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Email Archive: care2002-developers (read-only)

Re: [Care2002-developers] re Patient Registration and Admissions

From: <elpidio@la...> - 2002-12-14 08:57

Hi,

> If postal code were entered before town/city then the town, state ect could be 
> searched and entered via java script. This could simplify and validate the 
> address data entry.

Yes, that is a good option too. We could also implement that.

:-)
Elpidio

Thread View

Thread	Author	Date
[Care2002-developers] re Patient Registration and Admissions	<markp@sa...>

Re: [Care2002-developers] re Patient Registration and Admissions

From: <elpidio@la...> - 2002-12-09 17:23

Attachments: Message as HTML

Hi Mark,

thanks for your additional suggestions for improvement.

Re: 2 hospitals within an organization

I think, if we will consider the integration of 2 hospitals, we might as =
well design the
system to accomodate an indefinite number of hospitals within its scope =
of operation.

Actually, the hospital where I work is only one of many that belongs to =
an umbrella
organization. So, I believe this situation is very common in other parts =
of the world.
Your suggestion of using an extra table to crossreference the hospitals =
is good.

However, what are these folder numbers? Aren't these the admission =
numbers of the patients?

Re: Addresses and the use of selectable list of towns/cities.

This is a smart way of entering data and also ensures that the district, =
province, region, country are
correct. I think we should follow your suggestion.

I will also create the field for the phone code.=20

Re: Race/Ethnic Origin

This is quite a sensitive issue. I have no personal comments on this =
matter. But I will create the
field for this data and through the use of the global-config flags, the =
system admin can decide to hide or
show this on the entry forms.=20

RE: Social Security Nr. / National ID nr.

I will also create fields for both, and with the use of the =
global-config flags, the system admin
can decide if they need these elements to appear on the forms.

Thanks very much. Regards,
Elpidio

Re: [Care2002-developers] re Patient Registration and Admissions

From: <ngertrudizs@ya...> - 2002-12-09 19:33

I have a question, what about HL7, I suppose, it is
the way for the interface for differents institutions
and systems?

Nancy

--- elpidio@latorilla.com a écrit : > Hi Mark,
>
> thanks for your additional suggestions for
> improvement.
>
> Re: 2 hospitals within an organization
>
> I think, if we will consider the integration of 2
> hospitals, we might as well design the
> system to accomodate an indefinite number of
> hospitals within its scope of operation.
>
> Actually, the hospital where I work is only one of
> many that belongs to an umbrella
> organization. So, I believe this situation is very
> common in other parts of the world.
> Your suggestion of using an extra table to
> crossreference the hospitals is good.
>
> However, what are these folder numbers? Aren't these
> the admission numbers of the patients?
>
> Re: Addresses and the use of selectable list of
> towns/cities.
>
> This is a smart way of entering data and also
> ensures that the district, province, region, country
> are
> correct. I think we should follow your suggestion.
>
> I will also create the field for the phone code.
>
> Re: Race/Ethnic Origin
>
> This is quite a sensitive issue. I have no personal
> comments on this matter. But I will create the
> field for this data and through the use of the
> global-config flags, the system admin can decide to
> hide or
> show this on the entry forms.
>
> RE: Social Security Nr. / National ID nr.
>
> I will also create fields for both, and with the use
> of the global-config flags, the system admin
> can decide if they need these elements to appear on
> the forms.
>
> Thanks very much. Regards,
> Elpidio
>

___________________________________________________________
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Re: [Care2002-developers] re Patient Registration and Admissions

From: Anil DSouza <ante@vs...> - 2002-12-09 19:44

Yes nancy

HL7 is an interface to talk to different system.

anil
----- Original Message -----
From: "Nancy Gertrudiz" <ngertrudizs@yahoo.fr>
To: <care2002-developers@lists.sourceforge.net>
Cc: <elpidio@latorilla.com>
Sent: Tuesday, December 10, 2002 1:03 AM
Subject: Re: [Care2002-developers] re Patient Registration and Admissions

> I have a question, what about HL7, I suppose, it is
> the way for the interface for differents institutions
> and systems?
>
> Nancy
>
> --- elpidio@latorilla.com a écrit : > Hi Mark,
> >
> > thanks for your additional suggestions for
> > improvement.
> >
> > Re: 2 hospitals within an organization
> >
> > I think, if we will consider the integration of 2
> > hospitals, we might as well design the
> > system to accomodate an indefinite number of
> > hospitals within its scope of operation.
> >
> > Actually, the hospital where I work is only one of
> > many that belongs to an umbrella
> > organization. So, I believe this situation is very
> > common in other parts of the world.
> > Your suggestion of using an extra table to
> > crossreference the hospitals is good.
> >
> > However, what are these folder numbers? Aren't these
> > the admission numbers of the patients?
> >
> > Re: Addresses and the use of selectable list of
> > towns/cities.
> >
> > This is a smart way of entering data and also
> > ensures that the district, province, region, country
> > are
> > correct. I think we should follow your suggestion.
> >
> > I will also create the field for the phone code.
> >
> > Re: Race/Ethnic Origin
> >
> > This is quite a sensitive issue. I have no personal
> > comments on this matter. But I will create the
> > field for this data and through the use of the
> > global-config flags, the system admin can decide to
> > hide or
> > show this on the entry forms.
> >
> > RE: Social Security Nr. / National ID nr.
> >
> > I will also create fields for both, and with the use
> > of the global-config flags, the system admin
> > can decide if they need these elements to appear on
> > the forms.
> >
> > Thanks very much. Regards,
> > Elpidio
> >
>
> ___________________________________________________________
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>
http://www1.telethon.fr/030-Espace-Relais-Dons/webtirelire1.asp?hebergeur_id
=1309
>
>
> -------------------------------------------------------
> This sf.net email is sponsored by:ThinkGeek
> Welcome to geek heaven.
> http://thinkgeek.com/sf
> _______________________________________________
> Care2002-developers mailing list
> Care2002-developers@lists.sourceforge.net /> > https://lists.sourceforge.net/lists/listinfo/care2002-developers

