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References/Patient: Difference between revisions

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|type=reference
|type=reference
|domain=clinical
|domain=clinical
|title=Patient
|title=Patient (reference)
|summary=Technical reference for the Patient module in Care EMR — models, fields, relationships, and save behaviour.
|order=1
|order=1
|introduced=3.0
|introduced=3.0
|fhir=Patient
|fhir=Patient
|model=Patient
|model=Patient
|source=care/emr/models/patient.py
|concept=Concepts/Patient
|concept=Concepts/Patient
|flow=Flows/Create a patient
|flow=Flows/Create a patient
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Technical reference for the <code>Patient</code> module in Care EMR. For a product-oriented overview, see the [[Concepts/Patient|Patient concept]].
Technical reference for the <code>Patient</code> module in Care EMR. For a product-oriented overview, see the [[Concepts/Patient|Patient concept]].

'''Source:''' [<nowiki/>https://github.com/ohcnetwork/care/blob/develop/care/emr/models/patient.py <code>care/emr/models/patient.py</code>]


== Models ==
== Models ==


{| class="wikitable"
{| class="wikitable"
⚫
! Model !! Purpose
|-
|-
⚫
| <code>Patient</code> || Core patient record
! Model
⚫
! Purpose
|-
⚫
| <code>Patient</code>
| Core patient record
|-
|-
| <code>PatientOrganization</code>
| <code>PatientOrganization</code> || Links a patient to an <code>Organization</code>
| Links a patient to an <code>Organization</code>
|-
|-
| <code>PatientUser</code>
| <code>PatientUser</code> || Grants a <code>User</code> access to a patient with a <code>RoleModel</code>
| Grants a <code>User</code> access to a patient with a <code>RoleModel</code>
|-
|-
| <code>PatientIdentifierConfig</code>
| <code>PatientIdentifierConfig</code> || Defines identifier types (instance-wide or per-facility)
| Defines identifier types (instance-wide or per-facility)
|-
|-
| <code>PatientIdentifier</code>
| <code>PatientIdentifier</code> || Stores an identifier value for a patient
| Stores an identifier value for a patient
|}
|}


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{| class="wikitable"
{| class="wikitable"
! Field !! Type !! Notes
|-
! Field
! Type
! Notes
{{Field|model=Patient|section=Demographics|name=name|type=CharField(200)|notes=Display name}}
{{Field|model=Patient|section=Demographics|name=name|type=CharField(200)|notes=Display name}}
{{Field|model=Patient|section=Demographics|name=gender|type=CharField(35)|notes=Administrative gender}}
{{Field|model=Patient|section=Demographics|name=gender|type=CharField(35)|notes=Administrative gender}}
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|}
|}


=== Contact &amp; address ===
=== Contact & address ===


{| class="wikitable"
{| class="wikitable"
! Field !! Type !! Notes
|-
⚫
{{Field|model=Patient|section=Contact & address|name=phone_number|type=CharField(14)|notes=Validated with <code>mobile_or_landline_number_validator</code>}}
! Field
⚫
{{Field|model=Patient|section=Contact & address|name=emergency_phone_number|type=CharField(14)|notes=Same validator}}
! Type
⚫
{{Field|model=Patient|section=Contact & address|name=address|type=TextField|notes=Current address}}
! Notes
{{Field|model=Patient|section=Contact &amp; address|name=phone_number|type=CharField(14)|notes=Validated with <code>mobile_or_landline_number_validator</code>}}
{{Field|model=Patient|section=Contact & address|name=permanent_address|type=TextField|notes=}}
{{Field|model=Patient|section=Contact &amp; address|name=emergency_phone_number|type=CharField(14)|notes=Same validator}}
{{Field|model=Patient|section=Contact & address|name=pincode|type=IntegerField|notes=Nullable}}
⚫
{{Field|model=Patient|section=Contact &amp; address|name=address|type=TextField|notes=Current address}}
⚫
{{Field|model=Patient|section=Contact &amp; address|name=permanent_address|type=TextField|notes=}}
⚫
{{Field|model=Patient|section=Contact &amp; address|name=pincode|type=IntegerField|notes=Nullable}}
|}
|}


=== Organization &amp; access caches ===
=== Organization & access caches ===


These are '''denormalized caches''' rebuilt on every <code>Patient.save()</code> for fast filtering without deep joins.
These are '''denormalized caches''' rebuilt on every <code>Patient.save()</code> for fast filtering without deep joins.


{| class="wikitable"
{| class="wikitable"
! Field !! Type !! Notes
|-
{{Field|model=Patient|section=Organization & access caches|name=geo_organization|type=FK → Organization|notes=Geographic/administrative org assignment}}
! Field
⚫
{{Field|model=Patient|section=Organization & access caches|name=organization_cache|type=ArrayField[int]|notes=Rebuilt by <code>rebuild_organization_cache()</code> — includes <code>geo_organization</code> parent chain and all linked <code>PatientOrganization</code> orgs}}
! Type
⚫
{{Field|model=Patient|section=Organization & access caches|name=users_cache|type=ArrayField[int]|notes=Rebuilt by <code>rebuild_users_cache()</code> — user IDs from <code>PatientUser</code> rows}}
! Rebuilt by
|-
| <code>geo_organization</code>
| <code>FK → Organization</code>
| Geographic/administrative org assignment
|-
| <code>organization_cache</code>
| <code>ArrayField[int]</code>
⚫
| <code>rebuild_organization_cache()</code> — includes <code>geo_organization</code> parent chain and all linked <code>PatientOrganization</code> orgs
|-
| <code>users_cache</code>
| <code>ArrayField[int]</code>
⚫
| <code>rebuild_users_cache()</code> — user IDs from <code>PatientUser</code> rows
|}
|}


