Re: [Gnumed-devel] Synopsis (AOE?) attaches to the prior encounter?

[Karsten Hilbert]

On Mon, Dec 10, 2012 at 09:09:05PM +0000, Jim Busser wrote:

> > <gm-emr_by_mod_time-qeUi5P.txt>
> 
> Having now had a chance to look at the output, it's maybe
> useful to confirm what it is telling us and the consequence
> if the Journal would (in production) take this new approach.
> 
> 1. we see several occurrences of 
> 
>       Kontakt: in Praxis 2012-12-03 13:24 - 13:37
>         BA: wants to see Dr.McCoy for scar problems
> 
> … can I know whether all of them would have been shown in 
> Journal-by-clin-when ?

Yes.

> 2. the dates shown at right within Kontact lines include
> clin_when dates, correct?

Yes.

> 3. The risk of being misinformed would be when users would
> newly create (or else would revise previously-created)
> clinical entries which pertained to events some time before.
> So for example if a patient had a myocardial infarction in
> 2010 and the original entry said "right coronary artery
> stented" but it is now (2 years later) realized that that is
> wrong and is now corrected to "left coronary artery stented"
> then if we adopt a change to the structuring of the Journal
> output, the soap row of which that information is a part
> will show up at the bottom of the output.

If we order by .modified_when then, yes, that is what was requested.

> On the positive, it will be seen that information was
> recently either newly inputted (or newly revised to include)
> the fact that the left coronary artery had been stented.

Yes.

> We only will not know from the lines (as currently
> formatted) the associated clin_when.

Yes. I have now added .clin_when after each item.

> I still have the feeling that this offers some value
> because it informs whatever someone was most recently
> working on about a patient's record even if the problem
> being worked on was an old problem. The management of the
> patient remains best guided by a few things:

> 1) Per problem, the information that is available for *that* problem and 
> which is organized according to clin_when
> 
>       Question:
> 
>       In the current EMR tree right-side "Journal"
>       --> what is the hierarchy of organization?

Per node, per encounter.

> 2) Across problems, the ability to see what was going on
> at each contact (an Encounter-based view which makes
> available all of the content from any one encounter).

We don't yet have that view except in the form of the "old"
Journal (which stays available).

Karsten
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