Re: [Care2002-developers] re Patient Registration and Admissions

From: Gerard BULGER <gerryb@ca...> - 2002-12-09 21:59

Attachments: Message as HTML

Ethnic Origin

I think the best way to declare ethnic origin is to ask:

"What is/are your country(ies) of family ethnic origin?" All that is =
then required is a list of countries (or potential countries, such as =
Kurdistan).=20

I wrote a letter to the BMJ years ago suggesting this, but the Read Code =
system the UK still sticks to an old census definition of =
Caucasian/black/asian etc. This does not give any information as to =
place of origin, or the language and culture, let alone genetic risk.

For mixed race patients, I would put the mother first, believing she may =
have more influence (mitochondria come from the mother!)
So, a patient could then be described as Jamaica/Nigeria but in fact =
come from South London.

I suspect one would have to stick to an international standard in =
Snowmed or HL7.

Gerry Bulger
www.careprovider.com

----- Original Message -----=20
From: markp@sainet.co.za=20 /> To: care2002-developers@lists.sourceforge.net=20 /> Sent: Monday, December 09, 2002 3:42 PM
Subject: [Care2002-developers] re Patient Registration and Admissions

Hi

I received the e-mail the morning I went on holiday, hence the delay =
in responding. Well done Elpidio in getting the modules started going. =
I have some comments regarding the table care_patient (for some reason =
I didn't copy the care_admission table to my laptop). =20

1.. We'll need some other patient folder numbers available. We work =
out of 2 hospitals and each has a paper-based folder system, each with =
their own numbering system. I'm sure there may be many institutions in =
the same situation. Are there likely to be more than two - if so, we =
might need to have another table cross-referencing the various numbers =
(this would allow for unlimited numbers). This also means that the =
Patient search should be searchable using not only the names and =
patient_nr fields, but also these user defined numbers (paper-based =
folder users are more likely to search using the Folder Numbers). Some =
folder numbers might include non-numeric characters, eg 2002/16527.=20

2.. Addresses. The system as designed would work fine until one =
wanted to derive epidemiological data from the dataset. Some users will =
input Town names into Street fields, Provinces into Regions etc and it =
would prove very difficult to validate. Looking at the data from an =
epidemiological point of view, I would want to know how many, say, cases =
of acute rheumatic fever per 100 000 population we have per year. For =
that we need population statistics (from census data) and diagnostic =
data (count the number of cases we saw in a year). For this to work, =
we need to have every patient address mapped to a region with known =
population. The way to do this is:=20
1.. Only save the street address and the town/city/suburb etc in =
the care_patient. =20
2.. Input into the Town/city field must be validated and must be =
sent in a Town/city table.=20
3.. Users should be able to enter a few characters into the input =
box on the screen, then click on a button alongside - this will bring up =
another window with a list of all towns/cities which match these =
characters. The user can then select the town/city, the window closes =
and that town/city is entered into the input box. Users should also be =
able to add a new town/city to the Town/city table. (Perhaps we should =
just call it Town field and Town table). The zip code for the town =
would be stored in the town table. Perhaps even the phone area code =
could also be stored there.=20
4.. The Town table has a foreign key field called district_id =
which links to a District table. Each District has a known population =
derived from census data.=20
5.. Districts link to Regions in a similar way=20
6.. Regions link to Provinces in a similar way.=20
7.. Users would not have to add Districts, Regions or Provinces =
(these would be set up initially by the database administrator).=20
I know this adds a number of tables. In some ways it might complicate =
the data entry (being forced to enter a town name/open up a look up =
window etc) but it does save the user from entering province, region and =
country details so will probably even save some data entry time as well =
as have useable data (epidemiologically speaking!)

3.. Race/ethnic origin. From an epidemiological point of view, =
ethnic data might be useful. Here in South Africa and in many other =
parts of the world, ethnic origins are very strongly correlated with =
socio-economic status. Using various health indicators, for example the =
under 5 year old mortality and stratifying it according to ethnic origin =
can be helpful in planning interventions and targeting them =
appropriately. Monitoring the health indicator over time will =
demonstrate the efficacy of the interventions. In the real world, =
though, the usefulness of keeping this data might be offset by the =
possible abuse of it (discrimination against minorities etc). I am not =
sure myself where I would vote if asked whether I wanted to keep the =
ethnicity on file or not; I'd probably vote yes based on the =
epidemiological argument, but then, I've never been in the unfortunate =
position of being discriminated against! Let's have some other =
opinions from you all out there!!=20

4.. Do we need to have a field for Social Insurance number/National =
identity number etc?=20

When I next pick up my e-mail, I'll try to get the table_admission =
details and will comment on those next time. I look forward to the =
feedback and discussion!

Regards,

Mark Painter

Re: [Care2002-developers] re Patient Registration and Admissions

From: <elpidio@la...> - 2002-12-09 23:17

Hi Nancy,

Mark was saying that the 2 hospitals where he works,
use (or should be using) the same system or software (in this case, CARE).
This also means that they are using the same databank. Furthermore,
this also implies that the 2 hospitals become "subdepartments" of a
bigger institution separated both geographically and organizationally.

