Configure Patient Registration

Purpose and Benefits

The Registration module allows a patient's information to be captured and maintained. It also acts as a starting point for the patient through the medical facility's workflow. It supports a flexible configuration of patient attributes to suit several types of implementations. The patient's address hierarchy, patient relationships, visit details and death reasons can also be configured. 

You can also watch this Youtube Playlist which shows how to configure the registration screens in Bahmni: Registration Configuration Playlist


Steps

1. Configure Core Fields

Certain core fields such as name, gender and age come out of the box with Bahmni and do not need to be set up. However, the Patient Identifier needs to be setup.

Setup Patient Identifier

Bahmni comes pre-installed with the OpenMRS idgen module and a patient identifier type called "Bahmni Id". In order to modify the dropdown for ids, identifier sources for the Bahmni Id need to be edited. Here are the steps to edit the identifier sources for Bahmni. 

Configure Patient Identifier:

In Bahmni, patient identifiers are configurable. The default patient identifier prefix can be configured on the Registration page. 

Add or Edit a Patient Identifier

To add a new patient identifier or edit an existing one, please refer to this document: Patient Identifier

Display the Default Identifier Prefix for Primary Identifier Type

On the Patient Registration page if you want to display a default identifier prefix for primary identifier type , please add the following configuration under config section in the registration/app.json file.

Config
"defaultIdentifierPrefix”:source name of identifier/prefix


Sample Config
“config”:{
  "defaultIdentifierPrefix”:”GAN”
}

If the default identifier prefix is not provided, or if it is empty or invalid, Bahmni will pick the first patient identifier prefix after sorting the available identifier prefixes in alphabetical order, as the default identifier prefix.

Note: this configurations works only for the primary identifier type, not for the extra identifier types.

Make extra identifiers read only in registration page:

On the Patient Registration page if you want to make extra Identifier fields non-editable, please add the following configuration under config section in the registration/app.json file. And specify the extra Identifiers that needs to be non-editable, for example ("National Id") in below config. By default extra Identifier fields are editable.

Sample Config
“config”:{
  "readOnlyExtraIdentifiers": ["National ID"]
}

Note: This configurations works only for the extra identifier types, not for the primary identifier types.

Configure Gender

If you need custom values under the gender dropdown, add/edit an advanced settings property "mrs.genders" to have a custom value specified by a json structure. For example:

{"M": "Male", 
"F": "Female", 
"O": Other}

Pre-fill Address details based on login location

To use this functionality location needs to be configured as a login location in openmrs. The below configuration need to be added in registration/app.json is 

Sample Config
{ 
    "config": {
             "prepopulateFields" : ["Division", "Zilla", "Upazilla"]
        }
}

The fields specified in the configuration need to be the address fields labels as seen on the registration page. This data will only be pre-filled when new patients are being created.

2. Configuration to Enter Patient Name Fields in Multi-language

One can enter the patient name fields like First Name, Middle Name, Last Name in multi language in Registration Page. For this we have to delete the regular expression that validates the English alphanumeric characters. 

"familyName" : {"pattern" : "[a-zA-Z]{0,}", "errorMessage" : "Should contain characters"},
"givenName" : {"pattern" : "[a-zA-Z]{0,}", "errorMessage" : "Should contain characters"},
"middleName" : {"pattern" : "[a-zA-Z]{0,}", "errorMessage" : "Should contain characters"},

This will allow you to enter patient name in more than one language.

3. Configure Photo Capture

Configuration to Disable Photo Capture
"disablePhotoCapture": true

Photo capture can be disabled in Bahmni registration based on implementation specific needs. Default behavior is to display photo capture in Registration page.The configuration must be applied to app.json in registration to disable photo capture. From Bahmni 0.90v, uploading the patient profile pic feature from registration page is also supported.

4. Configure Address Information

This step is not mandatory.

Addresses can be configured to be populated from a dictionary using the Address Hierarchy configuration in OpenMRS. An address hierarchy is maintained in the application to ensure that addresses are codified and human errors can be prevented while entering patient addresses. 

