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LHR Presentation Strategy
Purpose: Define how to present the Longitudinal Health Record in Kulcare's UI, considering different user roles, workflows, and information needs.
Design Principles
1. Patient-Centric Organization
- Organize around the patient, not visits
- Show the "big picture" first, details on demand
- Highlight what's clinically important NOW
2. Context-Aware Density
- Dashboard view: High-level summary
- Problem view: Deep dive on one condition
- Timeline view: Chronological narrative
3. Role-Based Relevance
- Show what each practitioner type needs most
- Don't overwhelm with irrelevant data
- Allow customization without requiring it
4. Actionable Information
- Highlight items needing attention
- Show trends, not just current values
- Connect data to decisions
Presentation Modes
Mode 1: Summary Dashboard (Default)
The primary LHR view showing key health metrics at a glance.
+------------------------------------------------------------------+
| PATIENT SUMMARY: John Doe (52M) Health Score: 78/100 |
+------------------------------------------------------------------+
| |
| +------------------+ +------------------+ +------------------+ |
| | ACTIVE PROBLEMS | | CURRENT MEDS | | RECENT VITALS | |
| | 3 conditions | | 5 medications | | BP: 138/88 (!) | |
| | - Hypertension | | - Lisinopril | | HR: 72 bpm | |
| | - T2 Diabetes | | - Metformin | | Wt: 85kg (+2) | |
| | - Hyperlipidemia | | - Atorvastatin | | Last: Dec 24 | |
| | [View All] | | [View All] | | [View Trends] | |
| +------------------+ +------------------+ +------------------+ |
| |
| +------------------+ +------------------+ +------------------+ |
| | ALLERGIES | | ACTIVE EPISODES | | UPCOMING | |
| | 2 known | | 1 active | | Jan 2: Follow-up| |
| | - Penicillin | | - Diabetes Mgmt | | Jan 15: Labs due| |
| | - Sulfa drugs | | (6/12 visits) | | | |
| | | | [Open Episode] | | [Schedule] | |
| +------------------+ +------------------+ +------------------+ |
| |
| +--------------------------------------------------------------+ |
| | RECENT ENCOUNTERS [View Timeline] | |
| | Dec 24 - Diabetes Follow-up (Dr. Smith) - BP high, adj meds | |
| | Dec 10 - Lab Review - HbA1c 7.2% (improved) | |
| | Nov 28 - Routine Check (Dr. Smith) - Started metformin | |
| +--------------------------------------------------------------+ |
+------------------------------------------------------------------+Key Elements:
- Health Score prominently displayed
- 6-card layout for quick scanning
- Flags/badges for abnormal values
- Quick links to deeper views
Mode 2: Timeline View
Chronological view of all clinical events.
+------------------------------------------------------------------+
| PATIENT TIMELINE: John Doe Filter: [All v] |
+------------------------------------------------------------------+
| |
| 2024 |
| ---- |
| |
| Dec 24 [Encounter] Diabetes Follow-up |
| | Provider: Dr. Smith |
| | BP: 138/88 | HbA1c discussed | Metformin dose increased |
| | [View Full Encounter] |
| | |
| Dec 10 [Lab Result] Metabolic Panel |
| | HbA1c: 7.2% (improved from 7.8%) |
| | Fasting Glucose: 142 mg/dL |
| | |
| Nov 28 [Encounter] Routine Check |
| | Provider: Dr. Smith |
| | Started: Metformin 500mg BID |
| | Problem Added: Type 2 Diabetes |
| | |
| Nov 15 [Medication] Lisinopril dose increased |
| | 10mg -> 20mg (BP not controlled) |
| | |
| Oct 20 [Encounter] Annual Physical |
| Provider: Dr. Smith |
| New diagnoses: Hypertension, Pre-diabetes |
| |
+------------------------------------------------------------------+Key Elements:
- Clear chronological ordering
- Event type icons/badges
- Expandable details
- Filterable by event type
Mode 3: Problem-Centric View
Deep dive on a specific condition and all related data.
