Re: [Gnumed-devel] need assessment from fellow clinicians

[Jim Busser]

Part of Ian's posting (which he renamed "SOAP - Edit Area - Parser - some thoughts") pertains to this challenge of SOAPs and AOEs, but I wanted to ask from the RFE end:

Scenario:

Front desk staff receive a request for an appointment.
Makes sense to have the staff ask what it concerns (RFE)
Patient will either
- provide a specific answer, or
- indicate it's a "private matter", or
- indicate "the doctor wanted me to come back in followup"

The RFE presumably now exists, irrespective of whether there exist any active episodes, or active problems, or to-dos that instruct the staff to arrange the appointment, and also irrespective of whether an appointment has yet been given.

Now that I think about it, the process really begins with a REQUEST for an encounter. Presumably, receipt of the request (for example, the phone call or correspondence seeking the service) *is* an encounter. Is the receipt of information concerning a patient (say unsolicited or solicited correspondence) an encounter 'about" a patient? How about a phone call from a family member, or from some other doctor involved in the patient's care?

Is it agreed an encounter will not always involve a visit? Phone calls, a request for a form to be completed, or (in some practices) a request for medication renewal will not always require a visit.

We may at some point support a "task list" of things that need to be done concerning a patient. Some of these tasks include "needs followup appointment"; "needs tests or referrals"; "I need to review/read up on condition X". have we already established / agreed on the need for a "staging area", by which the desk staff and/or doctors assure that the tasks are covered off? I expect that anything in the scratch pad that warrants action in advance of the next visit would, if not actioned immediately, have to be copied/moved into such a staging area.

Is there overlap then between the RFE records and Task list items? Are they records in the same table, simply that when originated by the patient or other outside entity they are immediately an encounter (a communication of an issue or a need) whereas when they originate from within the office, they are not considered an encounter until a patient contact occurs e.g. the phone call in which the tasked followup appointment is pursued, or the mailing of a from letter advising a patient that they are due or overdue for a PAP test?