=== Identifiers &amp; tags ===
=== Identifiers & tags ===


{| class="wikitable"
{| class="wikitable"
! Field !! Type !! Notes
|-
{{Field|model=Patient|section=Identifiers & tags|name=instance_identifiers|type=JSONField|notes=List of <code>{config, value}</code> built from <code>PatientIdentifier</code> rows (instance-scoped configs)}}
! Field
⚫
{{Field|model=Patient|section=Identifiers & tags|name=facility_identifiers|type=JSONField|notes=Dict keyed by <code>facility_id</code> → list of <code>{config, value}</code>}}
! Type
⚫
{{Field|model=Patient|section=Identifiers & tags|name=instance_tags|type=ArrayField[int]|notes=Instance-level tag IDs}}
! Notes
{{Field|model=Patient|section=Identifiers &amp; tags|name=instance_identifiers|type=JSONField|notes=List of <code>{config, value}</code> built from <code>PatientIdentifier</code> rows (instance-scoped configs)}}
{{Field|model=Patient|section=Identifiers & tags|name=facility_tags|type=JSONField|notes=Dict keyed by facility → tag IDs}}
{{Field|model=Patient|section=Identifiers &amp; tags|name=facility_identifiers|type=JSONField|notes=Dict keyed by <code>facility_id</code> → list of <code>{config, value}</code>}}
{{Field|model=Patient|section=Identifiers & tags|name=extensions|type=JSONField|notes=Open extension bag for deployment-specific metadata}}
⚫
{{Field|model=Patient|section=Identifiers &amp; tags|name=instance_tags|type=ArrayField[int]|notes=Instance-level tag IDs}}
⚫
{{Field|model=Patient|section=Identifiers &amp; tags|name=facility_tags|type=JSONField|notes=Dict keyed by facility → tag IDs}}
{{Field|model=Patient|section=Identifiers &amp; tags|name=extensions|type=JSONField|notes=Open extension bag for deployment-specific metadata}}
|}
|}


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=== <code>PatientOrganization</code> ===
=== <code>PatientOrganization</code> ===


<syntaxhighlight lang="text">patient → FK Patient
<syntaxhighlight lang="text">
patient → FK Patient
organization → FK Organization</syntaxhighlight>
organization → FK Organization
</syntaxhighlight>

Saving a <code>PatientOrganization</code> triggers <code>patient.save()</code>, which rebuilds <code>organization_cache</code>.
Saving a <code>PatientOrganization</code> triggers <code>patient.save()</code>, which rebuilds <code>organization_cache</code>.


Line 122: Line 97:
Grants a Care user access to a patient record.
Grants a Care user access to a patient record.


<syntaxhighlight lang="text">user → FK User
<syntaxhighlight lang="text">
user → FK User
patient → FK Patient
patient → FK Patient
role → FK RoleModel (PROTECT)</syntaxhighlight>
role → FK RoleModel (PROTECT)
</syntaxhighlight>

Saving a <code>PatientUser</code> triggers <code>patient.save()</code>, which rebuilds <code>users_cache</code>.
Saving a <code>PatientUser</code> triggers <code>patient.save()</code>, which rebuilds <code>users_cache</code>.


Line 131: Line 109:
<code>PatientIdentifierConfig</code> defines what identifiers exist (status, optional facility scope, JSON config). <code>PatientIdentifier</code> stores the actual value:
<code>PatientIdentifierConfig</code> defines what identifiers exist (status, optional facility scope, JSON config). <code>PatientIdentifier</code> stores the actual value:


<syntaxhighlight lang="text">patient → FK Patient
<syntaxhighlight lang="text">
patient → FK Patient
config → FK PatientIdentifierConfig
config → FK PatientIdentifierConfig
facility → FK Facility (nullable)
facility → FK Facility (nullable)
value → CharField(1024), indexed</syntaxhighlight>
value → CharField(1024), indexed
</syntaxhighlight>

<code>PatientIdentifierConfigCache</code> provides in-process caching for configs (<code>get_instance_config()</code>, <code>get_facility_config(facility_id)</code>).
<code>PatientIdentifierConfigCache</code> provides in-process caching for configs (<code>get_instance_config()</code>, <code>get_facility_config(facility_id)</code>).


== Methods &amp; save behaviour ==
== Methods & save behaviour ==


=== Age ===
=== Age ===
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# <code>rebuild_organization_cache()</code> runs
# <code>rebuild_organization_cache()</code> runs
# <code>rebuild_users_cache()</code> runs
# <code>rebuild_users_cache()</code> runs
# A second <code>save(update_fields=[&quot;organization_cache&quot;, &quot;users_cache&quot;])</code> persists the caches
# A second <code>save(update_fields=["organization_cache", "users_cache"])</code> persists the caches


Integrators should expect '''two write passes''' when creating or updating patients through the ORM.
Integrators should expect '''two write passes''' when creating or updating patients through the ORM.
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* <code>extensions</code> is the supported place for custom key-value data without schema migrations.
* <code>extensions</code> is the supported place for custom key-value data without schema migrations.
* <code>users_cache</code> and <code>organization_cache</code> are maintained by the platform — do not set them directly from clients.
* <code>users_cache</code> and <code>organization_cache</code> are maintained by the platform — do not set them directly from clients.

{{Navbox clinical}}


{{Related}}
{{Related}}
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