Therefore, in a system where 2 (or indefinite number of) hospitals use the same
CARE software and the same databank, there is no need to use an interface like HL7 for intercommunication
but instead everything can be "hardcoded".

HL7 is an attempt to provide a
common communication protocol between different systems.
Regarding its implentation for CARE, yes we are looking for somebody to
concentrate on this. Guide Mitschke of Germany gave me a substantial amount of
information on how to implement this but I cannot concentrate on this at the moment.
If somebody would like to tackle this job, he would certainly expand the
project's capability.

Regards,
Elpidio

> I have a question, what about HL7, I suppose, it is
> the way for the interface for differents institutions
> and systems?
>
> Nancy

Re: [Care2002-developers] re Patient Registration and Admissions

From: <elpidio@la...> - 2002-12-10 19:32

Attachments: Message as HTML

Hi,

I am going to create the ethnic field in the care_patient table. The =
user will decide for himself if
he is going to use the field in his system or not. Also, the input in =
the form will accept a
free text entry, so the user can decide whether to use =
caucasian/black...etc. or the country of
origin.

Also the field description would not be a problem since the user could =
simply replace the variable's
value in the language table. However since we have to release the =
version with a default vaue, we (the whole group)=20
do need to discuss on the most appropriate word: "Race" ? or "Ethnic =
origin" ? or whatever.
I would highly apciate your opinion on this matter.

Thanks
Elpidio

Ethnic Origin

I think the best way to declare ethnic origin is to ask:

"What is/are your country(ies) of family ethnic origin?" All that is =
then required is a list of countries (or potential countries, such as =
Kurdistan).=20

I wrote a letter to the BMJ years ago suggesting this, but the Read =
Code system the UK still sticks to an old census definition of =
Caucasian/black/asian etc. This does not give any information as to =
place of origin, or the language and culture, let alone genetic risk.

For mixed race patients, I would put the mother first, believing she =
may have more influence (mitochondria come from the mother!)
So, a patient could then be described as Jamaica/Nigeria but in fact =
come from South London.

I suspect one would have to stick to an international standard in =
Snowmed or HL7.

Gerry Bulger
www.careprovider.com

RE: [Care2002-developers] re Patient Registration and Admissions

From: mark painter <markp@sa...> - 2002-12-11 13:56

Attachments: Message as HTML

Hi Elpidio

The folder numbers are not admission numbers - they would correlate
exactly with the patient_nr: when a new patient arrives, a folder is
opened - that folder has a number. If the patient comes back on another
visit or admission, the same folder is re-opened.

I'm getting the admission table details and will comment on those soon.

Regards, Mark

-----Original Message-----
From: care2002-developers-admin@lists.sourceforge.net /> [mailto:care2002-developers-admin@lists.sourceforge.net] On Behalf Of
elpidio@latorilla.com /> Sent: 09 December 2002 07:30 PM
To: care2002-developers@lists.sourceforge.net /> Subject: Re: [Care2002-developers] re Patient Registration and
Admissions

Hi Mark,

thanks for your additional suggestions for improvement.

Re: 2 hospitals within an organization

I think, if we will consider the integration of 2 hospitals, we might as
well design the

system to accomodate an indefinite number of hospitals within its scope
of operation.

Actually, the hospital where I work is only one of many that belongs to
an umbrella

organization. So, I believe this situation is very common in other parts
of the world.

Your suggestion of using an extra table to crossreference the hospitals
is good.

However, what are these folder numbers? Aren't these the admission
numbers of the patients?

Re: Addresses and the use of selectable list of towns/cities.

This is a smart way of entering data and also ensures that the district,
province, region, country are

correct. I think we should follow your suggestion.

I will also create the field for the phone code.

Re: Race/Ethnic Origin

This is quite a sensitive issue. I have no personal comments on this
matter. But I will create the

field for this data and through the use of the global-config flags, the
system admin can decide to hide or

show this on the entry forms.

RE: Social Security Nr. / National ID nr.

I will also create fields for both, and with the use of the
global-config flags, the system admin

can decide if they need these elements to appear on the forms.

Thanks very much. Regards,

Elpidio

Re: [Care2002-developers] re Patient Registration and Admissions

From: <elpidio@la...> - 2002-12-11 19:17

Attachments: Message as HTML

Ok, I understand now.

Regarding the numbers having alphanumeric characters, it might pose some =
problems=20
on technical implementation namely:

1) The patient_nr is auto-incremental, and as far as I know, this works =
only with numeric values.
2) The barcode being used needs pure numeric values. Currently the =
format is
set to - interlaced 2 of 5 - . Actually, the barcode generator class can =
generate other formats,=20
but I have not yet implemented the user-config GUI for selecting the =
format . But I am quite
sure that the other formats also need pure numeric values.

:-)
Elpidio
The folder numbers are not admission numbers - they would correlate =
exactly with the patient_nr: when a new patient arrives, a folder is =
opened - that folder has a number. If the patient comes back on another =
visit or admission, the same folder is re-opened.

I'm getting the admission table details and will comment on those =
soon.

Regards, Mark

RE: [Care2002-developers] re Patient Registration and Admissions

From: mark painter <markp@sa...> - 2002-12-12 11:50

Attachments: Message as HTML

Hi Elpidio. I wouldn't replace the patient_nr at all. I would only
have the ability to access the patient by using the other numbers as
well. They would be separate fields (or possibly another table to
allow for unlimited 'other numbers'). Regards, Mark

-----Original Message-----
From: care2002-developers-admin@lists.sourceforge.net /> [mailto:care2002-developers-admin@lists.sourceforge.net] On Behalf Of
elpidio@latorilla.com /> Sent: 11 December 2002 08:26 PM
To: care2002-developers@lists.sourceforge.net /> Subject: Re: [Care2002-developers] re Patient Registration and
Admissions

Ok, I understand now.

