Problem List

MU Requirements

Meaningful Use Measures:

At least 80% of all unique patients have at least one entry or an indication of none recorded.

Certification Criteria for EHR:

Enable a user to electronically record, modify, and retrieve a patient’s problem list for longitudinal care (i.e., over multiple office visits) in accordance with the applicable standards% specified in Table 2A row 1: Applicable HIPAA code set required by law (i.e.,ICD-9-CM); or SNOMED CT.

Proposed Solution

Problem list can be found in Issues section of each patient's Medical Record.

It will be easier to access in the new GUI developed by Tony. See Medical Problems.

The proposed solution is as follows:

1. Add a "problem_list_status" field to "patient_data" table. The default for this field is "". This status is displayed under Medical Problems (new GUI).

2. Create a new field in Encounter form to allow the provider to choose "None" if there is no problem.
O Add Problem O None
O Add Allergy O None
O Add Medication O None

Effected Code, Tables, etc

-- -- Table structure for table `patient_data` --

DROP TABLE IF EXISTS `patient_data`; CREATE TABLE `patient_data` (

 `id` bigint(20) NOT NULL auto_increment,
 `title` varchar(255) NOT NULL default ,
 `language` varchar(255) NOT NULL default ,
 `financial` varchar(255) NOT NULL default ,
 `fname` varchar(255) NOT NULL default ,
 `lname` varchar(255) NOT NULL default ,
 `mname` varchar(255) NOT NULL default ,
 `DOB` date default NULL,
 `street` varchar(255) NOT NULL default ,
 `postal_code` varchar(255) NOT NULL default ,
 `city` varchar(255) NOT NULL default ,
 `state` varchar(255) NOT NULL default ,
 `country_code` varchar(255) NOT NULL default ,
 `drivers_license` varchar(255) NOT NULL default ,
 `ss` varchar(255) NOT NULL default ,
 `occupation` longtext,
 `phone_home` varchar(255) NOT NULL default ,
 `phone_biz` varchar(255) NOT NULL default ,
 `phone_contact` varchar(255) NOT NULL default ,
 `phone_cell` varchar(255) NOT NULL default ,
 `pharmacy_id` int(11) NOT NULL default '0',
 `status` varchar(255) NOT NULL default ,
 `contact_relationship` varchar(255) NOT NULL default ,
 `date` datetime default NULL,
 `sex` varchar(255) NOT NULL default ,
 `referrer` varchar(255) NOT NULL default ,
 `referrerID` varchar(255) NOT NULL default ,
 `providerID` int(11) default NULL,
 `email` varchar(255) NOT NULL default ,
 `ethnoracial` varchar(255) NOT NULL default ,
 `interpretter` varchar(255) NOT NULL default ,
 `migrantseasonal` varchar(255) NOT NULL default ,
 `family_size` varchar(255) NOT NULL default ,
 `monthly_income` varchar(255) NOT NULL default ,
 `homeless` varchar(255) NOT NULL default ,
 `financial_review` datetime default NULL,
 `pubpid` varchar(255) NOT NULL default ,
 `pid` bigint(20) NOT NULL default '0',
 `genericname1` varchar(255) NOT NULL default ,
 `genericval1` varchar(255) NOT NULL default ,
 `genericname2` varchar(255) NOT NULL default ,
 `genericval2` varchar(255) NOT NULL default ,
 `hipaa_mail` varchar(3) NOT NULL default ,
 `hipaa_voice` varchar(3) NOT NULL default ,
 `hipaa_notice` varchar(3) NOT NULL default ,
 `hipaa_message` varchar(20) NOT NULL default ,
 `hipaa_allowsms` VARCHAR( 3 ) NOT NULL DEFAULT 'NO',
 `hipaa_allowemail` VARCHAR( 3 ) NOT NULL DEFAULT 'NO',
 `squad` varchar(32) NOT NULL default ,
 `fitness` int(11) NOT NULL default '0',
 `referral_source` varchar(30) NOT NULL default ,
 `usertext1` varchar(255) NOT NULL DEFAULT ,
 `usertext2` varchar(255) NOT NULL DEFAULT ,
 `usertext3` varchar(255) NOT NULL DEFAULT ,
 `usertext4` varchar(255) NOT NULL DEFAULT ,
 `usertext5` varchar(255) NOT NULL DEFAULT ,
 `usertext6` varchar(255) NOT NULL DEFAULT ,
 `usertext7` varchar(255) NOT NULL DEFAULT ,
 `usertext8` varchar(255) NOT NULL DEFAULT ,
 `userlist1` varchar(255) NOT NULL DEFAULT ,
 `userlist2` varchar(255) NOT NULL DEFAULT ,
 `userlist3` varchar(255) NOT NULL DEFAULT ,
 `userlist4` varchar(255) NOT NULL DEFAULT ,
 `userlist5` varchar(255) NOT NULL DEFAULT ,
 `userlist6` varchar(255) NOT NULL DEFAULT ,
 `userlist7` varchar(255) NOT NULL DEFAULT ,
 `pricelevel` varchar(255) NOT NULL default 'standard',
 `regdate`     date DEFAULT NULL COMMENT 'Registration Date',
 `contrastart` date DEFAULT NULL COMMENT 'Date contraceptives initially used',
 UNIQUE KEY `pid` (`pid`),
 KEY `id` (`id`)

) ENGINE=MyISAM AUTO_INCREMENT=1 ;

-- -- Table structure for table `lists` --

DROP TABLE IF EXISTS `lists`; CREATE TABLE `lists` (

 `id` bigint(20) NOT NULL auto_increment,
 `date` datetime default NULL,
 `type` varchar(255) default NULL,
 `title` varchar(255) default NULL,
 `begdate` date default NULL,
 `enddate` date default NULL,
 `returndate` date default NULL,
 `occurrence` int(11) default '0',
 `classification` int(11) default '0',
 `referredby` varchar(255) default NULL,
 `extrainfo` varchar(255) default NULL,
 `diagnosis` varchar(255) default NULL,
 `activity` tinyint(4) default NULL,
 `comments` longtext,
 `pid` bigint(20) default NULL,
 `user` varchar(255) default NULL,
 `groupname` varchar(255) default NULL,
 `outcome` int(11) NOT NULL default '0',
 `destination` varchar(255) default NULL,
 PRIMARY KEY  (`id`)

) ENGINE=MyISAM AUTO_INCREMENT=1 ;

The affected file is "\htdocs\openemr\interface\patient_file\summary\add_edit_issue.php".

Owner and Status

Design - Tony McCormick and Thomas Wong

Coding - Jeremy Wallace

Links

• CCHIT_MU_2011_Project
• Associated with sourceforge forum: http://sourceforge.net/projects/openemr/forums/forum/202506/topic/3529447