Visit Note enhancement

OpenMRS is an amazing software and really easy for health facilities owners who have little or no knowledge of coding. With help from the community β€” and , clinicians are able to provide a bespoke EMR services for their institutions and facilities without paying astronomical sums to coders. As a clinician myself, I wanted in openmrs, a format I am familiar with. I found the Visit Note in Openmrs slightly different from the way doctors are meant to write their clinical notes. I have with the help of the community modified the visit note that shipswith OpenMRS to a more familiar format. I suspect that other clinicians (especially those in the English speak developing world) may want something similar albeit with modification to enhance the Visit Note. the code is here

This is the entry view

This is the edit mode

This the view/printable mode

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This looks really good

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Thanks for all the work. Capturing notes in EHRs is particularly troubling as workflow and care management issues often make standardization difficult. One key point is the unstructured, narrative text entered by computer is nearly impossible to use. Voice dictation eliminates some of the more obvious challenges of weird spellings and abbreviation and symbols. However, the real problem is that the computer doesn’t know what the text means. Certain fields, like allergies, past medical, surgical and drug history really need to be structured during the evaluation and Assessment and Plans absolutely need structure and coding. Check out: Problem focused knowledge navigation: implementing the problem focused medical record and the O-HEAP note - PubMed