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

[Karsten Hilbert]

> > Once an episode has led to a medically well-founded diagnoses 
> > the most recent AOE is likely to contain the diagnosis text. 
> > So they will automatically appear as aPs, perhaps labelled 
> > permanently relevant. 
>  
> Do we thus avoid having to code things specially to be "problems", i.e. 
> by just having them declared programmatically as any AOE (in fact --> 
> any clin_narrative row) that has had a diagnosis coded? 
Hm, currently any soap item can have codes associated with it.
Any soAp item can be a diagnosis and it can be marked is_aoe.

If I understand you correctly, yes, we can avoid having to
mark things as "active problems" since we would simply draw
the problem list from the AOE rows, alternatively soAp where
is_diag, alternatively RFE.

> "Other" problems can include those carried into the practice or, as 
> Elizabeth pointed out, later input retroactively, as Past History.
Those can be entered as clin_narrative rows where soap_cat='a'
and marked is_diag (this isn't really a flag but rather
whether or not there's a link from the clin_diag table).

> I am wondering how the data structure can best be helped to assemble 
> these pieces into manageable views,
Well, look at the current schema and tell us :)

> which might be difficult if the 
> data is distributed across multiple tables.
Nah, that shouldn't trouble us all too much.

> Does that mean that the mechanism of entry of all clinical data - past 
> history, allergies, family history - will be through clinical narrative 
> rows? 
No, why ? Just because we store most of them in clin_narrative
doesn't mean we can't have diverse input widgets. Also,
allergies and vaccinations already have their widgets.

> Does it also mean in the example that if no diagnosis is being coded, 
> we need a way to make the Soap line "permanently relevant" so that the 
> programmatic definition of a problem is expanded to include any 
> clin_narrative (including AOE) rows marked Permanently relevant?
Selection of aP would go like this: AOE or soAp where is_diag
or RFE.

Karsten
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