hospital-management/tools/markdown/EMR_REFACTORING_PLAN.md

EMR App Refactoring Plan

Changes Required

1. Remove Encounter Model ❌

The entire Encounter class and EncounterManager need to be removed from emr/models.py since they now live in core/models.py.

2. Add Imports ✅

# At the top of emr/models.py
from core.models import Encounter, Patient, TenantScopedModel

3. Update Patient References (8 models)

All models currently reference 'patients.PatientProfile' - these need to change to 'core.Patient':

1. VitalSigns

   • patient = FK('patients.PatientProfile') → FK('core.Patient')
   • Keep encounter = FK(Encounter) (local reference, will become core reference)

2. ProblemList

   • patient = FK('patients.PatientProfile') → FK('core.Patient')
   • related_encounter = FK(Encounter) → stays the same

3. CarePlan

   • patient = FK('patients.PatientProfile') → FK('core.Patient')

4. ClinicalNote

   • patient = FK('patients.PatientProfile') → FK('core.Patient')
   • encounter = FK(Encounter) → stays the same

5. ClinicalRecommendation

   • patient = FK('patients.PatientProfile') → FK('core.Patient')
   • related_encounter = FK(Encounter) → stays the same

6. AllergyAlert

   • patient = FK('patients.PatientProfile') → FK('core.Patient')

7. CriticalAlert

   • patient = FK('patients.PatientProfile') → FK('core.Patient')
   • related_encounter = FK(Encounter) → stays the same

8. DiagnosticSuggestion

   • patient = FK('patients.PatientProfile') → FK('core.Patient')

4. Models That Don't Need Patient Changes

These models don't have patient FKs:

• NoteTemplate (tenant-scoped only)
• Icd10 (global reference data)
• TreatmentProtocol (tenant-scoped only)
• ClinicalGuideline (tenant-scoped only)

5. Consider Using TenantScopedModel

Many EMR models could inherit from TenantScopedModel instead of manually defining tenant/timestamps/etc. This is optional but recommended for consistency.

Implementation Strategy

Given the large file size (~1500 lines), we'll use a targeted approach:

1. Add imports at top
2. Remove Encounter and EncounterManager classes (lines ~20-300)
3. Update each model's patient FK using replace_in_file
4. Test that all references work

Expected Benefits

• ✅ Encounter available to all apps
• ✅ Patient identity centralized
• ✅ Consistent with core architecture
• ✅ Cleaner separation of concerns