Re: [Gnumed-devel] Re: Cannot change the dates of the encounters

[James Busser]

On 4-Sep-08, at 4:08 PM, Rogerio Luz wrote:

Sorry, still not convinced this is the best aproach, shouldn´t the program let me do it? You mean that progress notes that are filed under DIFERENT episodes are NOT independent? 

That seems weird, since the date could be a lot more important to some people than me, for example pediatricians. 

This will be easier for me to discuss once I finish with postgres bootstrapping on my vm, but am I wrong to think we need to separate two kinds (groups) of entities?

1)  the identification and recording of when it was --- i.e. on what year / month / date / time --- that a clinical event of interest had occurred. Examples might include removal of a patient's appendix back in 2002 (although we may not know the month or date) or the fact that the patient was seen in the office or praxis yesterday, when it was so crazy busy that I overlooked to record my progress note, which I may like to do *now*. Clearly, I can have no objection that the EMR records now as the date and time of my *entry* but have we a way to capture and display that a visit occurred yesterday even though it is only being documented now?

2) the datetimes when a single entry (or multiple entries) were written into the EMR, where the one entry (or the cluster) got defined as belonging to one single encounter, where each encounter is chronologically distinct from every prior encounter, and from every subsequent encounter?

I am almost getting the feeling that every clinical record needs not only a datetime stamp for when it was written, but also a clinical timeline entry which can default to current but which can be modified to determine its presentation order.

http://www.dipity.com/user/rwaltvincent/timeline/Hailys_Timeline_of_Medical_Events