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Public roadmap for development of Serenity's apps reported by our community of users
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ops/workspace issue prioritization #83

Open chris-dare opened 2 years ago

chris-dare commented 2 years ago

Tell us about your request! Need to prioritize issues impacting different workspaces/departments

Medical

(Updated 10 Feb 2022 with Dr. Darko and Dr. Ghartey)

  1. Metrics and reporting: Daily, weekly and monthly. See MIS report
  2. Migrating clinical data -> #84
  3. Fix issues of disappearing clinical notes on patient profiles. (notes saved but need to be displayed) -> #85
  4. Referrals: Display in patient profile, search through all doctors #86
  5. Automatic logouts of some practitioners when using the app especially at night #87
  6. Minimum obligatory fields for ending consultation: Chief complaint, diagnoses, care plan - at least one entry for each #88
  7. Lab machine integration (for diagnostics)
  8. Review add multiple labs: Not able to add more than one #61
  9. Save patient review when switching to next part of SOAP notes in patient encounter. Will save the number of clicks #90
  10. Register antenal panel for 1st Trimester ANC labs (Not an engineering issue)
  11. Fill prescriptions until complete
  12. Service requests and prescriptions do not show up in encounter notes #91
  13. Improve autosave for HPC in encounter patient wizard patient review. (Chief complaint reported not to give problems @seddie62) #92
  14. Faster page loads for the app impacting search and viewing patient profiles
  15. Customize page size for tables. Display total number of patients assigned to a doctor #93
  16. Filter patient visits by doctor assigned to #94

Nursing

Yet to host interview with Augustina. Will span OPD, ER and IPD

Diagnostic

  1. Integration of lab machines: Hematology and chemistry
  2. Diagnostics metrics reporting
  3. Additional input tags for qualitative test results. Try this with Blood type test
  4. Administrative editing of diagnostic reports pre and post approval with audit history
  5. Improving the reliability of search and filtering
  6. Improve speed of processing labs: Taking a sample, entering results, submitting for review, approving and rejecting results. Latency needs to be minimized
  7. Page layout and navigation: Process diagnostic report actions on the same page as service request just like in the PCR app
  8. Reference range adjustments and test intepretations

Pharmacy

(Updated 10 Feb 2022 with Evans Boadi and Wilson Dodovi) (Updated 18 Mar by Chris Dare)

  1. Reports a. Generation of daily report. Replicate the monthly reports but filter by yesterday (done) b. Revenue reports for pharmacy. Add to existing metrics (done)
  2. Cancellation or deletion of bills feature, and processing of patients refunds #121
  3. Ability to select specific medicines that are unavailable and print outsource prescriptions for the said drugs (wontfix)
  4. Developing and printing drug labels (not started)
  5. Functional filters: date filters in bills, dashboard and patient profile #32
  6. Exclusion lists for medications based on payment method (Flagging of medicines that are covered by specific insurance companies and corporate organizations)
  7. Inability to bill for walk-in clients (anonymous patient) -> #4
  8. Showing of patient's (last) mode of payment before pharmacy starts billing. Important to show the payment method type especially -> #89
  9. No indication of prescriptions deleted by doctors (set status to canceled/delete)
  10. Display all selected drugs on pending prescrptions page. Try at https://demo.provider.serenity.health/pharmacy/patients/14484/?type=existing
  11. Show patient's title on profile #120
  12. No access to patient encounter notes. Pharmacists should have permissions to view notes
  13. Go back to patient's profile from checkout screen

Actions:

  1. Create a tutorial for bill cancelations for pharmacy team
  2. Triage issues and revert with timelines by Monday 4pm

Customer experience

Last updated: 15 Feb 2022 Yet to host interview and align/add to issues below:

  1. Suspend employees/beneficiaries #23
  2. Edit coverage details of a employee/beneficiary #79
  3. Register policy dependents
  4. Link and unlink patient records #43
  5. Raise bills for patient registration #75
  6. Start scheduled patient visit
  7. Complete CE reports. (daily, weekly, monthly)

