Orthopaedic Sample Database
From Ajexus
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Sample configurations
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Note: Ajexus is suitable for any healthcare provider. The sample databases provided show how Ajexus might be configured to meet specific needs. If you have different requirements, remember that in Ajexus you define the information that is to be recorded therefore Ajexus can easily be tailored to your needs.
This sample is an extension of the Orthopaedics database that is used in the Ajexus Tutorial, and is designed to demonstrate how you might further develop the medical record.
The main extensions to where the Tutorial left you are as follows:
- Admissions - Inpatient admissions and discharges have been added along with the required wards and beds set up as locations and equipment respectively.
- Loan Equipment - A store location is set up for the allocation of equipment such as wheelchairs and crutches. Also, there is included a summary report that lists loan equipment that is overdue for return. This is described in more detail below.
- Diagnoses - The tutorial had limited diagnosis examples. This has been extended in this database to enable the physicians to specify the trauma site; classified into sub-elements of bone, muscle and connective tissue; and separately specify the trauma condition associated with the trauma site. This is explained in more detail below.
- The surgeries and tests can also use the same sub-elements for specifying the required site.
- Medication - This was limited in the tutorial, but has been extended here with medications grouped in categories. See below for more details.
Remember that this is only one interpretation of how an Orthopaedics medical record can be designed. In Ajexus you define the information that is to be recorded, therefore Ajexus can easily be tailored to your own needs.
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Logins available
The following User Names are available in the sample database:
- 'administrator' has full rights to all information, as well as rights to the Data Dictionary
- 'Bowl' (Lynn Bow) is a receptionist and has been given privileges to manage patient demographics and view all appointments. The only element she can add or change is Referrals.
- 'Adamsj' (Jane Adams) is a physical therapist and has privileges to view the entire medical record of a patient, but can only add or change Therapy elements.
The Password for all the users in the sample database is 'password'.
For information on logging into Ajexus refer to Getting Started in the Operation section in the User Guide.
Patients Available
To view a list of available patients, select the 'All Patients' predefined report on the Select screen. For information on selecting records, refer to Select a Patient Record in the Patient Record section in the User Guide
Elements
In the main, ABC Healthcare has followed the element layout that was outlined in the tutorial. The following elements have been extended.
Order/Result
ABC Healthcare has specified an Order element for ordering tests such as blood test, X-ray, MRI, CT scan, and so on.
Diagnosis
The decision here was to record diagnoses by site and by condition. Although this entails the physicians having to make a double entry (trauma site and condition), it circumvents the problem of there being almost an infinite number of combinations of site and condition; for example, avulsion, just one condition, can itself be associated with dozens of sites. One could leave it to the physicians to enter the diagnosis in free-form in a comments field, but that would detract from the standardisation of the medical record, since physicians would record their diagnoses in a variety of ways.
The method employed here means that physicians have a finite number of trauma sites and conditions from which to choose, and of course, the clinician or database administrator can add to these lists on the fly, if the physicians feel there are sites and conditions missing from the lists.
For an example, consider a diagnosis for a ruptured medial hamstring. The Physican chooses 'rupture' from the sub-element 'Conditions - Muscle & Connective Tissue' and then 'hamstring - medial' from the sub-element ' Affected Site - Connective Tissue'.
Another advantage for categorizing the trauma site in this way is that the trauma site sub-elements can also be referred to by the Order element to specify the site on which a test is to be performed, and the Surgery element to specify the site which requires surgery.
Medication
Due to the sheer number of available medications, ABC Healthcare has decided to record them under the following categories:
- Antibiotics
- Bone Stabilizers
- Corticosteroid Anti-Inflammatories
- Disease Modifying Agents
- Non-opioid
- Opioid Analgesics
- Skeletal Muscle Relaxants
- Vitamin/Calcium Supplements
Element Lists
In 'Full Record - Group By Episode', the full medical record for the patient has been grouped by the episodes. This element list would be useful for someone wishing to fully acquaint themselves with the medical history, such as a new clinician taking over the case. Over time, this element list can become unwieldy, as a large amount of information accumulates. However, you can just as easily create element lists that produce subsets of your complete medical record. The first subset to come to mind would be listing the medical record pertaining to one episode only; for instance, Orthopaedics.
Summary Reports
Various summary reports have been created in the ABC Healthcare sample. They cover the more standard reports like 'All Assessments for Today' and 'All Referrals Received this Week'. However, ABC Healthcare have created reports to monitor the return of loan equipment, such as wheelchairs and crutches.
To alert for overdue equipment, ABC Healthcare utilized Ajexus' automatic calculation of review date. When selecting the Review Period on the Loan Issue definition, they selected the following formula from the drop-down list:
- Date + Length (Days)
The review date is then automatically set to current date plus the number of days the user sets for the loan issue. Then when creating the 'Equipment Loans Overdue' summary report, they set the Date Type to 'Review Date' and the Date Default to 'Yesterday'. In this way, when they run the 'Equipment Loans Overdue' summary report, all loans that were due the previous day are reported.
Summary reports are instantly refinable. For example, the report 'Equipment Loans Due Tomorrow' could be instantly created based on the 'Equipment Loans Overdue' report described above, simply by replacing the Date Default of 'Yesterday', with 'Tomorrow'. Running the report again then shows loans that are due tomorrow, which provides a report that might be required to plan loan issue ahead of time.
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