PDA Wood Woman
From TAPASWiki
The purpose of this document is to describe the details of the data model and the functionality of the Wood Woman release of TAPETA.
The wood woman release is notably more complex than the straw man. It does not yet have the full envisioned functionality for TAPAS. It will, however, meet the requirements for a secure encrypted PDA viewer with two-way alerts.
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Wood Woman Functions
From a user's perspective, the PDA application for TAPAS wood woman (planned released Sep 30) will consist of:
- Secure Log-in
- Patient Search
- Patient Demographics Viewer
- Patient Summary Viewer
- Patient Note Editor
- Patient Alerts Editor
- My Alerts View
Secure Log-in
Like the messaging application, the TAPAS application requires secure log-in in order to access and decrypt patient data. The wood woman release will use the same security model as described in the general TAPAS specification.
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Patient Search
This functionality is already provided in the Strawman release.
It will be enhanced to leverage the SuperWaba SQL query system to improve the speed of searching.
Searching will occur through any combination of letters / numbers in the First name, last name, and health number.
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Patient Summary Viewer
Like in the Straw man, there will be a single view screen for patient summary. The formatting will be consistent (eg ordering) with the Tapear summary screen.
From the summary screen, the user will be able to access the patient note editor and the active patient alerts editor.
Patient Demographics Viewer
This is new functionality in the Tapeta client for the Wood Woman release.
The user will be able to look at the demographic data of the patient:
- name
- DOB
- Health Number
- GP
- Addresses
- Phone Numbers
This will be important while on call in order to access the patient or follow up on phone calls for labs, etc. The patient demographics will need to have two screens, due to the size limitations of the PDA.
Patient Note Editor
The patient note is a free text field that is tagged to each patient record. It is an easily visible space to record any variety of things. It will be synced, bidirectionally, between CASA and Tapeta.
There is only one note per patient. Notes will be encrypted while stored on the handheld.
Patient Alerts Editor
Alerts are an important part of the TAPAS functionality and something that need to be implemented and tested with users early in the development cycles. Therefore they will be in this release.
Elements in the CASA model will need to be replicated on the PDA client in a manner that support two way synchronization of all alerts.
For more information, please see the Patient Alerts page.
Only active alerts at the time of syncing will be uploaded to the PDA. Future and expired alerts will not need to be synced at this time. This should reduce the memory requirements for the application.
Automated alerts will not be synced to the PDA at this time. Currently the automated reminders (EGADSS) are focused on preventive care and the PDA is expected to be used while on call when preventive manoeuvres are less relevant.
Users will have the ability to create new alerts as well as edit / update / close existing alerts. These changes will sync to the server.
Alert titles and bodies will be encrypted.
From the patient summary screen, tapping the "Alt" button will bring you to all active alerts.
This screen will show all active alerts for that patient. From the Patient Alerts list, tapping on an alert will show you the details of that alert.
The detailed view will show comments, who the alert is assigned to, etc. This page will allow editing of the alert.
- Tapping the save button will save the information about the alert and return back to the previous screen.
- Tapping Back will return without saving (and will warn the user if there were changes).
- Tapping Delete will alert the user and, if confirmed, delete / archive the record. (NOTE: Nothing gets deleted in TAPAS of course).
My Alerts View
The "My Alerts" page is designed to provide each user with a view into the patient alerts that pertain to them, based on their userID and the groups that they are a part of. Essentially it will be a list of Alerts (aka action items) that are assigned to them. Assignment of Alerts occurs through the assignment directly to the user's name or to any group that the user is a member of. For example, physicians who are on call and belong to the On Call group will be able to view the list of "On Call Alerts" (those assigned to the On Call group) on their PDA. This will allow members of the call group to effectively share a to do list on their ill patients. Central to this will be the ability to view this list on either the PDA or the desktop.
To create new alerts, the user must enter the patient record to create new alerts. To share these alerts, the user must assign them to a group, such as "On Call". Some, however, may be assigned to other groups - e.g. An alert "Patient needs Monday Appointment" could be assigned to "Clinic A Staff" so that they could see this alert on Monday morning when clinic opens.
Users access the My Alerts list from the PDA menu that is available on all screens of the application, excluding the log in page.
The My Alerts list shows all alerts assigned to the selected user or group. This can be changed by the user by selecting from the pull down menu either himself/herself or one of the groups that they belong to.
The list will then show a list of alerts assigned to that group with the patient's last name and beginning of the title of the alert. Due to the limitation of the PDA screen not much more can be shown, although I would be happy if more could be (eg full name, date of alert).
Tapping on an alert will jump the user to the patient record, displaying the details of that Alert.
Here the alert can be updated as needed.
From the patient alert detail screen, the user will be returned to the My Alerts list so that the user can continue to review the list of alerts.
- Tapping the save button will save the information about the alert and return back to the previous screen. (NOTE: if the user was coming from the patient alerts screen to the detail screen this would move them back to that screen not the my alerts screen)
- Tapping Back will return without saving (and will warn the user if there were changes that were not going to be saved "Are you sure you want to continue? (changes will be lost) [YES] [NO]" - not shown).
- Tapping Delete will alert the user and, if confirmed, delete / archive the alert record. (NOTE: Nothing gets deleted in TAPAS of course).
