10 Replies Latest reply on Dec 12, 2012 4:22 PM by philmodjunk

    Developing patient flow in a medical procedural clinic

    iankatz

      Title

      Developing patient flow in a medical procedural clinic

      Post

           Quite new at this - hope this is the appropriate forum.

           Just trying to get a patient flow for a procedural medical clinic arranged in my head.

           1. A patient may have one or more problems

           2. A problem can occur in one or more patient

           3. A patient can have one or more visits

           4. A problem can be dealt with one or more types of procedures (eg one procedure this visit, the same or a different procedure next visit etc). There about 20 different procedures

           5. Obviously each procedure can be used on one or more problem

           My issue is how to put the procedures in a table form. Some are similar and some are quite different. Some will need things chosen off lists eg size of sutures, amount of anesthetic.

           Should each procedure be in its own table and how would I then show this on a relationship graph?

           Thanks

            

        • 1. Re: Developing patient flow in a medical procedural clinic
          philmodjunk

               This is an appropriate forum for this, if you are using FileMaker Pro to design a solution for your project.wink

               You might want to read this thread: Please Help Us to Help You... as there is a lot that you don't tell us that could help us to better help you.

               Each number on your list describes what should be a different table in your database. And the relationships needed are many to many in several instances--requiring an additional "join" table inorder to properly implement the relationships. How familiar are you with creating relationships in FileMaker and do you know how to work with many to many relationships?

               The basic relationships that I come up with from your initial post are these:

               Patients------<Visits------<Patient_Problem>------Problems------<Problem_Procedure>-----Procedures

               Patients::__pkPatientID = Visits::_fkVisitID
               Visits::__pkVisitID = Patient_Problem::_fkVisitID
               Problems::__pkProblemID = Patient_Problem::_fkProblemID
               Problems::__pkProblemID = Problem_Procedure::_fkProblemID
               Procedures::__pkProcedureID = Problem_Procedure::_fkProcedureID

               See this thread for an explanation of the notation that I am using. (Dont' need to read more than the first post...): Common Forum Relationship and Field Notations Explained

               or you might use:

               Visits>-----Patients------<Patient_Problem>------Problems------<Problem_Procedure>-----Procedures

               Patients::__pkPatientID = Visits::_fkPatientID
               Patients::__pkPatientID = Patient_Problem::_fkPatientID
               The other match fields in this will be the same as the first option.

               The difference is in how tightly you need to link a particular visit to a particular patient problem. I suspect the latter approach will work better, but the best option may be to use different occurrences of these tables in order to set up both sets of relationships so that you can see what problems were treated for each visit, but also track problems requiring ongoing visits without refering to a specific visit.

               If "table occurrence" is an unfamiliar term, you may find this thread on the topic helpful: Tutorial: What are Table Occurrences?

          • 2. Re: Developing patient flow in a medical procedural clinic
            iankatz

                 Thank you

                 Using FM Pro 12 trial package on Windows XP laptop. I am quite inexperienced in FM and database design but have a passion for learning more.

                 In fact can anyone recommend some online courses, video tutorials

                 Thanks

            • 3. Re: Developing patient flow in a medical procedural clinic
              philmodjunk

                   Start with the Help menu in FileMaker. There's a tutorial link there to start.

                   There are books on the subject that you can resarch via a web site such as Amazon--check the reader reviews to get a feal for whether a given title is a good "newbie" resource or one better suited for an experienced developer.

                   There are videos on YouTube you can search out also.

                   And we will be glad to supplement those resources by answering specific questions here in the forum. (Ask any question on FileMaker you want, but a forum format is most helpful when the question is specific.)

              • 4. Re: Developing patient flow in a medical procedural clinic
                iankatz

                     I am working my way through FM, the missing manual

                • 5. Re: Developing patient flow in a medical procedural clinic
                  iankatz

                       Thanks - just going over this.

                       Should the first line in the first example which you put as:

                  Patients::__pkPatientID = Visits::_fkVisitID

                  not be

                  Patients::__pkPatientID = Visits::_fkPatientID

                  thanks

                  • 6. Re: Developing patient flow in a medical procedural clinic
                    philmodjunk

                         yes, you are correct.

                    • 7. Re: Developing patient flow in a medical procedural clinic
                      iankatz

                           The first flow works better I think:

                           So at the end of the flow, with the actual procedures, there may be 20 or so of them, each with somewhat different details to be recorded.

                           In other words I would think that each procedure should be in its own table eg skin biopsy would be one table, freezing skin would be one table etc etc.

                           I would think that I would have a table of a list of all procedures, linked to the problem as you have indicated above, and then link the table for skin biopsy (for example) to that:

                      Patients------<Visits------<Patient_Problem>------Problems------<Problem_Procedure>-----Procedures > --- skin biopsy 

                                                                                                                                                                                        Procedures  >---- freeze

                                                                                                                                                                                      Procedure >------- skin excision

                            

                      Just not sure I am thinking about the specdifics of each procedureproperly

                      each problem can have one or more procedures

                      Each procedure can can be related to one or more problems

                      ??                                                                                                                                                                       

                            

                            

                            

                            

                            

                      • 8. Re: Developing patient flow in a medical procedural clinic
                        philmodjunk

                             That approach does not work at all well in FileMaker Pro, make each procedure a different record in the Procedures table.

                        • 9. Re: Developing patient flow in a medical procedural clinic
                          iankatz

                               But there are approximtaley 20 procedures, each of which have different fields. How would your suggestion work?

                          • 10. Re: Developing patient flow in a medical procedural clinic
                            philmodjunk

                                 Please note that I am basing my responses to this statement that you made:

                                 

                                      each with somewhat different details to be recorded.

                                 Add the fields you need, just don't use all the fields with every procedure. There are a lot of different approaches you can consider:

                                 1) A "procedure" need not be a single record. A procedure could be a group of records with a common identifier.

                                 2) You can often generalize your data storage by using pairs of fields instead of a single field and layout text used to label it. Instead, use one field for the data and a second text field to label the data. Then you can label the same field differently in each proceedure by putting different text in the labels field. For measurement data, this can often use a third field to record the units.

                                 3) You can use a Tab Control with multiple tab panels or multiple layouts to present data from the same table. A script can select the tab panel or the layout that is appropriate for the specific proceedure record.

                                 But also please note that I do agree that you will likely need two tables where you have one: Proceedures and ProcedureData. One identifies the procedure performed, the other records any data relevant to that procedure being performed on a given patient on a given date.