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

[James Busser]

>  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

> Hm, I don't think the GnuMed medical record should be into the
> business of tracking the actions of one practice vs. another
> but rather the state of the health of a particular person...

I agree that one cannot reliably know everything that happens 
elsewhere. And until such time as that info could be  gotten 
electronically, you would certainly not want to input everything you 
learn.

However, where an event "elsewhere" is important enough for you to 
ask about (vaccination or current medications), or to have been 
"copied" (report from a consultant invited by another party), you 
want the info to be accessible IN CONTEXT, and NOT hidden away in 
some accessory area.

e.g. vaccinations given elsewhere that would affect your care plan 
should show up among the list of vaccinations (or analogous 
treatments) given by you. You would NOT want to waste time having to 
click around in GnuMed for any alternate information storage areas in 
order to cover off this question of what's already been done.

Another example becomes relevant once GnuMed could support entering 
referrals for consultation. Your patient then goes to the emergency 
room with chest pain, and you learn from a discharge slip (or a phone 
message left by the patient) that the Emergency Physician arranged 
for the patient to be seen by Dr X, one of several local 
cardiologists. Dr X may have seen your patient at the time, and/or 
may intend an office visit in the near future. You may well want to 
capture that Dr X has become involved.

As it is not you who initiated that request for consultation, there 
is nothing your office staff need do to make it happen. Yet the next 
time you are responsible for care, if you were to check GnuMed for 
any consultant involvement, you would want Dr X's name to show up 
here, and not in some other section of the program called "hospital 
visits", "care delivered elsewhere" or "miscellaneous notes".