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Multi-Doctor Consultation Flow

Backend Implementation Details: Multi-Doctor Consultation Flow

Overview

The backend changes focus on removing the "single-session" restriction for patient visits, enabling multiple doctors to manage a patient's records simultaneously while ensuring proper queue synchronization during doctor reassignments.

Core Backend Changes

1. Prescription Modification Logic

File: app/services/patient_consultation_service.py

Modification: Refactored validate_consultation_status_for_prescription_modification

Change: Previously, the system enforced a "cycle number" restriction, allowing only the latest consultation record to be edited. This limitation has been removed to support multi-doctor (double consultation) workflows.

Impact: All consultation records associated with an active patient visit can now be edited by authorized users, enabling concurrent updates across multiple doctors.

2. Queue Specialization Synchronization

File: app/services/patient_consultation_service.py Function: reassign_doctor_for_consultation

Change: Added logic to dynamically update the queue specialization based on the newly assigned doctor.

Logic:

from app.models.doctor import Doctor

new_doc = db.query(Doctor).filter(Doctor.id == doctor_id).first()
if new_doc and queue_record:
    queue_record.specialization = new_doc.specialization.lower()

Impact: When a coordinator reassigns a doctor (e.g., Dentist → Pediatrician), the patient is immediately moved to the correct specialization queue without manual intervention.

3. Queue Deduplication (Unique Patients)

File: app/services/consultation_queue_service.py Function: get_all_active_queue

Change: Implemented PostgreSQL DISTINCT ON logic to ensure unique patient entries.

SQL Logic:

query = query.distinct(ConsultationQueue.book_no)
query = query.order_by(ConsultationQueue.book_no, po, ConsultationQueue.queue_number)

Reasoning: In a multi-doctor workflow, a single patient may have multiple consultation records. Without deduplication, dashboards (Counseling, Verification) would show duplicate entries for the same patient.

Impact:

  • Ensures one entry per Book Number
  • Displays the most relevant/latest queue status
  • Improves dashboard clarity and usability

4. Patient History Integrity

Validation Performed:

  • Verified via SQL queries that patient_consultations records are correctly indexed by:

    • patient_visit_details_id
    • doctor_id

  • Confirmed consistent retrieval of Book Number through joins with the patients table

  • Ensured cross-camp history integrity is maintained

Database Schema Relations

Table Column Relation Description
consultation_queue specialization Dynamically synced via patient_consultation_service
patient_consultations doctor_id Linked to doctors.id → users.user_name
camp_visits user_id Anchor for retrieving patients.book_no

Summary

These backend changes:

  • Enable true multi-doctor consultation workflows
  • Remove restrictive single-cycle editing logic
  • Ensure real-time queue synchronization
  • Prevent duplicate patient entries in dashboards
  • Maintain strong data integrity across visits and consultations

This provides a scalable and realistic workflow aligned with real-world medical camp operations.