Chiropractic Digital Patient Management System

System Overview

The HISA Chiropractic Digital Patient Management System is a purpose-built clinical information system designed for chiropractic teaching clinics. It replaces a fully paper-based patient management workflow with a structured, POPIA-compliant digital environment that mirrors every stage of the chiropractic consultation process as defined by HPCSA practice guidelines.

Intended Users

The system supports four distinct user roles: Patient (read-only access to their own consent and summary records), Student Clinician (form completion and SOAP note creation under supervision), Supervising Clinician (review, countersignature, and clinical oversight), and Administrator / Reception (patient registration, scheduling, and records access).

Patient Journey Modules

• Module 1: POPIA Consent and Data Disclosure: Digital consent with patient signature capture. Patients acknowledge the lawful basis for data collection and provide explicit consent as required under POPIA Section 11.
• Module 2: Patient Registration: Full demographic capture including ID number, contact details, emergency contacts, medical aid / insurance information, and referring practitioner.
• Module 3: Health History Form: Comprehensive structured intake covering chief complaint, history of present illness, past medical and surgical history, family history, medications, allergies, and systems review.
• Module 4: Physical Examination: Structured physical examination module covering vital signs, postural assessment, and regional physical findings with standardised scoring fields.
• Module 5: Regional Spinal Examination: Vertebral region-specific examination capturing range of motion, orthopaedic test results, neurological examination findings, and pain scales.
• Module 6: SOAP Note Documentation: Subjective, Objective, Assessment, and Plan documentation with ICD-10 diagnosis code lookup and auto-population of examination findings from prior modules.
• Module 7: PDF Export: Full consultation record generated as a signed, timestamped PDF matching the approved paper record format for medico-legal and HPCSA compliance.

Technical Specifications

• Frontend: React 18 with TypeScript: component-based architecture, mobile-responsive
• Backend: Node.js REST API with PostgreSQL database
• Authentication: JWT tokens (30-minute expiry) with mandatory 2FA for clinical users
• Encryption: AES-256 at rest, TLS 1.3 in transit
• Digital Signatures: Base64 PNG stored in private, non-public blob storage
• Audit Logging: Immutable log of all write operations: user ID, action, entity, timestamp, IP address
• PDF Generation: Server-side PDF rendering matching approved template
• Hosting: South African data centre (POPIA-compliant jurisdiction)
• Backup: Automated daily encrypted backups with 30-day retention
• Uptime SLA: 99.9%

Regulatory Compliance

• POPIA (Act 4 of 2013): Lawful processing, consent management, data subject rights, breach notification protocols
• Health Professions Act (Act 56 of 1974): Statutory record retention periods, professional scope of practice validation
• HPCSA Guidelines: Patient confidentiality, supervised student practice role enforcement, professional documentation standards
• ICD-10: Integrated diagnosis code lookup for all SOAP note entries

Access Control Matrix

• Patient: View own consent record and consultation summary only
• Student Clinician: Create and edit own consultation records for assigned patients (not countersignature)
• Supervising Clinician: Review all student records, countersign, escalate, and export PDF
• Administrator: Full patient registration, scheduling, and records access: no clinical editing
• System Admin: Configuration, user provisioning, audit log access: no patient record editing

Implementation Requirements

• Minimum browser: Chrome 110+, Firefox 110+, Safari 16+, Edge 110+
• Device: Desktop or tablet (minimum 1024px width recommended for clinical forms)
• Network: Stable internet connection required (offline mode not supported in this version)
• Training: Mandatory role-specific onboarding session required before system access is granted
• Data migration: Structured import process available for existing paper records (HISA team assisted)