Reduce incidence of 'No Reason' Visits

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Development Project Status: Under Discussion

Due date for completion of this stage: 
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Project description: 

This project is the result of two sets of forum discussions: and

These discussions indicate that most 'no reason' visits are created via two mechanisms: the "Add Visit & Note" button on the medical records & visit editor screens; the fact that generating a customer invoice creates a 'no reason' visit to record the sale to the patient.

This project will do the following to address the first:

  1. remove the 'Add Visit & Note' button from both the visit editor and medical records summary screens (note that this is already listed in OVPMS-1619)
  2. add  Note and Diagnosis buttons to these screens (which function in exactly the same way as New|Note and New|Problem)
  3. change the New|Visit screen so that you can also enter Note text so that it functions as 'Add Visit & Note'.  It thus has the convenience of the 'Add Visit & Note' button, but does not appear on the visit editor screen and thus tempt people to add a visit and a note when all they should be adding is a note.
  4. change "No Reason" to "-" in so that only "-" is shown if there is no appointment reason available when the visit is created

This project will do the following to address the second:

If a visit is created as the result of a customer sale then:

  1. the visit reason will be set to CUSTOMER_SALE if there is such a reason in the Visit reason lookup
  2. the visit status will be initially 'In Progress' (as is the case currently)
  3. when the invoice is finalised by pressing the Finalise button on the Customers|Charges screen) then the visit complete date will be set to today and the visit status set to Completed. Note that it is possible to have one visit containing multiple invoices.  In this situation the first invoice to be finalised will complete the visit and set the completed date.



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Re: Reduce incidence of 'No Reason' Visits

Tim -

There is certainly a need for both of these changes.  We have discussed the need for addressing the second issue above elsewhere, the only existing option now being cleaning up the dtabase with a direct SQL update.  As for the first issue, while we really don't use the Problems feature in OVPMS, I do remember that early on in the training it was remarked that after Checkin-In, no one should touch that New Visit and Note button! I even went so far as to put a reminder to Consult-Complete-CheckOut on each keyboard in each exam room to keep the staff from accidentally starting a new visit. So not having that button there removes a potental trap.  Yes, if a new visit has already been created via a Check-In, then that button should not exist.

In our pratice we have reordered the Visits themselves from oldest to newest (top to bottom) via a code change and re-compile so the medical record reads like a story as opped to a top-posted email.  I guess this change will have no impact however on where the cursor will be deplaced by default?  It will still go to top of the first page, i.e., the oldest visit for us?  I suppose cursor placement is a different issue? 


Sam Longiaru

Kamloops, Canada 

Re: Reduce incidence of 'No Reason' Visits

Sam - I do not see the proposed changes making any difference to your visit order display changes - aside from the fact that you will need to re-apply your source modifications. [You might also consider contributing your mod (together with the associated switch code and the practice option as to which visit order to use) so that this becomes a standard facility. However, I seem to remember that you have other mods to handle Canadian taxes so you will need to stay with your own fork.]

Regards, Tim G

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