Finance

Yet to host interview. Will split finance issues into payments, accounts, reporting and audit + risk

Payments

  1. Raise administrative bill for patient registrations #75
  2. Update patient receipts #67
  3. Request for patient labs in batches
  4. Raise bills for patient labs in batches
  5. Access and print patient billing history report

Accounts

Credit control

  1. Search and view claims
  2. Generate signed PDF of claims a. Summarized (with and without diagnoses) b. Detailed Subtotals need to match ** Important to make formatting updates to reduce page lengths
  3. Generate signed PDF of claims in foreign currency
  4. Cancel a bill and claim
  5. Claim cancelation report
  6. BI and reporting (viewing excel version of the claims)

Reporting

See requirements document: https://docs.google.com/document/d/1ko9R4edhIra328fXE9xcJBV6cW9O5E1xvMyJyTa3lq4/edit#heading=h.kcgppgmw9yga

Audit and risk

  1. Action history for finance and clinical activities

Sales (and marketing)

Yet to host interview. SM will likely concern payer onboarding and business intelligence Here are notes from previous interview with SM team:

  1. Sales and operations dashboard for realtime analytics and reporting
    • Real time visiblity will yield earlier interventions: improvements and course corrections
  2. Business unit reporting
  3. NPS ratings for payers (out of scope for EMR but can be done with corporate portal)
  4. CSAT, customer support and feedback (ratings and surveys) for patients a. Measure campaign effectiveness: How did you hear about us? (Patient sign up and visits) b. In app surveys (with patient portal)
  5. Customer profiling and recommendations
  6. Email marketing for campaigns (out of scope. best to set up with marketing tool like dripemail/mailchimp)
  7. Grow cash/debit accounts (feature exists. let's review to assess goodness of fit)
  8. Marketing analytics (out of scope. May relate to business intelligence)
  9. PCR reports (billing). See https://github.com/serenity-health/roadmap/issues/63
    • Patient report
    • Date range report
  10. Save airline and travel destination to be displayed on PCR diagnostic report
  11. Diagnosis analytics categorized by payers (Addition from Freda on 21 Jan 22 8am call)

Which app does this concern? Provider portal

What will be benefit of this feature? Product stability, user satisfaction, growth!

Describe the solution you'd like

  1. Scope issues (if not done already)
  2. Set timelines (group into end of month deliverables)
  3. Deliver on time
  4. Deprioritize new asks outside of scope

Additional context N/A

chris-dare commented 2 years ago

Notes from Interview with pharmacy team on 21 June 2022

Meeting participants (Serenity+NMC): Evans Boadi, Wilson Dodovi, Emma Odoi, Richmond Agbavor, Samuel Asiedu, Chris Dare

Held a user interview to elicit requirements for structuring project for next half of 2022. Will continue in the coming week. Discussed the following:

Outcome: Accountability via auditing and reporting Problem:

  1. Location inaccuracies in reporting
  2. Consistency (need a source of truth for inventory and supply chain)
  3. Supply chain dataset is not on EMR
  4. No audit changes made to prescriptions (what, by whom and when)

Impact:

  1. Different reports generated for May IPR

Asks:

  1. Fix location inaccuracies - this did not happen with previous reports (location was selected from consultations)
  2. Provide excel version of datasets. Helpful in generating variance reports
  3. Develop a stock issue report
  4. Need access to the same finance reports E.g.