Regarding the numbers having alphanumeric characters, it might pose some
problems

on technical implementation namely:

1) The patient_nr is auto-incremental, and as far as I know, this works
only with numeric values.

2) The barcode being used needs pure numeric values. Currently the
format is

set to - interlaced 2 of 5 - . Actually, the barcode generator class can
generate other formats,

but I have not yet implemented the user-config GUI for selecting the
format . But I am quite

sure that the other formats also need pure numeric values.

:-)

Elpidio

The folder numbers are not admission numbers - they would correlate
exactly with the patient_nr: when a new patient arrives, a folder is
opened - that folder has a number. If the patient comes back on another
visit or admission, the same folder is re-opened.

I'm getting the admission table details and will comment on those soon.

Regards, Mark

RE: [Care2002-developers] re Patient Registration and Admissions

From: mark painter <markp@sa...> - 2002-12-12 11:56

Attachments: Message as HTML

I would just use 'Race', easiest for everyone to understand. Regards,
Mark

-----Original Message-----
From: care2002-developers-admin@lists.sourceforge.net /> [mailto:care2002-developers-admin@lists.sourceforge.net] On Behalf Of
elpidio@latorilla.com /> Sent: 10 December 2002 09:41 PM
To: care2002-developers@lists.sourceforge.net /> Subject: Re: [Care2002-developers] re Patient Registration and
Admissions

Hi,

I am going to create the ethnic field in the care_patient table. The
user will decide for himself if

he is going to use the field in his system or not. Also, the input in
the form will accept a

free text entry, so the user can decide whether to use
caucasian/black...etc. or the country of

origin.

Also the field description would not be a problem since the user could
simply replace the variable's

value in the language table. However since we have to release the
version with a default vaue, we (the whole group)

do need to discuss on the most appropriate word: "Race" ? or "Ethnic
origin" ? or whatever.

I would highly apciate your opinion on this matter.

Thanks

Elpidio

Ethnic Origin

I think the best way to declare ethnic origin is to ask:

"What is/are your country(ies) of family ethnic origin?" All that is
then required is a list of countries (or potential countries, such as
Kurdistan).

I wrote a letter to the BMJ years ago suggesting this, but the Read Code
system the UK still sticks to an old census definition of
Caucasian/black/asian etc. This does not give any information as to
place of origin, or the language and culture, let alone genetic risk.

For mixed race patients, I would put the mother first, believing she may
have more influence (mitochondria come from the mother!)

So, a patient could then be described as Jamaica/Nigeria but in fact
come from South London.

I suspect one would have to stick to an international standard in
Snowmed or HL7.

Gerry Bulger

www.careprovider.com

Re: [Care2002-developers] re Patient Registration and Admissions

From: Gerard BULGER <gerryb@ca...> - 2002-12-12 22:44

Attachments: Message as HTML

Race: Race on its own is useless medically.
One also need to avoid describing people by nationality...but country of =
ethnic origin.
India not Indian

Caucasian tells me nothing, but country of family ethnic origin such as =
Bosnia tells me a lot....likely to be a refugee if in UK, language and =
so on. Cyprus tell me a lot, but not language, but at least alerts me to =
thalasmemia trait.
Ditto Black. Zambia says more. =20
Ditto "Asian" I need to have an idea as to language, current =
socio-political status, quite apart from likely disease states; e.g. =
"India" would imply (currently) tendency to type 2 diabetes or even TB

The system could list countries. =20

Gerry

----- Original Message -----=20
From: mark painter=20
To: care2002-developers@lists.sourceforge.net=20 /> Sent: Thursday, December 12, 2002 11:56 AM
Subject: RE: [Care2002-developers] re Patient Registration and =
Admissions

I would just use 'Race', easiest for everyone to understand. Regards, =
Mark

-----Original Message-----
From: care2002-developers-admin@lists.sourceforge.net =
[mailto:care2002-developers-admin@lists.sourceforge.net] On Behalf Of =
elpidio@latorilla.com /> Sent: 10 December 2002 09:41 PM
To: care2002-developers@lists.sourceforge.net /> Subject: Re: [Care2002-developers] re Patient Registration and =
Admissions

Hi,

I am going to create the ethnic field in the care_patient table. The =
user will decide for himself if

he is going to use the field in his system or not. Also, the input in =
the form will accept a

free text entry, so the user can decide whether to use =
caucasian/black...etc. or the country of

origin.

Also the field description would not be a problem since the user could =
simply replace the variable's

value in the language table. However since we have to release the =
version with a default vaue, we (the whole group)=20

do need to discuss on the most appropriate word: "Race" ? or "Ethnic =
origin" ? or whatever.

I would highly apciate your opinion on this matter.

Thanks

Elpidio

Ethnic Origin

I think the best way to declare ethnic origin is to ask:

"What is/are your country(ies) of family ethnic origin?" All that =
is then required is a list of countries (or potential countries, such as =
Kurdistan).=20

I wrote a letter to the BMJ years ago suggesting this, but the Read =
Code system the UK still sticks to an old census definition of =
Caucasian/black/asian etc. This does not give any information as to =
place of origin, or the language and culture, let alone genetic risk.

