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  1. #1
    Join Date
    May 2009
    Posts
    4

    Help In Clinic database model !!

    Hi guys..
    im new in forum.

    Really, i was intended to design a software for a rheumatology clinic ( a small private clinic for 1 doctor ) .. in brief i want to computerize the process of registering a new patient , enter a detailed infoormation about him ( personal, complain, illness and family history , examination results, laboratory results , current and previous visits ... etc)

    i'm using ASP.NET with c# .. the start point for sure is the DB desgin , as i'm not a dedicated DB desginer.. so im searching for some help about the basic tables and realtions.. that maybe tables initially for example:

    1-patients
    2-visits
    3-complain
    4-history ( there's some kinds of history, history of present illness, history of other deases, history of family ...)
    5-examination
    6-disease
    7-visit_deases


    thats my very initial thoughts about tables..

    attached is a table relations diagram..

    please if anyone have some experience in such clinic or medical center managemnet data models , i'll appreciate to explain the model and relations to help me figure out .. and if there is existing examples it will be very helpfull..

    thx for your time..

    TarekClick image for larger version. 

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  2. #2
    Join Date
    Feb 2004
    Location
    In front of the computer
    Posts
    14,943
    I've got more questions than answers.

    How many patients does the doctor see in a year? Is that number stable, or how is the number changing (this can have significant impact on design decisions)?

    What kinds of regulatory compliance are needed? How much of HIPPA is required?

    Which compendium does the doctor use for document exchange? Which compendia are used for insurance compliance? Are neurological issues incorporated, or are they discrete in this practice?

    Does your software need to manage EDI, or do you use a third party product? If you use third party, which provider do you use (this is critical information for both schema and application design).

    The problem with this kind of project is that compliance issues and information exchange are absolutely critical and are larger problems than the actual practice management, and they are both usually overlooked until far too late in the process... That's why well over ninty percent of the custom written clinic management packages get scrapped and one of the commercial packages is used. If we can help you get past those hurdles, then you have a chance to create software that might be useful to the practice, but if we fail to get past those issues there is little or no chance that you'll succeed.

    -PatP
    In theory, theory and practice are identical. In practice, theory and practice are unrelated.

  3. #3
    Join Date
    May 2009
    Posts
    4
    Dear PatP ...

    Thx for your reply,

    initially .. i like to tell you that this clinic system is considered a very small size.. the number of patients/year will not exceed (by approx.) 2000-3000 patient..

    Also i'd like to inform you that our requirement is far from formal and international Standards like HIPPA.

    Also, according to the small size of clinic,i'll not incorporate any kind of EDI , as there's no other parties involved (till now).

    Really, what im focusing on is :

    laying the foundation of managing a robust "Patient Record System".

    i want to manage the operations of what really happen in real, please consider the following scenario:

    - The patient goes to clinic, the doctor takes info from him ( personal info, current complain, previous and chronic disease, family disease history, ...) then the doctor make a physical examination ( its results will be saved in an examination entity for sure) , then he tell him to do whatever lab test or give him a drug , and for sure schedule him a next visit to see results and decide whatever next..

    - I though of handling this scenario by means of "VISIT" idea .. means : the patient existence in clinic is modeled by VISIT entity, each time the patient goes to clinic to do whatever anything, a VISIT record is created for his own Patient entity..

    - There's some principal points to take care of, like : we must distinguish between the main VISIT ( the time that the patient came first to tell about his complain) and subsequent visits in which patient come to tell about improvement results or provide a required LAB test result. I though about this by creating a table called e.g. "SUB_VISIT" that related to the main visit entity : VISIT 1---->many SUB_VISIT

    please share me your thoughts ..

    Tarek

  4. #4
    Join Date
    Feb 2004
    Location
    In front of the computer
    Posts
    14,943
    How does the doctor currently get paid for their services? Even in a "free" clinic where the client pays nothing there has to be some source of funding to keep the clinic open.

    Once you start doing business, you have to have ways of recording and reporting what services where offered, which of those were delivered, who will pay for them and how.

    Rhuemetology is an expensive practice even at the simplest level. Most of your patients have geriatric issues. Almost all of them have chronic pain issues. These need coordination with other care providers, health agencies, insurance companies, etc.

    This isn't a trivial task. Like most people first approaching the subject, you are trying to get to what you see as "the meat of the problem" and are ignoring the "hard" parts of the problem that will eventually determine if you will succeed or fail in automating the process.

    Step back, look at the bigger picture. If you are looking for the "thrill" of solving the easy problems, then have at it any way you choose because you'll never get to the point of putting it into production. If you are looking to really solve the problems and serve the doctor, you MUST learn to deal with the hard parts of the problem as well as the easy ones.

    I don't have the time or the patience to deal with "cowboy coders" anymore. If you want to solve problems, lets look at the business model. If all you want is the excitement of "let's code up something easy and cool" then have at it, with my blessing but without my commitment of time and energy to a project engineered to fail.

    -PatP
    In theory, theory and practice are identical. In practice, theory and practice are unrelated.

  5. #5
    Join Date
    May 2009
    Posts
    4
    Hello PatP

    Thx for your replay.. i was really waiting for it ..

    dear. Pat , i'm a newbie to database solutions, yes i've the some basic theory but never got into a real DB solution from scratch.

    First, im not searching for a fast solution to be built and i don't wanna be a "cowboy coder"

    don't forget, i got honor that your first reply to my post is your 10,000th post ..
    Congrats.

    YES i want to do the Solution the right way , even it takes a long time to do, im not in hurry, and i YES do want to learn more than accomplish fast unrobust solutions.

    Believe me, i don't look just to the "meat of the problem" but the points that i didn't mention ( like the payment entity) is due to my lack of experience in such design, not because im in hurry

    i'll begin thinking about PAYMENT entity to decide its right place in the model, and inform you about it.

    Please , if something you think im not doing it or ignoring it, ask me about it ,so i can figure out what should be done..

    Tarek

  6. #6
    Join Date
    May 2009
    Posts
    4
    I think i lost focus.

    Maybe this Helps:

    private dbForum_Enter(object sender, EventArgs e)
    {
    tarreqPost.getfocus();
    AllUsers.Redirect("Help In Clinic database model !!");
    }

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