Outcome: Approve bill cancelations Problem:

  1. Not able to approve requested cancelations sometimes

Impact:

  1. Can make reconciliation, audit and accountability a difficult process

Asks:

  1. Make the behavior consistent and reliable

Outcome: Dispensing prescribed medications Problem:

  1. Deleted prescriptions show up, causing pharmacists to fill prescriptions canceled by a doctor
  2. Not able to accurately view status of prescriptions items in realtime
  3. Sometimes dispensed medications are not marked as completed, resulting in them being filled again
  4. When you view a patients profile, you can sometimes see the medications of another patient’s medications
  5. Search result changes long after typing the search terms on the pharmacy dashboard - which can result in dispensing prescriptions to to another patient

Impact:

  1. Dispensing wrong prescriptions to patients
  2. Slow ops at pharmacy

Asks:

  1. Pharmacists should not see canceled prescriptions. If they do show up, we should know that they have been canceled
  2. Ensure that prescriptions viewed belong to the right patients
  3. Speed up search for patients and prescriptions

Outcome: Print outsourced prescriptions Problem:

  1. Patients can overdose by buying medications that have already been dispensed to them. Current print prescription feature displayed all prescribed medications

Impact:

  1. Damage to provider's brand
  2. Patients liable to overdose

Ask:

  1. Give the pharmacy team a way to mark prescriptions as outsourced. Reason for outsourcing also needs to be known. Often falls in the ff categories:
    1. Drug unavailable
    2. Not covered by patient’s payment plan
    3. Patient wants to get it elsewhere
  2. Print those ONLY prescriptions selected for outsourcing

Outcome: Fill prescriptions partially Problem:

  1. Some patient’s coverage/payment plan require periodic refills (e.g. monthly)
  2. No easy way to see what prescriptions have been partially filled
  3. No easy way to identify patients who need refills
  4. Bills do not show the quantity of drugs served per dispense

Impact:

  1. Risk of overdose/underdose

Ask:

  1. Support refills

Outcome: Patient bills should be clear and devoid of misunderstanding Problem:

  1. Line items of bills are a combination of the service/product name and the practitioner who fulfilled the request. This combination can sometimes be interpreted as the entire products name

Impact:

  1. Hard to distinguish products/services from line item titles

Ask:

  1. Make bills clearer to understand
  2. Display quantity and dose on bills (some prescription information). Will need validation

Outcome: Comply to prescription printing standards Problem:

  1. Patient information on prescriptions is inadequate

Impact:

  1. NoQa (No quality assurance)

Ask:

  1. Show patient’s name, dob, mr number, gender and mobile on prescriptions

Next steps:

  1. Conclude discussion with pharmacy team in coming week
  2. Develop specification to address deliverables
  3. Register items in product backlog
chris-dare commented 2 years ago

Serenity: Interview with Customer experience team 21 June 2022 Meeting participants: Frank Tsiagbe, Sylvia Quansah, Eben (NMC Airport), James Ananga, Samuel Asiedu, Chris Dare

Outcome: Accountability via auditing and reporting Problem:

  1. Location inaccuracies in reporting
  2. Reporting by assigned practitioners is not Practitioners are not assigned to
  3. Selected location in the app changes
  4. Not able to tell wait times for clinical activities Impact:
  5. Can’t improve what you don’t measure

Outcome: Receiving copays based on patient’s coverage plan Problem:

  1. Some copays differ per category of services. App only supports one contribution

Outcome: Suspending payer beneficiaries Problem:

  1. Not able to suspend insurance patient and add them to another payer

Outcome: Onboarding insurance beneficiaries Problem:

  1. Onboarding one patient also adds all their repeated beneficiaries who may not be covered under the plan - especially when they share the same phone numbers
  2. Not able to edit coverage plan
  3. Not able to add some patients sometimes
  4. Editing an coverage plan has created another profile for same the patient in the past Impact:

Outcome: Managing dependents of payer beneficiaries Problem:

  1. Not able to add or remove dependents of beneficiaries - just the beneficiaries

Outcome: Finding patients Problem:

  1. Long MR numbers generated
  2. Not able to see the payment method on their profile
  3. Need to see at quick glance the ff info:
    1. Site the patient belongs to
    2. Payment method
    3. Date and time of creating
    4. Nationality
  4. Search result changes long after search term is entered
  5. Need to see patient titles in displayed names