For mixed race patients, I would put the mother first, believing she =
may have more influence (mitochondria come from the mother!)

So, a patient could then be described as Jamaica/Nigeria but in fact =
come from South London.

I suspect one would have to stick to an international standard in =
Snowmed or HL7.

Gerry Bulger

www.careprovider.com

Re: [Care2002-developers] re Patient Registration and Admissions

From: <elpidio@la...> - 2002-12-12 23:25

Attachments: Message as HTML

Hi Mark,

I have a suggestion: We do not create an extra table for "other numbers" =
but instead create a
single field "other_nr" in the care_patient table. To make it store =
"unlimited" numbers we just concatenate these
numbers pended as well as appended with "_" and separated with space.

For example: =20
patient_nr =3D 10000009
other numbers =3D 2002/10909 , 22/33009, 2002-B-10909, 2-107783

the field "other_nr" would then store =3D _2002/10909_ _22/330099_ =
_2002-B-10909_ _2-107783_

To find the patient using one of the other numbers we just make a query =
similar to:

.... WHERE other_nr LIKE '%_".$seachkeyword."_%";

Eventually, one would like to remove one or all other numbers. This =
could also be done with:

"UPDATE care_patient SET other_nr =3D ( REPLACE (other_nr, =
'_".$other_nr."_', '') ) WHERE other_nr LIKE '_".$other_nr."_'";

At the moment, I do not know which is better, the above technique or =
adding a new table.

:-)
Elpidio

Hi Elpidio. I wouldn't replace the patient_nr at all. I would only =
have the ability to access the patient by using the other numbers as =
well. They would be separate fields (or possibly another table to =
allow for unlimited 'other numbers'). Regards, Mark

Re: [Care2002-developers] re Patient Registration and Admissions

From: <elpidio@la...> - 2002-12-12 23:25

Attachments: Message as HTML

Hi Mark,

I would create the field and name it ethnic_origin. IMHO, this is more =
neutral and=20
saves us from eventually offering explanations if we would have used =
the "race" term.

:-)

I would just use 'Race', easiest for everyone to understand. Regards, =
Mark

Re: [Care2002-developers] re Patient Registration and Admissions

From: Robert Warren <robert@3t...> - 2002-12-13 17:31

On Monday 09 December 2002 08:42 am, markp@sainet.co.za wrote:
> Hi
>
>
>
> I received the e-mail the morning I went on holiday, hence the delay in
> responding. Well done Elpidio in getting the modules started going. I
> have some comments regarding the table care_patient (for some reason I
> didn't copy the care_admission table to my laptop).
>
>
>
> 1. We'll need some other patient folder numbers available. We work
> out of 2 hospitals and each has a paper-based folder system, each with
> their own numbering system. I'm sure there may be many institutions in
> the same situation. Are there likely to be more than two - if so, we
> might need to have another table cross-referencing the various numbers
> (this would allow for unlimited numbers). This also means that the
> Patient search should be searchable using not only the names and
> patient_nr fields, but also these user defined numbers (paper-based
> folder users are more likely to search using the Folder Numbers). Some
> folder numbers might include non-numeric characters, eg 2002/16527.
>
>
>
> 2. Addresses. The system as designed would work fine until one
> wanted to derive epidemiological data from the dataset. Some users will
> input Town names into Street fields, Provinces into Regions etc and it
> would prove very difficult to validate. Looking at the data from an
> epidemiological point of view, I would want to know how many, say, cases
> of acute rheumatic fever per 100 000 population we have per year. For
> that we need population statistics (from census data) and diagnostic
> data (count the number of cases we saw in a year). For this to work,
> we need to have every patient address mapped to a region with known
> population. The way to do this is:
>
> a. Only save the street address and the town/city/suburb etc in the
> care_patient.
> b. Input into the Town/city field must be validated and must be
> sent in a Town/city table.
> c. Users should be able to enter a few characters into the input
> box on the screen, then click on a button alongside - this will bring up
> another window with a list of all towns/cities which match these
> characters. The user can then select the town/city, the window closes
> and that town/city is entered into the input box. Users should also be
> able to add a new town/city to the Town/city table. (Perhaps we should
> just call it Town field and Town table). The zip code for the town
> would be stored in the town table. Perhaps even the phone area code
> could also be stored there.

If postal code were entered before town/city then the town, state ect could be
searched and entered via java script. This could simplify and validate the
address data entry.

> d. The Town table has a foreign key field called district_id which
> links to a District table. Each District has a known population derived
> from census data.
> e. Districts link to Regions in a similar way
> f. Regions link to Provinces in a similar way.
> g. Users would not have to add Districts, Regions or Provinces
> (these would be set up initially by the database administrator).
>
> I know this adds a number of tables. In some ways it might complicate
> the data entry (being forced to enter a town name/open up a look up
> window etc) but it does save the user from entering province, region and
> country details so will probably even save some data entry time as well
> as have useable data (epidemiologically speaking!)
>
>
>
> 3. Race/ethnic origin. From an epidemiological point of view,
> ethnic data might be useful. Here in South Africa and in many other
> parts of the world, ethnic origins are very strongly correlated with
> socio-economic status. Using various health indicators, for example the
> under 5 year old mortality and stratifying it according to ethnic origin
> can be helpful in planning interventions and targeting them
> appropriately. Monitoring the health indicator over time will
> demonstrate the efficacy of the interventions. In the real world,
> though, the usefulness of keeping this data might be offset by the
> possible abuse of it (discrimination against minorities etc). I am not
> sure myself where I would vote if asked whether I wanted to keep the
> ethnicity on file or not; I'd probably vote yes based on the
> epidemiological argument, but then, I've never been in the unfortunate
> position of being discriminated against! Let's have some other
> opinions from you all out there!!
>
>
>
> 4. Do we need to have a field for Social Insurance number/National
> identity number etc?
>
>
>
>
>
> When I next pick up my e-mail, I'll try to get the table_admission
> details and will comment on those next time. I look forward to the
> feedback and discussion!
>
>
>
> Regards,
>
>
>
> Mark Painter

--
Robert Warren
robert@3tec.biz /> (970) 349 1523

Re: [Care2002-developers] re Patient Registration and Admissions

From: <ngertrudizs@ya...> - 2002-12-13 20:10

Gerard,

I think that sometimes the race is a basic data, for
example in laboratory results it depends on the region
and race, some normal values changes.

