Re: [Gnumed-devel] automatic episode namin

[Karsten Hilbert]

> Why in the first place have we chosen to have a multi-lined progress note?
> This has more to do with organisation of information than anything else. For 
> example context sensitive pop up phrase wheels can be implemented according 
> to whilch line the user is on.
I agree.

> Remember my postings some time ago when I tried various combinations of 
> headings, when I entered progress notes using a widgit during real 
> consulations and posted the png's to the list
I have in fact taken up your final suggestion and hardcoded
that as the default labels for the progress note input
widget. How does that sound ?

> Now at the other extreme consider that many medical records programs have as 
> their data input area -  a single large textbox, where the user combines all 
> the information as they so desire.
Even this is possible with a appropriately crafted widget.

> Now think about what you put down on a page (this is how I do anyway),
> 
> 20/10/2004  Complaining of headaches, myalgia                                 
>         
>                   No skin rash, no fever bla bla                              
>                  O/E T=38 BP=134/70, no meningism, red throat 
>                         chest clear, no rashes                                
>     
>                  Dx   viral influenze                                         
>         
>                  Rx    symptomatic script panadeine forte,             
>                          advised review if deteriorates                       
>     
>               
>               pm visit:
>                          Sudden deterioration, haemorrhagic rash      
>                          obtunded, BP 60/40                                   
>      
>                          Dx   Meningococcal Septicaemia                    
>                        Rx    ivi penicillin, urgent transfer to hospital    
Same here. I do the same.

> Now niether of these visits are 'tagged'
Not true. One might consider the "Dx" as a problem label.

> but it is self evident what has happened
Here comes the important part !!!!

It is only self-evident *when displayed in this way* ! The
machine itself knows nothing about the relation between the two.

If they were tacked to a problem even the machine could know
!!! And use it for intelligent data mining. That is our real
purpose, after all ! I am after the answer to questions such
as "How many other patients that initially presented with
... did I misdiagnose with ... while they actually developed
... within a timeframe of ... ?" 

Here is how the linking to a problem would work:

After typing the first progress note the system would decide
to use Dx as the episode name. Later, when the patient comes
back *I already know* (because it's the next day or so) that
I am dealing with this flu-thingy again. So I choose to add
a progress note to that. However, I notice it's Mening.
Sept. and put that into Dx. Now, the system might notice
that I have put something (else) into Dx this time. It might
in that case prompt me as to whether to use the new Dx as
the episode name or always override the episode name with
the latest Dx (which I wouldn't like, personally).

Karsten
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