To ensure that these address fields get synced to correct Labels in OpenELIS, refer to these steps Address Mapping between OpenELIS and Bahmni / OpenMRS

5. Configure Additional Patient Information

This step is not mandatory.

Additional patient attributes that need to be captured can be configured by adding/changing OpenMRS' PersonAttributes. Further customizations can be performed on the Registration page via custom Bahmni configuration. Features include custom field level validations (mandatory fields, field value restrictions etc), show/hide fields, autocomplete, etc. See the Registration App Configuration section for more details.

Fields on the Additional Patient information section can also be configured using OpenMRS person attributes with some additional Bahmni configuration


6. Configure Patient Relationships

This step is not mandatory.

The patient relationship functionality is used to maintain relationship information between various players within the application (Doctors, Nurses, Patients and Patient's relatives). There are three types of relationships that can be defined in the application

  1. Self relationship: This applies to patients who are registered into a program and then subsequently registered for another program. Consider a patient who is registered into a program with the ID GAN200013. If the the patient is the registered for another program, then during that subsequent registration, the patient can be linked with the initial ID GAN200013.
  2. Provider relationship: A doctor/nurse who administers to a patient can be added in the relationship field as a provider to the patient .
  3. Patient relationship: A patient can have a relationship with another patient such as father, mother, brother, sister, etc. This helps in tracking and screening prospective patients of communicable diseases like TB, HIV, etc.

In order to use the registration module to capture patient relationships, we need to:

  1. Add relationship types using the OpenMRS Admin UI. 
  2. Configure a property called 'bahmni.relationshipTypeMap'  in OpenMRS Advanced Settings to contain a json file that maps relationships to relationship types. A typical value would look like this {"provider":["Doctor"],"patient":["Parent","Sibling"]}.The list helps Bahmni identify how to autocomplete values for the field on the screen. 

7. Configure Visits

Bahmni uses Visits as a way to record a patient's admittance to the hospital and also to track the various consultations the patient goes through during a round of admission.

Bahmni supports Visits to be categorized into different types. Having multiple types of visits is useful for: 

  1. Reporting based on the number of visits per type.
  2. Configuring queues in other apps such as Clinical or Radiology. 

Visit Setup

It is mandatory to set up at least one Visit type for an implementation. Visit types are shown as dropdown options when creating or editing a patient in Registration. Visit types can be added via the OpenMRS Admin screen. All visit types added show up in the Patient Registration screen (see the screenshot below). 


"Default Visit Type" setup based on Login Location

Available from release 0.78 onwards


Bahmni supports default visit types to be set based on login location. The implementer will be able to set defaultVisitType for Location by adding entries to the entity_mapping table. 

For example for Location Registration Desk, if the default visit type has to be OPD, it can be configured in the following way:

Run the queries below to set the default visit type:

entity1_uuid - "SELECT uuid FROM location where name = 'Registration Desk';" .
entity2_uuid -"SELECT uuid FROM visit_type where name = 'OPD;"  
entity_mapping_type_id -"SELECT id FROM entity_mapping_type  where name = 'loginlocation_visittype';"

Insert the UUID's and id in to entity_mapping tables:

"INSERT INTO entity_mapping ( uuid, entity_mapping_type_id , entity1_uuid , entity2_uuid , date_created) VALUES (uuid(),9,'c5854fd7-3f12-11e4-adec-0800271c1b75','c2402997-3f10-11e4-adec-0800271c1b75','2015-11-25 14:43:56.0');"

Doing this will ensure that when a user tries to create a new patient on the Registration page, the 'start OPD visit' will be displayed as the default visit type.


8. Configure Visit Details form:

Once user starts a visit page will redirect to visit details form(see the screenshot below).


On the visit details form user can configure what data he/she want to capture as part of registration process.Those configurations will go under extension.json  file. For reference please follow the link Default Config

To add new section similar to Fee Information, user should create a new concept set. For more information please refer to the links below.  

https://wiki.openmrs.org/display/docs/Create+and+Edit+Concepts 

https://wiki.openmrs.org/display/docs/Managing+Concept+Sets

And then add the following configuration to extension.json file.