Nancy

--- Gerard BULGER <gerryb@careprovider.com> a écrit :
> Race: Race on its own is useless medically.
> One also need to avoid describing people by
> nationality...but country of ethnic origin.
> India not Indian
>
> Caucasian tells me nothing, but country of family
> ethnic origin such as Bosnia tells me a
> lot....likely to be a refugee if in UK, language and
> so on. Cyprus tell me a lot, but not language, but
> at least alerts me to thalasmemia trait.
> Ditto Black. Zambia says more.
> Ditto "Asian" I need to have an idea as to
> language, current socio-political status, quite
> apart from likely disease states; e.g. "India" would
> imply (currently) tendency to type 2 diabetes or
> even TB
>
> The system could list countries.
>
> Gerry
>
>
>
> ----- Original Message -----
> From: mark painter
> To: care2002-developers@lists.sourceforge.net
> Sent: Thursday, December 12, 2002 11:56 AM
> Subject: RE: [Care2002-developers] re Patient
> Registration and Admissions
>
>
> I would just use 'Race', easiest for everyone to
> understand. Regards, Mark
>
>
>
> -----Original Message-----
> From:
> care2002-developers-admin@lists.sourceforge.net /> >
[mailto:care2002-developers-admin@lists.sourceforge.net] /> > On Behalf Of elpidio@latorilla.com /> > Sent: 10 December 2002 09:41 PM
> To: care2002-developers@lists.sourceforge.net /> > Subject: Re: [Care2002-developers] re Patient
> Registration and Admissions
>
>
>
> Hi,
>
>
>
> I am going to create the ethnic field in the
> care_patient table. The user will decide for himself
> if
>
> he is going to use the field in his system or not.
> Also, the input in the form will accept a
>
> free text entry, so the user can decide whether to
> use caucasian/black...etc. or the country of
>
> origin.
>
>
>
> Also the field description would not be a problem
> since the user could simply replace the variable's
>
> value in the language table. However since we have
> to release the version with a default vaue, we (the
> whole group)
>
> do need to discuss on the most appropriate word:
> "Race" ? or "Ethnic origin" ? or whatever.
>
> I would highly apciate your opinion on this
> matter.
>
>
>
> Thanks
>
> Elpidio
>
>
>
> Ethnic Origin
>
>
>
> I think the best way to declare ethnic origin is
> to ask:
>
>
>
> "What is/are your country(ies) of family ethnic
> origin?" All that is then required is a list of
> countries (or potential countries, such as
> Kurdistan).
>
>
>
> I wrote a letter to the BMJ years ago suggesting
> this, but the Read Code system the UK still sticks
> to an old census definition of Caucasian/black/asian
> etc. This does not give any information as to place
> of origin, or the language and culture, let alone
> genetic risk.
>
>
>
> For mixed race patients, I would put the mother
> first, believing she may have more influence
> (mitochondria come from the mother!)
>
> So, a patient could then be described as
> Jamaica/Nigeria but in fact come from South London.
>
>
>
> I suspect one would have to stick to an
> international standard in Snowmed or HL7.
>
>
>
> Gerry Bulger
>
> www.careprovider.com
>
>
>

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Re: [Care2002-developers] re Patient Registration and Admissions

From: <ngertrudizs@ya...> - 2002-12-14 00:47

Hi! Elpidio:

I have a question, why the systems assign an number
admision before the register of the patient?. I think
It's better to assure the register and at this moment
assign an identification number. In the other case, it
is not possible to obtain a sequence and verifiy it,
some number could be lost.

Regards,

Nancy

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Re: [Care2002-developers] re Patient Registration and Admissions

From: <ngertrudizs@ya...> - 2002-12-14 00:50

Elpidio,

Where does the systems use the ICD9 codes? Or the dx
are always register as a text?

Nancy

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Re: [Care2002-developers] re Patient Registration and Admissions

From: <elpidio@la...> - 2002-12-14 08:57

Hi,

> If postal code were entered before town/city then the town, state ect could be
> searched and entered via java script. This could simplify and validate the
> address data entry.

Yes, that is a good option too. We could also implement that.

:-)
Elpidio

Re: [Care2002-developers] re Patient Registration and Admissions

From: <elpidio@la...> - 2002-12-14 08:57

Hi,

> I have a question, why the systems assign an number
> admision before the register of the patient?. I think
> It's better to assure the register and at this moment
> assign an identification number.

The reason for this in the initial design proposal is my stubborn
effort to keep the admission item in the main menu list. I admit
that this gives me some difficulties in streamlining the navigation
flow. We might as well discard it to simplify navigation and
avoid confusion. Let us see, I am going to modify the
navigation flow considering all the feedbacks so far.

> In the other case, it
> is not possible to obtain a sequence and verifiy it,
> some number could be lost.

