[Gnumed-devel] Results tracking (was: gnumed ideas 0.1 and post-0.1)

[Ian Haywood]

J Busser wrote:
> Karsten, you have seen this post of Ian's, but are maybe thinking about 
> it before replying?
Probably thinking, what, not *this* again!

> I must say that in the current version of my hospital's inpatient "EMR" 
[snip]
> to have reviewed with them the various results received is again a big 
> headache.
We have this problem too, this is precisely what I wish to avoid.
To me, this integration is a major motivation for working on a "proper" EMR,
which is why I perseverate on it.

> Ian, were you thinking that incoming communications like letters, 
> consultation reports would also go here (i.e. not just the results of
Yes, all external ("asynchronous") communications, which then need to be 
followed
up.
The idea is a single Inbox tab which looks like an E-mail client, showing all
path results/written reports/letters etc. (so it *is* an e-mail client,
but "clinically-aware" so it can match automatically to patient records, and
display "special" formats like PIT and HL7.)
The idea is once your Inbox is empty, you *know* nothing has slipped through 
the cracks.

> "tests". But not things like phone calls from patients or involved 
> health care professionals because these would instead get SOAPed because 
> the content is not 'sent" into the office but instead input *by* the 
> gnumed user(s)?
It may be useful to allow secretarial staff etc. to put simple messages into 
ones inbox
Whether this should be SOAP or not I'm not sure. Also you should be able to 
"handball"
messages to other users (locum covering for other doc, etc.)

It would also be good for the checking of results to be placed in a 
clin_root_item table,
so it appears in the SOAP notes narrative.
(NOT the results themselves, as they come into our system automatically by 
e-mail, download, etc.,
it doesn't make any sense to try to attach them to an episode and encounter)


So what I'm looking toward is

create table med_messages
(
        fk_patient integer, -- the linked patient
        fk_to integer, -- who the message is directed at (whose inbox it 
appears in)
        fk_encounter, -- the encounter where smeone checked this message and 
takes clinical responsibilty for
                -- managing the result
        fk_from_identity, - the identity sending the message
        fk_from_org, -- the organisation sending the message (one or other of 
these may be NULL)
        when datetime,
        title varchar (128), -- the printed title
        fk_type integer references doc_types (pk),
        plain_text text, -- if plain text reporresentation is possible (PIT, 
some HL7, plain e-mails)
);

doc_obj and lab_result link to this table as before.

Ian

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