TicklerPlus

by Marc Dumontier Sept 8 2005 - Nov 16 2005

Summary

OSCAR currently has a feature called the tickler. It can be used as a task management system. The current implementation needs to be extended for CAISI purposes.

Requirements

The OSCAR tickler has the following features

• list ticklers (allows filtering criteria)
• create new tickler (set patient,service date, task assigned to, and message)
• change status from Active to Completed, Deleted

TicklerPlus extends these features to include the following:

• record who or when it was completed
• allow updates to the message, or at least appending to

• a custom filter (allow user to choose a name and group/self association)
• a tickler history table whereby we track everything about the tickler, such as who and when a status change occurred.
• a filter for showing all expired ticklers. This will allow the administrator or other provider to see what has been left outstanding. This is currently handled by the entry showing up as ‘red’, but in the case where there’s a lot of active ticklers, this might be cumbersome for the user.
• ability to reassign ticklers to other people while keeping track of the history of assignments of a tickler

Ticklers and Privacy

Ticklers are used to assign tasks between staff in a multidisciplinary team that cares for a clien. All tasks are linked to a client/patient. As such tasks may contain confidential information about a client. E.g. "Please reorder HIV medications".  For this reason, ticklers follow a similar privacy framework as a client note.

• all ticklers are linked to the program the tickler is written in
• all ticklers are linked to the facility the tickler is written in
• all ticklers are linked to the role of the provider who assigned the tickler

The privacy framework around notes and ticklers is as follows:

Providers can be given the following access rights for ticklers:

• "ability to read tickler assigned to nurse".
  

• ticklers written by a person with role A should be readable by anyone who has role A or by anyone who has permission to read notes written by role A
  

For example:

Consider Program A in facility 1

ability to read ticklers assigned to doctor: doctor, nurse
ability to read ticklers assigned to nurse: doctor, nurse, counsellor
ability to read ticklers assigned to counsellor: doctor nurse, counsellor
ability to read ticklers assigned to CSW: doctor nurse, counsellor, CSW

In this case:

• a tickler written by a doctor to a nurse can be read by doctors, nurses and counsellors
• a tickler written by a doctor to a doctor can be read by doctors and nurses
• a tickler written by  doctor to a CSW can be read by CSW's, counsellors, nurses and doctors
• a tickler writen by a CSW to a doctor can be read by CSW's, counsellors, nurses and doctors
  

 Default privacy rules also include the following:

• providers can only read ticklers (e.g. in tickler filter page) for clients that belong to their program and facility domain

Next version of Tickler Plus

The current implementation of ticklers and privacy (as above) has redundancies in it, namely there is much overlap between notes rights and tickler rights. The next version should be more efficient and have the following:

 Providers can be given the access rights for ticklers or notes in same access setting:

• "ability to read doctor notes".
  

• ticklers written by a person with role A to a person with role B should be readable by anyone who is allowed to read notes by role A or notes for role B.
  

For example:

Consider Program A in facility 1

ability to read doctor notes: doctor, nurse
ability to read nurse notes: doctor, nurse, counsellor
ability to read counsellor notes: doctor nurse, counsellor
ability to read to CSW notes: doctor nurse, counsellor, CSW

In this case:

• a tickler written by a doctor to a nurse can be read by doctors, nurses and counsellors
• a tickler written by a doctor to a doctor can be read by doctors and nurses
• a tickler written by  doctor to a CSW can be read by CSW's, counsellors, nurses and doctors
• a tickler writen by a CSW to a doctor can be read by CSW's, counsellors, nurses and doctors
  

Implementation

TicklerPlus is implemented using Hibernate, Spring, and Struts.

Documentation

The Tickler List page is broken up into 2 sections. The top section is the filter criteria, and the bottom section is a tabular summary of the ticklers which match the filter criteria. This allows users to quickly find ticklers of interest.

TicklerPlus allows a user to create personal predefined filters, and reuse them

Create a new tickler. There are additional options available such as posting the message to the patients eChart.

TicklerPlus allows developers to create components which plugin into the web framework and autogenerate ticklers based on some minimal input. This is very useful to standardize orders.

Download

The latest working build of TicklerPlus can be downloaded from here. (note: follow the "Build Artifacts" link)

The latest stable release of TicklerPlus can be downloaded from here. (note: TicklerPlus 1.0 is not yet released)

for more information, contact Marc Dumontier