CASA - Tapeta Data Synchronization
The Tapeta data model for wood woman will not be as robust as the server. Indeed, it will likely never be the case that the PDA viewer will have as robust a data model as the server due to the limitations of the PDA platform and the deeply nested structures of the RIM model.
For the Wood Woman release, there will be 4 main sections for the patient summary illustrated below and described in more detail further down.
Record Target
The Record Target section is, essentially, the core demographics of the patient, plus a few extra bits of information. The record target is a term from the e-MS specification.
| Data Element | Detailed Description |
| PtID | The TAPAS ID of the patient to allow for syncing. |
| LastName | |
| FirstName | |
| DOB | The Date of birth of the patient. |
| Gender | As defined by the e-MS |
| Contact Info | Patient can have multiple phone numbers, etc, as defined by CASA. Convert to a formatted text block for viewing on the PDA. |
| Address | Patients can have multiple addresses. Convert to a formatted text block for viewing. |
| GP | The patients GP (a user of TAPAS) as registered in the CASA core |
NOTE: This table needs to be reviewed to ensure all the demographic data that might be needed is included.
Patient Summary
For the Wood Woman release all described patient summary elements below will be put into a single text string, complete with formatting and section titles.
This will be encrypted using blowfish encryption as described in our security specification.
In each described section below there can be 0..many elements (eg multiple active problems, etc).
| Section | PDA Title | Elements Used | Comments / Detailed Description |
| Active Problems | Active Problems | Title, Start Date | Sorted by date in reverse chronological order (newest first) |
| Medical History | Medical Hx | Title, Start and end date | Sorted by Start date in reverse chronological order (newest first) |
| Surgical History | Surgical Hx | Title, Start Date | Sorted by Start Date in reverse chronological order (newest first) |
| Medications | Current Medications | Medication name (size is included), amount, route, frequency, PRN status and expected end date. | Medications are the most complex element of the system and one that is needed most while on call. We will need to test how best to display the detail elements and confirm what are important to show. Only current medications will be synced at this time. That is, medications with a start and end date that include the sync date. There are other elements that we could consider, but at this time we will restrict ourselves to a minimum list and add as requested. That is to say, expect some change, especially here. |
| Allergies | Allergies | Title, Type | This part should be in red and bold to be consistent with the Tapear UI if possible. |
| Family History | Family Hx | Title, Family Member | Sorted by Title |
| Social History | Social Hx / Risks | Title, Start Date | Sort by start date in reverse chronological order (newest first) |
| Immunizations | Immunizations | Immunization Title, Date. | Sort by start date in reverse chronological order (newest first) |
There are more data elements in TAPAS, certainly. These will be added in following release cycles.
For this version element comments will not be shown as they will make a single list view too cumbersome. In future iterations, when all data elements are shown individually, then we will add more as it can be nested into multiple screens.
If anything is missing, please comment to the mailing list and add to this document.
Formatting for Summary Text
It is hoped, but not expected, that we'll be able to format the summary text in someway to increase usability (through better readability). Likely, however, we will not be able to use HTML formatting for this application and will have to rely on ASCII text formatting on the PDA. This does have the benefit of being simpler to implement for this iteration as well.
Here is the format of the ASCII text for the summary as would be expected on the PDA. Everything outside of the quotes will be formatting, elements inside quotes correspond to data elements in the summary.
NOTE: only two elements / section are shown here for illustration. Each patient will have 0..many elements in each section.
NOTE2: This assumes the summary will be encrypted.
Active Problems: "Title" -"Start Date" "Title" -"Start Date" Medical History: "Title" -"Start Date" - "End Date" "Title" -"Start Date" - "End Date" Surgical History: "Title" -"Date" "Title" -"Date" Current Medications: "Name" "amount" "type" "route" "frequency" "PRN Status" "Start Date - "End Date" "Name" "amount" "type" "route" "frequency" "PRN Status" "Start Date - "End Date" Allergies: "Substance" -"Type" "Substance" -"Type" Family History: "Title" -"Family Member" "Title" -"Family Member" Social History: "Title" -"Date" "Title" -"Date" Immunizations: "Title" -"Date" "Title" -"Date"
Patient Note
Elements in the CASA model will need to be replicated on the PDA client in a manner that support two way synchronization of all notes.
| Element | Description |
| Note field | The note field is a free text element that users can simply jot down notes about the patient they are seeing. This is an unstructured that can be used as needed. |
| Author | Author will need to be tracked for auditing purposes. |
| Last Edit | This date / time stamp will be updated when the record changes and be used for syncing. |
Patient Alerts
Patient Alerts will have to be synced between CASA and Tapeta bidirectionally.
| Alert Element | Detailed Description |
| Title | Short description of the alert that can be seen in the lists. |
| Body | Long description of the alert that describes any additional details of that alert. |
| Author | Last author of an alert |
| Last Edit | Date / Time of last edit |
| Category | Currently only "general" or "on call" categories. |
| Assigned to | user that the Alert is assigned to. In the future this will be important and will need to be supported on the PDA. |
NOTE: This needs to be confirmed based on the CASA model
Future Functions
At this point the ability to view individual elements of the summary with their corresponding notes and details has not been implemented. This will come in the next iteration.
It will require a significant addition to the PDA application in terms of additional screens, logic, etc.
