DOC - Clinical Case

Naming and Coding

The patient's clinical case is created as a markdown file with the code name ccXYZ-N.clincase, where XYZ is the patient's numeric identifier and N is the sequential number for the current case. For example, cc100-1.clincase refers to the first (No. 1) clinical case of the patient with the aliasNICKOLAOS_PAPADOPOYLOS_6945678901.

To show the current file in the Obsidian File Explorer (left panel), click the 📄 icon at the top right of the file title (see Fig. 1). There is also the pages icon ; clicking it opens the current file in the Windows File Explorer.

Clinical Case Overview

At the top of the clinical case tab, Fig. 1, we see the buttons that provide quick access to the patient's profile, medical history, medication, and medical library. The NEW DOCUMENT button allows us to create and link a medical document to the clinical case. We can also view the patient’s full name and age, the attending physician overseeing the case, and the referring physician, if the patient was referred.

Fig. 1: Patient's first clinical case
Fig. 1: Patient's first clinical case

Clinical Case Content

The clinical case is organized into the following sections. By clicking the corresponding link, you will be taken directly to the relevant part of the patient's clinical case. (see. Use of internal links):

Fold Headings

Obsidian also offers the ability to fold and unfold text (folding). We have placed two buttons for this function above the banner photo (Fold headings and list, Unfold headings and list). After folding, you can open just one section of the medical case; for example, the history of the present illness; to view the information (Fig. 2).

Fig. 2: Fold all sections of the medical case except for the History of the Present Illness section.
Fig. 2: Fold all sections of the medical case except for the History of the Present Illness section.

Embedding a Section of the Clinical Case

Thanks to the embedding feature provided by Obsidian, we can, for example, embed the patient's Diagnosis right at this point:

Diagnosis

...

DATE:


ICD10:

Description:

Notes:

Encounters (Visits) and Medical Documents

In the same way, using embedding, we can display below the patient's clinical visits that are linked to the first (1) clinical case. Note that the entries in the S/N and Case columns are internal links, which, when clicked, will take us to the corresponding clinical case or clinical visit.

🏠Encounters

And here we see the medical documents that are linked to the first clinical case. Similarly, the entries in the S/N and CASE columns are internal links.

Medical Documents

(S/N)3CaseTagsTotalMedia
41
  • type/patient/medical_document
  • media/image
  • category/labs
2
    • mm_name: capture_6
    • mm_name: capture_7
21
  • type/patient/medical_document
  • media/image
  • media/audio
  • category/imaging
3
    • mm_name: Transcription of the history of the present illness.
    • mm_name: MRI εγκεφάλου
    • mm_name: Computed Tomography (CT scan)
11
  • type/patient/medical_document
  • media/image
  • category/labs
3
    • mm_name: capture_1
    • mm_name: capture_2
    • mm_name: capture_3

Νew Clinical Case

To create a new clinical case for the patient NIKOLAOS_PAPADOPOULOS_6945678901, you need to open the summary of the patient’s folder and click the NEW CASE button. Once the new case is created, the internal link Current Clinical Case will open the most recently created case, Fig. 3.

Fig. 3: The summary of the patient record with buttons for creating a new case and a new visit. The internal link `Current Clinical Case` will open the most recently created case.
Fig. 3: The summary of the patient record with buttons for creating a new case and a new visit. The internal link Current Clinical Case will open the most recently created case.

This will create the second clinical case for the patient (cc100-2.clincase). And at this point, we can embed the history of the present illness:

History of Present Illness (HPI)

...

Reminders/Alerts/Warnings

Obsidian MEDILIG has the capability to add reminders in a checklist of required actions that need to be completed. For example, if in the second clinical case the patient needs to bring a chest X-ray and undergo blood tests.

Reminders/Warnings/Alerts

...

Medical examinations that need to be done:

  • Chest X-ray (@2024-08-21)
  • Blood test (@2024-08-22)

The syntax (@YYYY-MM-DD) automatically creates a reminder that on this date the patient is expected to have completed these examinations.

Fig. 4: Message regarding the chest X-ray: we can choose to mark it as completed, postpone it and be reminded later, or mute it so we are not notified about it again
Fig. 4: Message regarding the chest X-ray: we can choose to mark it as completed, postpone it and be reminded later, or mute it so we are not notified about it again

On the scheduled date, a system notification will appear for the Obsidian MEDILIG application, followed by an in-app message prompting us to choose what action to take regarding the specific reminder (Fig. 4).

Patient Visits for the 2nd Clinical Case

Here, we use embedding again to display the patient’s visits associated (linked) with this specific case.

🏠Encounters

Medical Documents for the 2nd Clinical Case

And at this point, we use embedding to display the patient’s medical documents associated (linked) with this specific case.

Medical Documents

Front-matter data for the clinical case

Data entered in the fields of the clinical case forms are automatically saved in the front-matter fields, which you can access from the right panel of the application, (Fig. 5), by clicking on the 🛈 icon.

Fig. 5: The front-matter fields with their different data types (text, date/time, boolean, numerical, object) and the corresponding values they hold to describe the patient’s clinical case
Fig. 5: The front-matter fields with their different data types (text, date/time, boolean, numerical, object) and the corresponding values they hold to describe the patient’s clinical case