Kordeus.SURGERY

Flow of a surgery planning

Step 0: Surgery capacity planning (by practise management)

Before any surgery can be planned, available slots are to be planned. See the Surgery days & Capacity planning tool.

Step 1: Surgery request (by doctors)

In a regular encounter, a surgery is requested to be planned by a doctor. The doctor has to specify:

1. Surgery to plan
2. Priority (Emergency, Priotity, Regular)
3. Organ & Location to plan
4. If multiple surgeries plan the sequence of surgeries. E.g. Which is the 1st eye, which is the 2nd eye)
5. Recommended Surgery timeframe (e.g. in 1 month, with 3-6 months, ... )
6. Requested products for the surgery (e.g. Lens with refraction)

This creates a surgery planning object, which holds most essential data (differs per surgery type), which has be extracted from the documentation mask.

Step 2: Surgery assignment and planning (by Surgery planning officer)

There is a surgery planning app in which surgery planning sees a list of requests sorted by priority, date of creation and latest day of performance request timeframe. Surgery officer now assignes surgery planning objects to available surgery capacity. This happens by dragging it to a list of open surgery slots in a surgery theater. Surgeries can be rearranged by drag and drop.

For each of these planned surgeries, surrounding appointments can be made. Alternatively the surrounding appointments can be made in KORDEUS.Core, but must be assigned to the surgery planning object in a simple way)

Step 3: Surgery preparation (by Surgery planning officer)

In this app, the surgery planning officer has two views:

• list view - shows all planned surgery sorted by date and their status (patient, birthday, surgery type, surgery location, surgeon ok [OK/Rejected], surgeon comments, medical ok, financial ok, paperwork ok)
• schedule view - the user sees the upcoming surgery days in a calendar overview and sees on the date (by background color) if all prework is done and the surgery is good to go. When selecting a date, he will see like in the list view a table of surgeries planned on that date in the day plan (similar to surgery assignment and planning)

From here:

• the planning officer can summon for each planned surgery the "surgery data update documentation form" in Kordeus.CORE (see surgery planning template administration), where he can update medical data if the doctor has changes. (NOTE: This form only works for one surgery, so if both eyes are undergoing surgery, this is two independent surgeries and changes!)
• the planning officer can print a day plan as pdf or automatically send it to the doctors doing the surgeries. This automatically triggers a approval request with the doctors for surgeries, which have not received the medical ok from the surgeon

Please note: On any change of the medical data or product, the medical approval is revoked (if already provided)

Step 4: Surgeon approval app

In this app, a doctor logs on and sees a list of days with planned surgeries. Each day with surgeries should show the overall medical approval status.

Once the surgeon clicks on a day, he sees the list of scheduled surgeries with his participation. The surgeon can click on each of them and sees:

• patient, gender, birthday, surgery type, surgery location, surgeon, medical ok, financial ok, paperwork ok

• relevant medical information for review on this patient (see surgery planning template administration)
• planned products, ... .
• Doctor may: OK, Request change. If change: enter text.

Step 5: Surgery app

This app shows the list of surgeries planned for the current day. The user can pick one surgery and see the medical parameters. In this app he can document the surgery:

1. pick actions from predefined actions
2. pick products from predefined products
3. add non-std. products and non-std. actions

After surgery is finished, the doctor needs to sign the protocoll.

Dependencies

Medical Document Blocks Administration

• Name
• Type (Static, Text-with-Kordeus-UI-Date, Dynamic content, AI generated)
• If static, provide text
• if text-with-placeholders,
  • select placeholder from KORDEUS available ones, we will grow this list more and more)
  • enter text with placeholders
• dynamic Placeholders (e.g. for patient consent forms)
• if AI generation
  • enter generative AI context information, e.g. "medical letter to doctoral colleague"
  • enter placeholders to include from KORDEUS available ones (we will grow this list more and more). For each placeholder add context information for generative AI, "e.g. value for best corrected vision OD"

Medical Document Template Administration

• Name
• Type
• Used placeholders (select from KORDEUS available ones, we will grow this list more and more)
• Used medical document blocks

Surgery Type Administration

• Name (e.g. "CAT-Op + FEMTO" or "Standard CAT-Op")
• Linked surgery planning documentation forms
  • Applicable surgery planning documentation form (used by doctor)
  • Applicable surgery planning data update documentation form (if the planning officer needs to change)
  • Binding element to this surgery type
    • static binding - if this is selected, this surgery-type is always used, if one of the documentation forms is discovered.
    • documentation form item binding - this surgery type is relevant, if a setting on the documentation form has been made. e.g. "Femto-Lasik" is active. This setting allows to define the setting by which the system detects this surgery type to be applicable.
• Surgery related appointment flow
  This bears multiple appointments, which contain the surgery appointment and surrounding appointments". This is required for assisting the surgery planning process and appointment making and case detection. For each of these appointments:
  • Appointment Name (e.g. "Cataract pre-examination", "PostOP Followup", "3 day followup"
  • Appointment-Type and days before or after surgery appointment
  • A handling comment during appointment making (e.g. "Do this close to 2nd eye surgery if applicable").
  • Is main surgery appointment - points to the main surgery appointment
  • Appointment is covering multiple locations - This is required for preexaminations, which cover both eyes.
  • Appointment is optional - This appointment is optional. E.g. is required for followups, where some are optional and some are mandatory. Mandator options force tasks to be created to call after these people and get them to the appointments.
• Surgery type billing settingsSurgery billing includes prepayment managment and comes with different flavors like Flatrate, Individual pricing, ... .
  • Define, when prepayments are created (Never, onAppointmentmaking)
  • Define, until when the prepayments have to be made (x days before surgery)
  • Surgery base price
    • The user may define a charging ruleset used for evaulation of the base price of this surgery.
    • Charge products which do not have a charging rule.
    • Charge products, which do no have a chargng rule, if product flat-rate is active
    • Charge services which do not have a charging rule.
    • Charge services, which do no have a chargng rule, if service flat-rate is active
  • Surgery chargeable services By default, all services are chargeable to the patient, unless the base price triggers a service flat-rate. In this section, the user may define a list of services and for each of them:
    • documentation form item binding - reference to a setting on the documentation form, which indicates that this service is planned or was used. E.g. "Full anaethesia"
    • a charging ruleset for this service
  • Surgery chargeable products By default, all products are charged to the patient, unless the base price triggers a product flat-rate. In this section, the user may define a list of products and for each of them:
    • documentation form item binding - reference to a setting on the documentation form, which indicates that this product is planned or was used. E.g. "Full anaethesia"
    • a charging ruleset for this product

• Possible Document-Templates to be signed by patient (Select from Document Templates) and placeholders
• Required checks to be made by surgery planning
• Medical parameters to be shown in medical approval mask (select placeholder from KORDEUS available ones, we will grow this list more and more), which will be taken from last preexamination of this patient holding data for the target location of the surgery)
• Define standard medical Actions and Products during the surgery
  • Products used / applied
  • Actions performed

Surgery days & Capacity planning

You should see a surgery theater (facility) and be able to define manually or automated surgery slots. You can create one-time-slots and create slots from surgery day templates (each Thursday 9-12, 10 Cat-OP Slots). One or several appointment-slots can be persisted as templates. Templates should be easily deletable.

For each slots you can assign:

• Appointment-Type (not variation)
• Fill in planned devices, facility and staff for the positions required by the Surgery Planning Template

Note: Only these surgery slots, where capacity exists can be filled in surgery planning!