Outpatient Consultations & Electronic Medical Records (EMR)

1. Overview & Business Value#

This comprehensive operational guide details the architecture, business workflows, configuration parameters, and execution steps for Outpatient Consultations & Electronic Medical Records (EMR) within SmartERP.

Clinical guide for physicians to document outpatient encounters using structured SOAP notes, ICD-10 diagnostic coding, and electronic orders.

{screenshot:outpatient-consultations-and-emr-overview-dashboard}

2. Prerequisites & Security Access Groups#

• Required Modules: smarterp_healthcare, smarterp_clinical_core, smarterp_pharmacy
• Security Groups:
  • Healthcare Receptionist (Technical ID: smarterp_healthcare.group_medical_receptionist)
  • Physician / Attending Doctor (Technical ID: smarterp_healthcare.group_medical_doctor)
  • Pharmacy Dispenser (Technical ID: smarterp_healthcare.group_medical_pharmacist)
• Master Data Dependencies: Patient master registry (Medical Record Number - MRN), EFDA drug formulary, Ethiopian Ministry of Health (MoH) HMIS disease codes, and EHIS insurance tariffs.

3. Step-by-Step Configuration & Execution#

Step 1: Navigating to the Module Interface#

1. Log into your SmartERP instance at https://smarterp.et/odoo.
2. Open the main App Switcher (grid icon in the top-left corner).
3. Select the Healthcare app icon.
4. From the top navigation bar, open Healthcare → Clinical Dashboard → OPD Triage / Inpatient ADT / EMR / Pharmacy Dispensing.

{screenshot:outpatient-consultations-and-emr-app-switcher-navigation}

Step 2: Creating and Parameterizing Records#

1. Click the New button in the top-left control panel.
2. Complete the mandatory fields in the record form:
   • Medical Record Number (MRN) (Mandatory): Unique national health identifier or generated hospital record code
   • Patient Demographics (Mandatory): Full legal name, gender, date of birth, and Kebele residential location
   • Encounter Type (Mandatory): Outpatient (OPD), Inpatient (IPD), Emergency, or Triage consultation
   • Attending Physician (Mandatory): Licensed healthcare practitioner responsible for clinical encounter
3. Configure optional operational parameters and localized tags as required:
   • Insurance Provider & Policy (Optional): EHIS CBHI/SHI policy or corporate credit contract
   • Triage Vital Signs (Optional): Blood pressure, pulse rate, respiratory rate, temperature, and SpO2
   • ICD-11 / HMIS Diagnosis Code (Optional): Standardized diagnosis category for statutory health reporting
4. Click the Save icon in the control bar to commit the record.

{screenshot:outpatient-consultations-and-emr-record-creation-form}

Step 3: Validating and Processing Transactions#

• State Transitions: Execute operational state progression (Reception / Triage → Consultation → Lab / Radiology → Prescription → Billing / Discharge).
• Ledger & System Impact: Patient billing registers medical service revenue, debits patient or insurance accounts receivable, and debits pharmaceutical inventory upon prescription dispensing.
• Audit Verification: Automated recording of author ID, timestamp, and immutable revision history.

{screenshot:outpatient-consultations-and-emr-transaction-processing-state}

Physician Workspace Navigation#

The physician workspace organizes waiting patients, active encounters, and diagnostic results in an ergonomic single-screen dashboard. Clinicians view the patient's longitudinal medical history, previous admissions, chronic medications, and active allergies without leaving the consultation canvas.

Documenting Structured SOAP Clinical Notes#

Medical notes adhere to the internationally recognized SOAP structure:

• S - Subjective: Record chief complaints, history of presenting illness (HPI), review of systems (ROS), and past medical/surgical history.
• O - Objective: Physical examination findings organized by system (General Appearance, HEENT, Respiratory, Cardiovascular, Abdomen, Neurological).
• A - Assessment: Working and differential diagnoses linked to the ICD-10 clinical coding dictionary.
• P - Plan: Therapeutic management plan, diagnostic orders (laboratory, radiology), non-pharmacological advice, and follow-up schedules.

ICD-10 Diagnostic Coding & Morbidity Reporting#

Accurate diagnostic coding ensures clinical auditability and feeds statutory MoH HMIS outpatient morbidity registers:

1. In the Assessment tab, type the clinical term or code (e.g., Typhoid or A01.0).
2. Select the matching entry from the standardized ICD-10 classification database.
3. Designate the diagnosis as Primary Working Diagnosis, Secondary / Comorbid, or Rule Out / Differential.
4. Specify encounter type: New Case or Repeat Visit (crucial for HMIS annual disease incidence tracking).

Electronic Ordering: Labs, Imaging & Referrals#

1. Click Add Order on the consultation toolbar.
2. Select Laboratory Investigation to order hematology, clinical chemistry, microbiology, or serology profiles.
3. Select Radiology Request for X-rays, ultrasound, CT, or MRI scans, specifying clinical indication and anatomical view.
4. Select Internal Referral to route the patient to specialty clinics (e.g., Ophthalmology, Cardiology, Dental).
5. Click Sign & Authorize. Orders instantly appear on departmental worklists with real-time tracking badges.

4. Advanced Configuration Points#

• Automated Actions & Scheduled Tasks (Crons):
  • Healthcare: Generate daily MoH HMIS aggregate tally (smarterp_healthcare.ir_cron_hmis_sync): Runs daily at 23:00 to prepare DHIS2 health data summaries
  • Pharmacy: Flag expiring EFDA medicine batches (smarterp_healthcare.ir_cron_fefo_expiry): Runs daily at 06:00 to alert dispensers of lots expiring within 60 days
• Custom Print Templates & Reports:
  • Official Patient Encounter Summary & Medical Certificate
  • Electronic Prescription Order Form (Model 19 Compliant)
  • Ethiopian Health Insurance Service (EHIS) Claim Dossier
  • Daily MoH Outpatient / Inpatient Morbidity Tally Sheet
• Multi-Company Rules: Record-level security isolation under Company 1 (Ashewa Technology Solutions S.C.), preventing cross-company ledger leakage across parent and subsidiary legal entities.

5. Comprehensive Troubleshooting Matrix#