[Gnumed-devel] Re: Re: Immunisation edit question

[jbusser]

Noting vaccinations given "outside" the practice is analogous to noting:
- medications the patient is receiving (prescribed by someone else)
- important tests or procedures (MRI scans), done by someone else
- consultants seen by patient, arranged by someone else

I wonder if the general approach is to be able to input the information from 
the same screens as if ordering them oneself, BUT in those screens to be 
able to specify "elsewhere" or "someone else" or, if the physician identity 
is known, to have the option of specifying.

If the item would then ordinarily be treated as an action item 
(prescription to be printed/sent, test or consult to be arranged), the logic 
would need to trap items "done elsewhere/by someone else" to avoid their 
mistreatment as action items.

If information is stored in 2 areas (what's been done "within" the practice 
versus what has been done "elsewhere") I could see a risk of action being 
taken with only one (and not both) areas' information being taken into 
account. I've certainly seen that happen.

I am not sure of a best option for recording dates, when the exact date in 
unknown. Empty date fields distract once there is no hope of providing a 
value. Partial dates (e.g. year known, but not month or date) require a 
separate field or non-date field type which complicates validation and 
calculation. If a standard within GnuMed has yet been developed to convey 
that a date "is known to be unknown", extra work COULD permit certain dates 
to have a companion "unknown" field which, if filled, could shade the date 
area. Hope that doesn't sound wacky! Sorry I know little enough yet about 
GnuMed, I have only recently started to look at it.