Oncology in OpenMRS

[Andrew Miller]

Hello, I am new to OpenMRS. I am working on a project to use OpenMRS as a regional medical record instrumented for routine data reuse in analysis including GP and Oncology data.

My problem as a MD is that most of the documentation is infested with so many informatics concepts that finding what I want is difficult. In fact the places where I think I have found what I want are populated by short sentences with little actual data to explain. If I could get some help it would ease my entry into UI and concept/data structure development.

1. if there are people working on an oncology module, could you contact me please? We should collaborate. My initial concern is developing an Oncology Information System UI for the oncologist before continuing on to include therapy specification.
   
2. while I have an understanding of the CONCEPT, I don't clearly see any way to associate concepts into a knowledge structure to answer questions like - what symptom prompted this imaging test? or for what diagnosis was this operation performed? Can someone give me help on how this occurs? It is a basic tenet of Oncology that Diagnosis is informed by Stage, and that Treatment is related to Diagnosis.
   
3. I already have a data structure/ontology described but I need to translate it into an OpenMRS acceptable format. Is there a way to import an XML data structure or ontology specification into OpenMRS to automate concept definitions and relationships?

I suppose that is enough as a starter.

AM

[Friedman, Roger (CDC/CGH/DGHA) (CTR)]

Andrew, welcome to OpenMRS.  There has been a lot of discussion lately about implementing both oncology records and regimens, but there is not one place to find it.  I have just started a new page https://wiki.openmrs.org/display/projects/Oncology+Implementation+Issues .  If you could join OpenMRS and post a description of your goals and your xml, that would be great.

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Post: implem...@openmrs.org
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[Rajib Sengupta]

Andrew,

 

As you have mentioned primarily the two things that are required for a good oncology implementation: A. Concept and B. UI

 

I. In the concpet front,  we have added significant number of concepts for our implementation in RG Kar Hospital for Oncology and Radiation Oncology (specifically in Brachy and EBRT).  We are completely in sync with MVP - that means, we don't create a concept in our dictionary instead follow the process as mentioned here -

https://wiki.openmrs.org/display/docs/Getting+and+using+the+MVP-CIEL+concept+dictionary+%28link%29

( we cheated the process a little this weekend - as I needed two new concepts , Andy created those in MVP and I have created is at the same time so that the concept id remain same)

As such, if you take the latest MVP dictionary from dropbox you will get all those new concepts

 

In the concpet area the principal that we followed are:

A. Create coded concepts as much as possible for the nodes, diagnosis (TNM classification), Specific procedures (such as in EBRT what type of machine is used etc)

 

B. Used numeric values whenever applicable  (such as instead of ECOG PS to be a coded, it is a numeric )

 

C. We have used texts concepts whenever we have found difficulty to code.

 

The concepts are not 100% correct and obviously not coded, but instead of waiting and completely mapping out everything we are going ahead with these concepts.

 

I need to do some cleansing and will the concept excel file that I have used to communicate with Andy  for MVP update. Please give me couple of weeks. I will load it in the wiki in the page mentioned below

 

II. The next part is the UI. We have used standard HFE to create the forms. Again in this area, there are several limitations of HFEs that is causing is to not very user friendly - some of those features are :

 

a. Not having  an anatomy drawing tool

b. Not having a file upload tag

c. Not having a dynamic repeat tag (so that you can add on number of observation instead of hardcoding)

e. Not able to repeast same obs in the same form

 

All the above three are GSOC project and are well underway for completing within a month or so.

 

But again, we haven't waited for everything to be fixed/enhanced and so we have moved forward in creating the HTML forms (again not 100% correct). Our apporach was as following:

 

A. Patient registration was done using core openmrs patient create process (we are also using the idgen and patient matching module - another awesome addition in the tool set)

B. Set 1 Forms (approx 3) - Complaint, History, Family History and General examination (mostly coded)

C. Set 2 Forms - Examination by body parts (coded and text mixed)

D. Set 3 forms - Imaging and Reports (mostly text)

E. Treatment plan (includes tumor board recommendation - an internal board of physicians) & Final diagnosis - text & coded

 

I will publish all these forms in the wiki in few weeks.  I am just too swamped in the actual go-live.

 

III. And another thing that is very important, for a full end to end EMR , specifically for oncology implementation is a Patient Portal where the patient's journal/journey can be maintained by the patient and patient can communicate with the doctor.  In that area, the PHR module developed by Hui Xiao for lance armstrong foundation is a great module. As part of the GSOC project, that is also getting improved and hopefully we will be able to use that.

 

Thanks,

Rajib 

From: "Friedman, Roger (CDC/CGH/DGHA) (CTR)" <rd...@cdc.gov>
To: "implem...@openmrs.org" <implem...@openmrs.org>
Cc: Andrew Miller <alexis...@gmail.com>
Sent: Monday, July 30, 2012 10:25 AM
Subject: RE: Oncology in OpenMRS

[Friedman, Roger (CDC/CGH/DGHA) (CTR)]

Rajib, I have taken the liberty of posting this on the "Oncology Implementation Issues" page.