Impact:

  1. Difficult to copy these mr numbers for manual charting operations
  2. Wrong patient visits are ended

Outcome: Registering patients Problem:

  1. Emergency contact details are not saved when entered
  2. Not able to tell if the patient has paid their registration fee
  3. Patients do not have registration cards (Todo: Ask for a sample) Impact:
  4. Don’t know who to call in case of emergency
  5. Revenue loss
  6. Not easy to find a patient

Outcome: Processing payments Problem:

  1. Not able to see patient’s payment option on profile
  2. When starting a visit and processing insurance/corporate patient without copays, payments are not processed. Has to be manually done by a cashier
  3. Payments still go through if coverage is expired
  4. Pharmacists not able to process copayments because they do not have permissions to process cash

Impact:

  1. Patients can see doctors for consultations that they are yet to pay for
  2. Revenue loss

Outcome: Start/Continue consultations Problem:

  1. Sometime, doctors are not able to start consultations. Seems to be related to billing. More details required to understand the problem. Support ticket to be raised the next time this occurs with more details on the context

Ask about appointments' 
 Outcome: Booking appointments Problem:

  1. Not able to see checked in patients on visits dashboard
  2. Not able to recycle a time time slot via appointment cancelation
  3. Need to see all upcoming appointments on the dashboard
  4. Need to share appointment information with patients and remind them of upcoming appointment

Impact:

  1. Doctor can miss a patient encounter
  2. Revenue loss from wasted time slots

Outcome: Cancelling bills Problem:

  1. Not able to find bills with cancelation requested
  2. Shouldn’t be able to request a cancelation for an already canceled bill
chris-dare commented 2 years ago

Serenity: Interview with NMC finance team (Wed 29th June 2022)

Meeting participants: Philip Adubeng, Dorothy Ako, Ken (NMC finance team), Marian Addo, Alexander King, Desmond (NMC finance team), Chris Dare Link to recording: https://drive.google.com/file/d/1DH_sHGXby9MhpTARonYTXmtuHxBVtWfl/view?usp=sharing

Outcome: Paying commissions specialists Problem:

  1. Not finding some specialists in the reports
  2. Not finding some transactions included Impact:
  3. Manual reconciliations for 4000 bills each month resulting in salary payment delays for specialists. Also impacts other financial reports because more hands are
  4. Impacts doctor morale and ultimately patient care Notes/Asks:
  5. Perform reconciliations between manual books and digital reports on Serenity to identify problem
    1. Could some be related to cancelations?
    2. Could some be related to consultations with unassigned doctors?
  6. Digitize revenue share/commissions computation for doctors
    1. Note: Commissions are mainly determined by the type of the service but can vary based on doctor’s contract

Outcome: Claiming credit revenue Problem:

  1. Policy numbers on the bill do not match insurance patients policy. Have to cross-check with Rx
  2. ICD-10 codes are not displayed on bills (displays code)
  3. Not able to delete duplicate bills/claims
  4. Don’t see policy numbers in excel reports
  5. Not able to print invoices per patient
  6. Not able to generate invoices in USD by self-service
  7. Sum totals do not tally on corporate invoice/claims
  8. Sometimes, sum totals do not show (see example)
  9. Not able to configure level of detail for the invoice/claims
  10. Excel revenue reports needs to tally with pdfs generated (Up to excess of 200K)
  11. Not able to download excel reports from metabase
  12. Some patients can be processed for a lab on credit payment but not follow through with the clinical process. Will lead to claim rejections. Need a way to identify completed clinical activities (for each service class)
  13. Not able to determine clients owing in bill payments due to rejected claims / claims with potential to be rejected hence not submitted
Note: Team annotates customer details to identify patients in debt but this needs to be automated to avoid revenue loss Impact:
  14. More manual reconciliations and lower productivity in other
  15. Revenue loss from rejected claims
  16. Annotations on paper bills have an impact on Nyaho’s brand - also have medicolegal/ethical concerns Ask:
  17. Policy number registered needs to tally with that on bill
  18. Def solve each problem above
  19. Need a way to handle recon on EMR RCM extensions