"conceptSet":{
        "id": Unique id for the section, //Eg:"bahmni.registration.conceptSetGroup.feeInformation"
        "extensionPointId": "org.bahmni.registration.conceptSetGroup.observations",
        "type": "config",
        "extensionParams": {
            "conceptName": Concept set group name //Eg:"Fee Information"
            "translationKey": "FEE_INFORMATION_LOCALE_KEY", //For internationalization, not mandatory
            "required":true // true, if it mandatory otherwise false
        },
        "order": 2, 
        "requiredPrivilege": "Edit Visits"
}


From Bahmni release version-0.90 onwards, users are allowed to configure the new forms(created by form builder app) on the visit details page. Add the following configuration to the extension.json file.

"formName":{
        "id": Unique id for the section, //Eg:"bahmni.registration.conceptSetGroup.feeInformation"
        "extensionPointId": "org.bahmni.registration.conceptSetGroup.observations",
        "type": "forms",
        "extensionParams": {
            "formName": "Nutritional Values", // Name of the form created using form builder
            "conceptNames": ["Height", "Weight", "BMI Data", "BMI Status Data"],
            "required":true,
            "showLatest": true
        },
        "order": 3,
        "requiredPrivilege": "Edit Visits"
    }

Display more than only 1 latest record in the registration 2nd page:

In the registration second page, for whatever the forms that we configured we will be able to see the latest observations captured for the concepts in the "latest" section as shown below. For now this is hardcoded to latest one record. To change that to more than one record, we don't have configuration property available for now. This requires adding numberOfVisits:5 inside config section in the visit.html file.

Before Change:

After Change:

Configure "Close Visit" Button

In scenarios where either a visit was accidentally started, or was not closed due to some procedural lapse, the hospital needs a capability to be able to "Close a Visit". A button can be added to the "Visit Details" page in the Registration module to allow Bahmni Users to close a visit. However, this button is visible only to those users who have been assigned the privilege "app:common:closeVisit". To assign this privilege, follow these steps:

  1. Go to the OpenMRS Admin page.
  2. Go to "Manage Roles".
  3. Select the role to which this privilege can be added. For e.g. "RegistrationClerk-Advanced".
  4. Assign the privilege "app:common:closeVisit" and click Save.
  5. Ensure that the person who is supposed to perform this operation is assigned to this role.

9. Configuring 2nd page availability based on Visit type

Earlier if a single visit is configured, the registration second page can be configured to appear or not. However, if multiple visits are configured, the registration second page always comes up and there is no way to bypass it.

From 0.89 onwards, users can configure registration second page availability even when multiple visits are configured.

On registration/app.json, add this config, under "config" section

"forwardUrlsForVisitTypes": [
               {
                   "visitType": "First Stage Validation",
                   "forwardUrl": "../clinical/#/programs/patient/{{patientUuid}}/consultationContext",
                   "translationKey": "Enter Visit page details",
                   "shortcutKey": "c"
               },
               {
                   "visitType": "Follow-Up Validation",
                   "forwardUrl": "../document-upload/?encounterType=RADIOLOGY&topLevelConcept=Radiology#/patient/{{patientUuid}}/document",
                   "translationKey": "Enter <u>D</u>ocuments upload",
                   "shortcutKey": "d"
               }
           ]

10. Death Information

Death Information has only one field that is configurable. To set it:

  1. Log into OpenMRS.
  2. Go to Concept Dictionary, and Add a new Concept Set that contains all possible death reasons. The reasons themselves will also be individual concepts.
  3. Add/Edit a property in Advanced Settings called concept.reasonForDeath with the fully qualified name of the concept set that was just created. 

In summary the expectation is that the concept.reasonForDeath global property should store fully specified name of the concept set having reasons as set members.

