Re: [Gnumed-devel] clin_health_issue - some thoughts

[Karsten Hilbert]

> Ah, here is where the design has been troubling me. If the health 
> item is an overarching one as is the case with your post-polytrauma 
> above, it is the only link across the various episodes.
True.

> As a result, 
> all of the back pain episodes (some variably named as the details 
> within tempt modified AOEs) will be interspersed among the 
> osteomyelitis episodes... this example is not so compelling because 
> maybe there is only one episode of osteomyelitis... but in the event 
> of mutliple "issuelets" each of which have several episodes we have 
> no means to isolate, and view as a series to retrospectively 
> scrutinize, the series or thread of episodes that pertain to any one 
> issuelet. Sorting by AOE will not cut it since the naming by design 
> has not had to remain constant across the AOEs for that issuelet.
I still think string proximity within issues will do.

> A limitation of the diagnostic codes is that their names 
> ("hypopotassemia" as a poor example) can feel clinically unnatural or 
> otherwise fail to optimally describe our particular patient's flavour 
> however there is no reason why we cannot, in the diagnosis table, 
> have a field that lets us taylor the description usefully to our 
> patient... the code remains as correct as it would have been before 
> such tayloring and the "proper" description always remains available 
> to be looked up in the source code table.
We already have that. Codes are stored together with their
official descriptions. They are then linked to free text
entries that provide the name of, say, a diagnosis. There are
two views to more conveniently handle the linking in display.
One shows all the codes attached to rows (eg. diagnoses) for a
given patient. The other one shows codes attached to a given
free text description regardless of patient. The latter can be
(and is, by the middleware) used to search for codes
previously deemed fit for attaching to a particular patient's
rows (diagnoses).

Karsten
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