Outcome: Reporting on operations Problem:

  1. Breakdown patient attendance (footfall) by service
  2. Not able to identify and report on follow ups
  3. Specialist report is fragmented into 3 reports. Not able to connect some dots
    1. Walk-ins not explicitly stated
  4. Not able to filter many reports by revenue tag/business unit
  5. Not able to report on copays Impact:
  6. Not able to effectively evaluate business units (per business profit) and plan for growth

Outcome: Processing payments on EMR Problem:

  1. Pharmacists are not able to see the last used payment method
  2. Patients have access to unauthorised payment method
  3. Pharmacists not able to raise bills for co-pays without permission to receive cash
  4. Not able to search service requests by date and select subset to raise bills
  5. Not able to bills OPD procedures Impact:
  6. Higher frequency of claim disputes and potential revenue loss
  7. Increased patient wait times and bills cancelations

Outcome: Canceling a bill Problem:

  1. Bill cancelation approvers are not automatically notified of requested cancelations
  2. Not able to search and filter for bills
  3. Able to request a cancelation on an already canceled bill
  4. Difficult to see visibility on users with cancelation permissions
  5. Not able to see audit trail of bill cancelations
  6. Not able to reverse cancelations (undo mistakes) Impact:
  7. Manual processes are used which are liable to fraud and revenue loss
chris-dare commented 2 years ago

@rejoicehormeku @lew-monk please review: https://github.com/serenity-health/roadmap/issues/83#issuecomment-1170120689

There's a good deal of items that will relate to your ops here.

chris-dare commented 2 years ago

Serenity: Interview with NMC Nursing team 5 July 2022

Outcome: Recording vitals Problem:

  1. Not able to edit vitals
  2. Not able to document nursing notes from encounter with recording of vitals
    1. Reasons why patients refused to have their vitals taken
    2. Administration of medication in first aid use cases (for nursing notes)
  3. Not able to triage patients / risk
    1. Pain assessment scale
    2. South African triage tool (MEWS & TEWS)
    3. Fall risk assessment tool
  4. Viewing the history of recorded vitals (added by Chris). Basically allowing to see multiple vitals taken for the same encounter (i.e. recheck)
    1. Because it’s helpful to track the patient’s vitals progression during their visit

Outcome: Accountability Problem:

  1. Not able to edit vitals
  2. Not able to document nursing notes from encounter with recording of vitals
    1. Reasons why patients refused to have their vitals taken
    2. Administration of medication in first aid use cases (for nursing notes)
  3. Not able to triage patients / risk assessment
  4. Impact: Different reports generated for May IPR Asks:
  5. Fix location inaccuracies
  6. Provide excel version of datasets. Helpful in generating variance reports
  7. Develop a stock issue report
  8. Need access to the same finance reports E.g.

Outcome: Booking and confirming appointments Problem:

  1. Patients are booked first on HIS and then Serenity. Time slots differ so brings confusion when the patient finally arrives on site. E.g patient

Outcome: Interpreting diagnostic reports Problem:

  1. Appropriate reference ranges need to be displayed
chris-dare commented 2 years ago

Serenity: Interview with Medical team 8 July 2022

Outcome: Interpreting diagnostic reports Problem: Results don’t come with all necessary details

Outcome: Making a referrals Problem:

  1. Not able to find all doctors to search by name or specialty
  2. Could reason information be limiting in terms of character
  3. Need to print a fashionable version of printout. Printed referral does not display reason
    1. Perhaps
  4. Customer experience and patients can forget to
  5. Need to see all items sorted by recent first
  6. Need to report on referrals
    1. How many patients visiting the centre were referred to the centre?
    2. What did they do on their visits?
    3. What’s the internal referral activity and why?
    4. Were external referrals from Nyaho fulfilled?

