Jan 21, 2015
Visits in 1.920-Jun-2012
From the upcoming version of the OpenMRS Guide at http://booki.flossmanuals.net/openmrs-guide/_full/
A Visit in OpenMRS represents exactly what it sounds like: a time period when a patient is actively interacting with the healthcare system, typically at a location.
The metadata differentiating different types of visits is a Visit Type. Visit Types are displayed in the user interface, and can be searched against.
A visit contains Encounters, which store more granular data about treatments or services.
What are Visits?
Historical note: Encounters were supposed to be what Visits are, but we got them wrong…
Visit◦ Patient◦ Visit Type◦ Location (optional)◦ Start DateTime◦ End DateTime
i.e. a duration
◦ Contains Encounters
Encounter◦ Patient◦ Encounter Type◦ Location (optional)◦ DateTime
i.e. a single instant
◦ Providers◦ Contains Obs
Visits vs. Encounters
Think of an Encounter as a “data collection transaction” or a “clinical transaction”
A big improvement in our information model◦ Especially if you’re doing point-of-care work
If you already have workflows and forms built around encounters, shifting to visits may require significant work and reconfiguration.
Disabling visits lets you continue with the old model
Don’t want to migrate yet?
Visit Types
Assigning Encounters to Visits
Auto-closing Visits
Visit Attributes
Configuring Visits
To categorize Visits
Displayed in the UI
Make them granular enough for meaningful use: Outpatient Primary Care is better than just Outpatient
Just a Name and Description◦ In the future Visit Type may
drive which encounters are allowed/expected in a visit
Visit Types
Reporting and Reporting Compatibility don’t let you search on them◦ If you want this, create a ticket or vote for it!
HTML Form Entry and XForms don’t explicitly support visits◦ thus you need to configure automatic assignment
of encounters to visits
Many Modules do not support Visits (yet)
Choose one of the two “Assign …” options
As each encounter is created (assuming it doesn’t have a visit specified explicitly) it will be assigned to a visit with:◦ encounter location is visit.location or a sublocation◦ visit start <= encounter datetime <= visit end
“Create New” option also requires you to set “Encounter Type to Visit Type Mapping” GP
Assigning Encounters to Visits
This is all very new. Let us know how it works out. Tickets welcome!
HTML Form Entry works fine with Visits if you configure your forms right!
Bad:<encounterDate default=“today”/>
Good:<encounterDate default=“now”
showTime=“true”/>
A note about HTML Form Entry
The UI creates visits starting “now.”
An encounter at 00:00 today cannot be assigned to a visit started at 9:15.
???◦ I haven’t used XForms in OpenMRS 1.9.◦ I assume it works.◦ Can someone comment?
A note about XForms
Outpatient visits typically do not have an official check-out
Need to auto-close outpatient visits, or they will never get closed.
Inpatient visits typically have a real-life discharge workflow.
Ending Visits
If you’re building a custom UI, you probably want something like this:
Custom attributes, Recorded for each visit
Virtual “columns” in the visit table
Arbitrary use cases. I can’t think of any good examples. :-)
Visit Attribute Types
Data collected pre-1.9 doesn’t have visits We need to improve this UI a bit
◦ https://tickets.openmrs.org/browse/TRUNK-3299
Legacy Encounters w/o Visits
Start Visit defaults to “now”. Add Visit asks you to enter the date
Starting a New Visit
Billing code should be shown as required. We have some UI issues to work out.
Significant Bugs around AttributesAvoid these in production at the moment…
Encounters grouped by visit Active Visits highlighted
Visits on the Dashboard
Entering a form adds an encounter to the visit◦ With the correct setup
(note the ugly time widget)
Adding an Encounter to a Visit
Header shows encounters in active visit Visits tab shows encounters grouped by visit
Multiple Encounters in a Visit
Close a visit from the dashboard header◦ In 1.9.1 a popup will let you confirm the datetime
on “End Visit Now”◦ Otherwise, “Edit Visit”, set end datetime, and
save.
Closing a Visit
Allowed to have simultaneous visits (intentionally)
Overlapping Visits
Manually assigning encounters to visits is tedious (partly due to poor UI)◦ https://tickets.openmrs.org/browse/TRUNK-3460 ◦ Won’t actually let you do the obvious wrong thing
Manually Adding Encounters