow on the Bahmni wiki documentation), I’m curious to hear the “generic doctor” perspective on this from @jteich, @burke, and others.

As I understand it, the typical flow of seeing a patient in clinic is something like this: (Bahmni tab in parens)

  • discuss problem with the patient and ask questions (Observations)
  • have a working diagnosis in your mind (optionally record a non-confirmed Diagnosis)
  • maybe order some lab tests to test your working diagnosis (Orders)
  • maybe ask more question (Observations)
  • refine your diagnosis based on test results (Diagnosis)
  • prescribe some meds (Treatment)
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