Re: [Gnumed-devel] clin_health_issue - some thoughts

[J Busser]

At 1:05 PM -0800 11/28/04, J Busser wrote:
> we need to keep the names of the "newly opened" episodes the same as 
> the names of the older ones - maybe in the widgets some kind of 
> batch naming function, the "problem" can have all of its episodes 
> named identically based on some user-defined name maybe updated via 
> AOE (however we would then lose the ability of the AOE to speak 
> specifically to the episode in question ).

Self-commenting,

How about this:

1) let us start with an episode this is so far unlinked to any 
clin_health_issue:

- at the point of being newly-created, an episode will have a first 
encounter, and can default to take the name of the AOE (if there is 
one) else the soAp row (if there is one) else the RFA

- if a software widget can easily/reliably determine so, then for as 
long as an episode description matches what is predicted by default 
(based on the above), the episode description be updatable by default 
to carry the new value of AOE etc across new encounters within that 
episode (whereas if the description no longer matches what would have 
been predicted, it so clear that a user must have exercised a choice 
to specify the episode description and it is left to the user to make 
any further changes - no special field(s) required

2) say we now consider an episode that has been linked to a clin_health_issue

- if we wish to create a "new episode of same" (as opposed to a first 
episode of a brand new problem under the health issue) then **here** 
we would likely
- - set is_open to FALSE under the old episode
- - put new encounter rows under this newer episode
- - preserve the *identical* name for this episode description
- - modify the name of the episode only as part of a procedure to
      rename in common all these "same problem" episodes
- - probably *not* retrospectively attach *new* encounter info to the 
older episode

3) the concept of "create new episode of same" is clear for episodes 
(problems) already linked under a clin_health_issue but what about 
episodes unlinked to a health_issue? Since the "problem" seems to be 
recurring, yet could be just another episode of something trivial, 
might we desirably prompt the user to choose among:

a) attach prior & new episodes of same to an existing clin_health_issue or
b) create a new clin_health_issue "recurrent <episode name> NYD" to 
which the existing and new episode would be attached or
c) leave episodes unattached to a health issue (as might be chosen 
with "URTI" is "sick note"

I suppose there is even another scenario in which, despite many 
visits for their joints, a patient with Rheumatoid arthritis and many 
episodes of "knee pain" might have another episode of knee pain, but 
where the doctor is worried it may not be an RA flare (perhaps 
worried about infection) and so wishes to "detach" this episode for 
now,  it can always be re-attached later if it proves to be 
non-infected and just RA