re: [Gnumed-devel] Possible development opportunity (was Gui-Designers was the id_name debate)

[sjtan]

> Lab results are obtained in a variety of ways, some by fax or by mail. 
> Around 90% of the results are available electronically but, as the 
> clinic does not presently have an EMR into which to download them,


> prints these from a web-based portal

> Results are copied by hand onto a worksheet, as are the dosage changes 
> and the next test date.


> for those who are out-of-range, to batch them together and by phone 
> obtain from the cardiologist a dose revision and advice on the next 
> due INR.

Just my 0.01 cents ( i.e. using this for practice in requirements 
gathering):

The current schema looks like it can hold demographic and lab data .
I don't  know if there is a specific messaging code, but  to get the 90% 
inr results (+clinical notes) in,

may see if there are specs of how/if the results can be downloaded from 
the individual path  labs.  ( e.g. as csv files , simplest). These can
be put in the test_result table collaboration.

otherwise , perhaps the results have a web   .xml  form that  can be 
easily parsed ( perhaps the path companies
are using xml + xslt to generate the web pages).  Do they have dummy 
test web pages for developers?

You could also have a hand entry screen, perhaps a table form  
resembling the work sheet, and each row linked
to patient search for linking with a patient.  This work sheet also 
allows nurse to enter dosage change, clinical notes  and next test date 
entry,
after it has been written down on paper as usual after discussing with 
cardiologist, and the patients' have been rung, as usual.
In other words, the nurse stilll writes it down on paper and the 
original workflow isn't changed too much.

Someone can modify the schema to accept planned actions in general, or 
just dosage change specifically, and I think
the current schema has lab_request table which can be used to store the 
next test date entry.



A application trigger can be used to scan for  lab_requests with id 
numbers newer than before the worksheet was invoked,
and  generate mail to be sent the path company ( possibly signed  as 
well) and also publish to a web (?xml files) directory on your
web server as further confirmation.  Scheduled , sent and confirmed  
mail can be recorded in a table and viewed as a  report.


Reports can be generated joining the demographic detail, lab_request, 
lab_result  ,  and a cardiologist recorded recommended dose and recommended
next test, and comments, which should probably be double  checked by 
nurse and cardiologist each day.


Makes for a good exercise in requirements discussion anyway.