+------------------------------------------------------------------+
| PROBLEM DETAIL: Type 2 Diabetes |
| Status: Active | Severity: Medium | Onset: Nov 2024 |
+------------------------------------------------------------------+
| |
| +----------------------+ +------------------------------------+ |
| | TREND: HbA1c | | RELATED MEDICATIONS | |
| | | | - Metformin 1000mg BID (active) | |
| | 8.0 | * | | Started: Nov 28, 2024 | |
| | 7.5 | * | | Increased from 500mg: Dec 24 | |
| | 7.0 | * | | | |
| | +------------> | | DISCONTINUED: | |
| | Oct Nov Dec | | - None | |
| +----------------------+ +------------------------------------+ |
| |
| +--------------------------------------------------------------+ |
| | RELATED ENCOUNTERS | |
| | Dec 24 - Follow-up: Dose adjustment, diet counseling | |
| | Nov 28 - Initial: Diagnosis, started metformin | |
| | Oct 20 - Pre-diabetes identified at annual physical | |
| +--------------------------------------------------------------+ |
| |
| +--------------------------------------------------------------+ |
| | CARE PLAN | |
| | Goal: HbA1c < 7.0% by March 2025 | |
| | Progress: 7.8% -> 7.2% (on track) | |
| | Next Steps: | |
| | - Continue current medications | |
| | - Recheck HbA1c in 3 months | |
| | - Dietitian referral | |
| +--------------------------------------------------------------+ |
+------------------------------------------------------------------+Key Elements:
- Trend visualization for key metrics
- All related medications grouped
- Encounter history filtered to this problem
- Care plan and goals if defined
Mode 4: Episode View (Planned)
View for program-based care (therapy, physio, etc.)
+------------------------------------------------------------------+
| EPISODE: Post-ACL Rehabilitation |
| Type: Physiotherapy | Status: Active | Progress: 5/12 sessions |
+------------------------------------------------------------------+
| |
| [===========> ] 42% Complete |
| |
| +------------------+ +------------------+ +------------------+ |
| | TREATMENT GOALS | | RECENT PROGRESS | | NEXT SESSION | |
| | 1. Full ROM | | ROM: 95 -> 110 | | Dec 28, 10am | |
| | [75% done] | | Strength: +15% | | Provider: PT | |
| | 2. Return to run | | Pain: 4 -> 2 | | | |
| | [40% done] | | | | [View Details] | |
| +------------------+ +------------------+ +------------------+ |
| |
| +--------------------------------------------------------------+ |
| | SESSION HISTORY | |
| | #5 Dec 24 - ROM exercises, quad strengthening, ice | |
| | #4 Dec 17 - Added resistance, stationary bike introduced | |
| | #3 Dec 10 - Progressed to weight-bearing exercises | |
| | #2 Dec 3 - Gentle ROM, pain management | |
| | #1 Nov 26 - Initial assessment, treatment plan created | |
| +--------------------------------------------------------------+ |
| |
| +--------------------------------------------------------------+ |
| | MEASUREMENTS OVER TIME | |
| | [Chart showing ROM progression across sessions] | |
| +--------------------------------------------------------------+ |
+------------------------------------------------------------------+Key Elements:
- Progress bar showing completion
- Treatment goals with progress
- Session history specific to this episode
- Measurements trending within episode
Role-Based Views
General Practitioner / Family Doctor
Primary Need: Complete patient context for diagnosis and coordination
Default View: Summary Dashboard
- All active problems visible
- Recent encounters from all providers
- Medication reconciliation view
- Referral status tracking
Emphasized:
- Health score and trends
- Preventive care gaps (immunizations, screenings due)
- Care coordination notes
Specialist (Cardiologist, Endocrinologist, etc.)
