Epic Description:
The Patient Management System allows healthcare organizations to efficiently manage patient information, including demographics, medical history, and more. It supports registration, updates, and ensures seamless care coordination, data integrity, and compliance with healthcare regulations.


User Stories for Patient Management

For Front Desk Staff:

  1. Patient Registration (Admin/Receptionist)
    As a front desk staff member, I want to register new patients in the system so that I can quickly create and maintain accurate patient records.

Acceptance Criteria:

    • Enter patient demographics (name, DOB, gender, contact info)
    • Scan and upload identification documents
    • Automatic check for duplicate records
    • Assign a unique patient ID
    • Capture emergency contact information


2. Patient Search and Retrieval (Admin/Receptionist)
As a front desk staff member, I want to search for existing patients using various criteria so that I can quickly access and update patient information.

Acceptance Criteria:

    • Search by name, DOB, patient ID, or phone number
    • Display results in a clear, sortable list
    • View and edit patient info from search results
    • Option to print a patient summary


3. Appointment Check-In (Admin/Receptionist)
As a front desk staff member, I want to check in patients for appointments so that I can track arrivals and notify providers.

Acceptance Criteria:

    • Easily locate daily appointments
    • Update patient status to "checked in"
    • Capture or update insurance information
    • Collect and record copayments
    • Notify relevant staff of patient arrival


4. Insurance Verification (Admin/Receptionist)
As a front desk staff member, I want to verify and update patient insurance information so that billing can be processed accurately.

Acceptance Criteria:

    • Enter and update insurance information
    • Verify insurance eligibility in real-time
    • Record verification date and status
    • Flag any insurance issues for billing staff


For Healthcare Providers:

5. Patient Medical History Review (Healthcare Provider)
As a healthcare provider, I want to view a comprehensive patient medical history so that I can make informed decisions about patient care.

Acceptance Criteria:

    • Display past appointments, diagnoses, and treatment plans
    • Show diagnosis history, lab results, and imaging reports
    • List medications and allergies


6. Patient Clinical Notes (Healthcare Provider)
As a healthcare provider, I want to add and view clinical notes for each patient encounter so that I can document important medical information.

Acceptance Criteria:

    • Add and timestamp notes
    • Use customizable templates
    • Include voice-to-text options
    • Attach relevant documents or images
    • Sign and lock notes to prevent changes


7. Care Plan Management (Healthcare Provider)
As a healthcare provider, I want to create and manage care plans so that I can outline treatment goals and track patient progress.

Acceptance Criteria:

    • Create care plans with specific goals
    • Update care plans based on patient progress
    • Set reminders for care plan reviews
    • Share care plans with patients and other providers
    • Track outcomes related to care plan goals


For Billing Staff:

8. Patient Billing Profile (Billing Staff)
As a billing staff member, I want to manage patient billing profiles so that I can ensure accurate billing and claims processing.

Acceptance Criteria:

    • View and update patient financial information
    • Manage multiple insurance policies per patient
    • Record patient payment preferences and history


9. Financial Responsibility Estimation (Billing Staff)
As a billing staff member, I want to estimate patient financial responsibility so that I can inform patients of potential out-of-pocket costs.

Acceptance Criteria:

    • Calculate estimated costs based on insurance coverage
    • Generate patient-friendly cost estimates
    • Record patient acknowledgment of estimated costs


For System Administrators:

10. Patient Record Merge (System Administrator)
As a system administrator, I want to merge duplicate patient records so that I can maintain data integrity.

Acceptance Criteria:

    • Search and identify duplicate records
    • Compare and select information to keep from each record
    • Maintain an audit trail of merged records


11. Patient Data Access Control (System Administrator)
As a system administrator, I want to manage access controls for patient data so that I can ensure patient privacy and regulatory compliance.

Acceptance Criteria:

    • Set up role-based access controls for patient data
    • Implement break-glass procedures for emergency access
    • Generate reports on user access to patient records


For Patients (via Patient Portal):

12. Personal Information Update (Patient)
As a patient, I want to update my personal information through the patient portal so that my records remain current.

Acceptance Criteria:

    • Edit contact information and demographics
    • Update emergency contacts
    • Request changes to insurance information
    • Receive confirmation of submitted changes

13. Medical History Review (Patient)
As a patient, I want to review my medical history through the portal so that I can stay informed about my health.

Acceptance Criteria:

    • View past diagnoses and treatments
    • Access lab results and imaging reports
    • Download or print health summaries


For Care Coordinators:

14. Patient Population Management (Care Coordinator)
As a care coordinator, I want to manage groups of patients with similar health conditions so that I can implement targeted care programs.

Acceptance Criteria:

    • Create and manage patient cohorts based on specific criteria
    • Generate reports on cohort health trends
    • Implement bulk actions for patient outreach or education programs
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