In normal cases, it will not happen since the number is only
generated during the "save" process. The patient_nr or
encounter_nr is auto-incremental, so a number should not be lost.

Re: [Care2002-developers] re Patient Registration and Admissions

From: <elpidio@la...> - 2002-12-14 08:57

Hi Nancy,

> Where does the systems use the ICD9 codes?

Currently, the ICD10 codes are accessible only via the OR
(operating room) module (I work in OR, thus the design).

Once we implement the new structure, there would be an
extra module for entering these codes regardless of the
department. All icd codes pertaining to an encounter would be
stored in a table. Of course the codes entered via the OR module
(and eventually via other modules) would also be stored in this table.

> Or the dx
> are always register as a text?

If the ICD codes are used, only the code numbers are stored. Currently, one
can still enter diagnoses in text form in the Medocs module. This module
is a replica of the software being currently used in my workplace.
I am not sure how long this would be useful, because the hospital is
systematically implementing the DRG system (with ICD).

On the other hand, the diagnoses in text form as in the case of Medocs
are much easier to understand than a series of code numbers. Probably,
one compromise is to list the ICD codes on the Medocs form.
This would mean redundant work for the doctor, however.

;-)
Elpidio

RE: [Care2002-developers] re Patient Registration and Admissions

From: mark painter <markp@sa...> - 2002-12-15 19:48

Hi

I think it is important that we use colloquial - easily understandable -
terms when we use diagnoses. If a user wants to enter a diagnosis, say,
Right upper lobe pneumonia, we should allow that. The user would need
to add it to the diagnoses table, though, and the administrator would
need to allocate the correct ICD9 (or 10) code to the diagnosis. I
would hate to limit the user to the actual description in the ICD9 files
(things like 'Inability to obtain normal physiological parameters' or
whatever the description of 'Failure to Thrive' might be!

This means that the text would need to be saved, not the code.

I feel the same way about addresses - if a user wants to enter the town
address as 'Upper Claremont', we should allow it. However, it does put
more work on the administrator who would have to map 'Upper Claremont'
to the area which has a known population from census figures.
Obviously, though, this is not as important as for diagnoses.

One more point about Race/ethnic origin: all we would want to achieve
with this is to facilitate epidemiological data collection and help with
normal values for some laboratory data. For this, all we need is the
usual classification - white, black etc - this might vary from place to
place.

Regards, Mark Painter

-----Original Message-----
From: care2002-developers-admin@lists.sourceforge.net /> [mailto:care2002-developers-admin@lists.sourceforge.net] On Behalf Of
Nancy Gertrudiz
Sent: 14 December 2002 02:50 AM
To: care2002-developers@lists.sourceforge.net /> Subject: Re: [Care2002-developers] re Patient Registration and
Admissions

Elpidio,

Where does the systems use the ICD9 codes? Or the dx
are always register as a text?

Nancy

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Re: [Care2002-developers] re Patient Registration and Admissions

From: <ngertrudizs@ya...> - 2002-12-16 15:36

Hi Elpidio,

Yes, I am sure the sequence doesn't lost, I mean all
the numbers are generated but some identification
numbers are not assign to a patient, because the user
doesn't complete a new register.

Regards,

Nancy

--- elpidio@latorilla.com a écrit : > Hi,
>
> > I have a question, why the systems assign an
> number
> > admision before the register of the patient?. I
> think
> > It's better to assure the register and at this
> moment
> > assign an identification number.
>
> The reason for this in the initial design proposal
> is my stubborn
> effort to keep the admission item in the main menu
> list. I admit
> that this gives me some difficulties in streamlining
> the navigation
> flow. We might as well discard it to simplify
> navigation and
> avoid confusion. Let us see, I am going to modify
> the
> navigation flow considering all the feedbacks so
> far.
>
> > In the other case, it
> > is not possible to obtain a sequence and verifiy
> it,
> > some number could be lost.
>
> In normal cases, it will not happen since the number
> is only
> generated during the "save" process. The patient_nr
> or
> encounter_nr is auto-incremental, so a number should
> not be lost.
>
>
>
>
>
>
>
>
-------------------------------------------------------
> This sf.net email is sponsored by:
> With Great Power, Comes Great Responsibility
> Learn to use your power at OSDN's High Performance
> Computing Channel
> http://hpc.devchannel.org/
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> Care2002-developers@lists.sourceforge.net /> >
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Re: [Care2002-developers] re Patient Registration and Admissions

From: <elpidio@la...> - 2002-12-16 19:15

Hi Nancy,

> Yes, I am sure the sequence doesn't lost, I mean all
> the numbers are generated but some identification
> numbers are not assign to a patient, because the user
> doesn't complete a new register.

Do you mean that the user starts a new registration form,
enters some patient data, then cancels the process without
saving? If so, then no problem, because in this case, no
patient number has been generated.

The normal process runs like this:

start new regisration form -> enter patient data -> save & generate patient_nr -> show saved data (with patient_nr)

Now, if you mean that the user saves the data and thereby generating a patient nr, then
decides to discard the data. Well, that would be a subject for discussion whether we allow the
user to delete a stored data or not. As far as I know, it is not allowed to delete any stored
information in medical sector regardless of whether it is wrong data or not. In case of a wrong data, it is only marked
as wrong but never deleted. Also, any changes must be documented (in this case, CARE is not yet fully equipped to
document all changes in a record item, although the field "history" is ready).

One possibility is to set the "status" field to "discard" and enter the reason in the "history" field.