Primary Need: Deep dive on their specialty area
Default View: Problem-Centric
- Filter to relevant conditions (e.g., cardiac conditions)
- Specialty-specific labs trending (e.g., lipid panels)
- Related medications only
Emphasized:
- Specialty-specific assessments
- Prior specialist notes
- Treatment response over time
Therapist / Psychologist
Primary Need: Session continuity and treatment progress
Default View: Episode View
- Current therapy program details
- Session notes from previous visits
- Assessment scores over time (PHQ-9, GAD-7)
Emphasized:
- Treatment goals and progress
- Mood/symptom tracking
- Safety plans
Physiotherapist
Primary Need: Functional assessments and exercise progression
Default View: Episode View
- Current rehab program
- ROM/strength measurements trending
- Exercise progression history
Emphasized:
- Physical measurements
- Functional goals
- Pain levels over time
Dietitian / Nutritionist
Primary Need: Nutritional assessments and meal plan adherence
Default View: Episode View
- Nutrition program details
- Weight/BMI trending
- Lab values (glucose, lipids, vitamins)
Emphasized:
- Anthropometric measurements
- Dietary assessments
- Metabolic labs
Navigation Patterns
Primary Navigation
Patient Search
|
v
Patient Selected
|
+-- Quick Actions: [New Encounter] [Schedule] [Message]
|
+-- LHR Dashboard (default landing)
|
+-- Tab: Summary (dashboard view)
+-- Tab: Problems (list + detail view)
+-- Tab: Medications (timeline view)
+-- Tab: Vitals (trend charts)
+-- Tab: Labs (results + trends)
+-- Tab: Encounters (timeline view)
+-- Tab: Documents (file list)
+-- Tab: Episodes (if any exist)Drill-Down Pattern
Summary Dashboard
|
+-- Click "Hypertension" problem
|
v
Problem Detail View
|
+-- Click "Dec 24 Encounter"
|
v
Encounter Detail View
|
+-- [Back to Problem] [Back to LHR] [View Full LHR]Cross-Reference Pattern
Any view should allow quick access to related items:
- From medication: See related problem, see prescribing encounter
- From encounter: See all problems addressed, medications prescribed
- From problem: See all related medications, encounters, episodes
- From lab result: See ordering encounter, trend with previous results
Information Density Guidelines
Dashboard Density
- High-level metrics: Numbers, badges, trend arrows
- Lists: Max 3-5 items with "View All" link
- Alerts: Prominent but not overwhelming
- Target: Scannable in 10 seconds
Detail View Density
- Full context: Complete information for that entity
- Related items: Links to connected data
- History: Chronological changes
- Target: Complete picture in 60 seconds
Timeline Density
- Event summaries: One-line descriptions
- Expandable details: Click to see more
- Visual grouping: By date, by type
- Target: Scan 6 months in 30 seconds
Visual Design Guidelines
Color Coding
| Element | Color | Usage |
|---|---|---|
| Normal/Healthy | Green (#10B981) | Within range, resolved, improving |
| Warning | Amber (#F59E0B) | Approaching limits, needs attention |
| Critical | Red (#EF4444) | Out of range, urgent, active problem |
| Chronic/Ongoing | Blue (#3B82F6) | Long-term conditions, stable |
| Neutral/Info | Gray (#6B7280) | Historical, informational |
Status Badges
- Active: Red badge - needs ongoing management
- Resolved: Green badge - completed/cured
- Chronic: Blue badge - ongoing but stable
- Improving: Teal badge - positive trend
Trend Indicators
- Improving: Green up arrow
- Stable: Gray horizontal dash
- Worsening: Red down arrow
- Unknown: Gray question mark
Implementation Recommendations
Phase 1: Enhance Current Dashboard
- Add allergies to summary cards
- Add episode summary card (even if empty state)
- Improve problem-medication linking display
- Add care plan summary when exists
Phase 2: Add Missing Views
- Create Problem-Centric view
- Create full Timeline view
- Enhance lab results with trending
Phase 3: Episode Integration
- Create Episode view layout
- Add episode grouping to encounter history
- Add episode filter to vitals/measurements
Phase 4: Role-Based Customization
- Save default view preferences by role
- Allow quick switching between views
- Specialty-specific data emphasis
Related Documentation
- LHR Concept - What LHR means
- LHR Components Audit - What's implemented
- Clinical Data Hierarchy - Data relationships
- Frontend Code: LongitudinalHealthRecord - Component location