Outcome: See patients visit status in (near) realtime Problem:

  1. Not able to tell what activity the patient has just completed
  2. Need to see the patients payment method (last used, visit payment method)
    1. Why? Because it informs decision on what services/products to prescribed

Outcome: View consultation notes Problems:

  1. Consultation notes should have details of the notes recorded from that consultation and not anything else

Outcome: Interpreting observation vitals Problem:

  1. Interpretation flags for vitals are wrong (all displayed as “normal”)

Outcome: Refilling medications / Repeat prescriptions Problem:

  1. Not able to easily find previously created prescriptions to repeat

Outcome: Claim credit revenue Problem:

  1. ICD-10 codes need to be displayed

Outcome: Find a patient Problem:

  1. Not able to find patient by the last doctor they saw
  2. Not able to see the last encounter

Outcome: Recording consultation notes Problem:

  1. Sometimes, autosave doesn’t save at all
  2. Viewing labs, codes are displayed instead of their display names
  3. When moving from OPD to ER, transferring consultations to share context is a bit of a hassle
  4. Consultation notes should automatically close after a period
  5. Show authorship of notes

Outcome: Communicating updates effectively Problem:

  1. Don’t always know what’s updated to relay to other users and stakeholders in the medical group

Outcome: Managing prescriptions Problem:

  1. Deleted prescriptions can still be seen sometimes on the patient’s record
chris-dare commented 2 years ago

Serenity: Interview with diagnostics team 13 July 2022

Outcome: Making a service requisition Problem:

  1. Doctors request for tests not configured as healthcare services

Outcome: Processing collecting samples in pre-analytics

Problem:

  1. Don’t have an identifier for tests requested in batches
    1. Having batch numbers also allows us to group test results based on requested batches
  2. Not able to print sample labels (with barcodes)
  3. Specimen type not extensive. Other possible options not present

Outcome: Generating a diagnostic report Problem:

  1. Not able to enter partial results to be updated and completed at another time
  2. Not able to edit wrongly entered results. Team currently cancels and regenerates diagnostic reports. Can lead to multiple docs for the same service request
  3. Not able to find a diagnostic report by accession number
  4. When printed, some trailing test results do not show up
  5. Some references ranges are not displayed
  6. Results displayed in-app are not be sorted by rank

Outcome: Managing blood bank.- receiving and issuing medical resources to patients Blood units received from a blood bank facility. Unit will have a label, containing:

Problem:

  1. Not able to manage and issue blood units
  2. Not able to report on:
    1. state of inventory
    2. Items issued
    3. Items nearing expiry

Outcome: Integrating lab machines Next steps: Will be integrating respons 920 and replicate across sites

chris-dare commented 2 years ago

Serenity: Interview with NMC Sales and Marketing team 14 July 2022

Outcome: Reporting and analytics Problem:

  1. Not able to view data and reports the other teams have access to
    1. Revenue by business unit, payer, payer beneficiaries, payment methods
    2. Sales and operations dashboard for realtime analytics and reporting
    3. Active patients

Outcome: Selling healthcare packages Problem:

  1. Not able to track conversions from sales and marketing campaigns (selling packages) Notes:
  2. Ability to apply discounts?

Outcome: Manage customer relationships Problem:

  1. Managing leads and conversions: pre-sales

Outcome: Onboarding customers and managing accounts Problem:

  1. Not able to record deposits (corporates, insurance, family)
  2. Not able to change admin/owner information

Outcome: User training Problem:

  1. Might need more familiarity with the application?
  2. Encountering usability issues from time to time

Key takeaways:

Major areas of concern have to do with:

  1. Operational visibility
  2. Growth
  3. Managing customer (payer) relationships Helpful to develop solutions that yield these outcomes

Action items:

  1. Investigate system bugs
  2. Conduct user training
  3. Need to revert with comms on Tues 19 July 2022 concerning resolutions and user training