Hide Death Information Section

If the concept.reasonForDeath global property is not configured or configured with invalid concept name (which doesn't exist), then the death information section is hidden


11. Configure Date of Birth

On the registration page, both 'age' and 'date of birth' fields are available. They are both dependent fields, which means that populating one field automatically populates the other with appropriate values. One of these fields can be set as mandatory. For example, if 'age' is mandatory, it will automatically place the 'age' field above the 'date of birth' field and highlight it as a mandatory field by placing a '*' mark beside it. To specify which field is mandatory for your implementation, follow these steps:
  1. Go to bahmni-config (an implementation-specific configuration folder). The settings are available at bahmni-config/openmrs/apps/registration/app.json.
  2. Add the following piece of configuration in the 'config' section of the file.


Configuration for data of birth
"dobMandatory": true

12. Configure to Hide Birth Time

On the registration page, 'birth time' field is available. This field can be configured to be hidden. Default behaviour(i.e.. when the configuration is not available) is to show the field always.To hide 'birth time' field, follow these steps:
  1. Go to bahmni-config (an implementation-specific configuration folder). The settings are available at bahmni-config/openmrs/apps/registration/app.json.
  2. Add the following piece of configuration in the 'config' section of the file.


Configuration to hide birth time
"showBirthTime": false

Birth time field on Registration Page

13. Configure Enter ID field

We have Enter Id option if user wants to manually enter the patientId for the patient. By default this option is enabled.

To restrict the users from manually entering the id, add the following configuration in app.json file under registration folder. Add the following under config section.

Hiding Enter Id option
    "showEnterID":false

14. Configure Display Order of Sections in Registration

The various sections under patient Information will be shown in the order of the "order" value that is present in the configuration. If some of the sections have an order value and other sections do not have the order value then all the sections with order value will be shown, while default behavior for the remaining sections will function As-Is. If none of the sections have order value, then default behavior(that is the order in which sections are entered) will be displayed.

  1. Go to bahmni-config (an implementation-specific configuration folder). The settings are available at bahmni-config/openmrs/apps/registration/app.json.
  2. Add the following piece of configuration in the each section under 'patientInformation' of the file.

Configuration for display order of sections in registration
"order" : 1 // order number specifies the sequence in which the section should be displayed

15. Configure After Save Forward Url in Registration Visit Page

The Registration visit page save button action can be controlled through configuration. When one clicks the save button, one will be navigated to the configured url. Default behaviour is to stay on the same page (i.e.. visit page of registration), when there is no configuration available.

  1. Go to bahmni-config (an implementation-specific configuration folder). The settings are available at bahmni-config/openmrs/apps/registration/app.json.
  2. Add the following piece of configuration  under 'config'  section of the file.

    Configuration for after save url in Registration Visit Page
    "afterVisitSaveForwardUrl" : "../clinical/#/default/patient/{{patientUuid}}/dashboard" // forward url to navigate after save (In this example after save one will be navigated to patient dashboard

    Registration Second page (save highlighted)

16. Show/Hide sections in Registration create patient page.

There can be many patient attribute sections in the registration page. We can show or hide each section based on a condition. This condition can be based on age, gender or any of the patient attributes.

For example:- 

If  age is less than 18, only then show the "Gaurdian Details" section.

Follow the steps given in this link.


17.  Hide visit start button

On registration page, in case you would like to hide the 'start visit' button, you may disable it by doing the following in the "config" section. 

"config": { 
   "showStartVisitButton": false
}

Note that, turning off the visit start button is probably not very useful, as without a visit open, you may not record information for a patient. However, there are certain use cases like

  • You are using Bahmni for just registration
  • You are doing a phase wise rollout where you intend to start visit in subsequent phases. 
  • You are capturing data for the patient in retrospective mode

18.  Configure display order of Patient Name fields 

"patientNameDisplayOrder": ["firstName", "middleName", "lastName"]

Patient Name field can be configured only in Registration Page, by specifying the order in "patientNameDisplayOrder" setting in app.json

  • This configuration should include all the three fields in desired order.

  • If any invalid configuration is provided, the default behaviour is to display FirsName, MiddleName and LastName.

  • Use existing hide/show options of configuration for middleName and lastName.

  • Default behaviour is to display FirstName, MiddleName and LastName if specific configuration is not specified in app.json in registration.