I am not well informed about the details of the legal laws and regulations pertaining to medical sector.
Hopefully, somebody could help us in this matter.

:-)
Elpidio

Re: [Care2002-developers] re Patient Registration and Admissions

From: <ngertrudizs@ya...> - 2002-12-16 20:04

Hi Elpidio,

No, I say, two users need register a patient then the
system assign an identification number for example 100
and 101. One of the users cancel the operation
(100)and the other performs the action (101). There
are a hole in the secuence, the 100 doesnt exist. I am
sure the systems would generate the next number 102,
but the patient 100 doesnt exist?
It could not be a problem in this case because the
systems generate ok the autonumber, but I think it
could be more trasparent the other way.

Nancy
--- elpidio@latorilla.com a écrit : > Hi Nancy,
>
> > Yes, I am sure the sequence doesn't lost, I mean
> all
> > the numbers are generated but some identification
> > numbers are not assign to a patient, because the
> user
> > doesn't complete a new register.
>
>
> Do you mean that the user starts a new registration
> form0
> enters some patient data, then cancels the process
> without
> saving? If so, then no problem, because in this
> case, no
> patient number has been generated.
>
> The normal process runs like this:
>
> start new regisration form -> enter patient data ->
> save & generate patient_nr -> show saved data (with
> patient_nr)
>
> Now, if you mean that the user saves the data and
> thereby generating a patient nr, then
> decides to discard the data. Well, that would be a
> subject for discussion whether we allow the
> user to delete a stored data or not. As far as I
> know, it is not allowed to delete any stored
> information in medical sector regardless of whether
> it is wrong data or not. In case of a wrong data, it
> is only marked
> as wrong but never deleted. Also, any changes must
> be documented (in this case, CARE is not yet fully
> equipped to
> document all changes in a record item, although the
> field "history" is ready).
>
> One possibility is to set the "status" field to
> "discard" and enter the reason in the "history"
> field.
>
> I am not well informed about the details of the
> legal laws and regulations pertaining to medical
> sector.
> Hopefully, somebody could help us in this matter.
>
> :-)
> Elpidio
>
>
>
>
-------------------------------------------------------
> This sf.net email is sponsored by:
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> Learn to use your power at OSDN's High Performance
> Computing Channel
> http://hpc.devchannel.org/
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> Care2002-developers@lists.sourceforge.net /> >
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Re: [Care2002-developers] re Patient Registration and Admissions

From: <elpidio@la...> - 2002-12-16 21:13

Hi Nancy,

I think you are referring to the current admission module of beta 1.0.03.
If so, yes you are right , a number could be lost. This is a known
design error in the current release version.

The revamp of the database structure and the data model is
ongoing. I am also writing the prototype modules that will
work with the new data model. The problem of "lost identification number" is
is already solved in the prototype modules.

;-)
Elpidio

> No, I say, two users need register a patient then the
> system assign an identification number for example 100
> and 101. One of the users cancel the operation
> (100)and the other performs the action (101). There
> are a hole in the secuence, the 100 doesnt exist. I am
> sure the systems would generate the next number 102,
> but the patient 100 doesnt exist?
> It could not be a problem in this case because the
> systems generate ok the autonumber, but I think it
> could be more trasparent the other way.

Re: [Care2002-developers] re Patient Registration and Admissions

From: Are Kristensen <arek@ma...> - 2003-01-10 17:10

> HL7 is an attempt to provide a
> common communication protocol between different systems.
> Regarding its implentation for CARE, yes we are looking for somebody to
> concentrate on this. Guide Mitschke of Germany gave me a substantial amount
> of information on how to implement this but I cannot concentrate on this at
> the moment. If somebody would like to tackle this job, he would certainly
> expand the project's capability.

We need to interchange some EDIFACT and XML messages here in Norway, so I can
take ownership of an EDI module if you guys want? It would solve both HL7 and
EDIFACT communcation, or whatever dataformat you want to interchange.

I've depended then on the result from an other open-source project that want
deliver anything before late in mars. But after that (april sometime) I could
give you a beta of an Care interface against a EDI server, and a example of
how to automate pulling out data from the Care DB and translating it to
different message formats...

To then make Care deliver HL7 and/or UN/EDIFACT messages fully is an other
project that maybe someone wants to help with :-D

--
Med vennlig hilsen/best regards
Are I. Kristensen

Re: [Care2002-developers] re Patient Registration and Admissions

From: <elpidio@la...> - 2003-01-10 19:28

Hi Are,

it is nice to hear from you again.

[...]
> We need to interchange some EDIFACT and XML messages here in Norway, so I can
> take ownership of an EDI module if you guys want? It would solve both HL7 and
> EDIFACT communcation, or whatever dataformat you want to interchange.

That would be great :-) Please feel free to work on it. That would surely enhance
the capabilities of the project.

> I've depended then on the result from an other open-source project that want
> deliver anything before late in mars. But after that (april sometime) I could
> give you a beta of an Care interface against a EDI server, and a example of
> how to automate pulling out data from the Care DB and translating it to
> different message formats...
>
> To then make Care deliver HL7 and/or UN/EDIFACT messages fully is an other
> project that maybe someone wants to help with :-D

I am sure when your interface is available, somebody will offer to help in the
further development.

By the way, I found the link to your norwegian version of CARE in the log files
of www.maryhospital.com . I could not resist to follow it, and I found your
translated version. :-) Wow! I was surprised by how much you have done
so far. Please tell me if I can report about this on the mailing lists.

Thank you very much for all the help. I really apciate it.
Best regards,
Elpidio

CARE2X php Integ Hospital Info System

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