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[Gnumed-devel] results handling (was Re: [Oscarmcmaster-bc-users] Is the

From: J Busser
Subject: [Gnumed-devel] results handling (was Re: [Oscarmcmaster-bc-users] Is there a generic US req?)
Date: Sat, 7 Jul 2007 10:11:15 -0700

(I have cross-posted this to the gnumed list)

On Jul 7, 2007, at 12:49 AM, Carole White wrote:

When my associate goes away, I can look at his
results and acknowledge those that have my name attached to them, but
they will not go away from his box until he acknowledges them.

I might suggest some value to a subgroup of people getting together on the question, perhaps spending 30-60 minutes to think it through and to present, to the group, some options. Some of the relevant considerations could include:

- the ordering doctor could be required to see the result even if it was normal, but where no action on the result would have been required, multiple results (even on multiple patients) could be easily dismissed (oops... acknowledged) in a single, scrollable screen

- the converse must also be considered however, i.e. the fact that a test was normal (and even if acknowledged by someone else) may not be the "end of the line"... the "normal" test may have failed to identify the disorder that prompted it, so some way of not overlooking the need to proceed to another test, or the need to repeat the test at some interval, or the need to recall the patient to discuss and possibly pursue other explanations, is needed

- I might wonder therefore if a "covering" physician should not acknowledge the "normal" results except if where they are doing more than just covering the "danger" aspect and in fact providing comprehensive care and followup for the patients including the tests that although normal were associated with patients who had since needed to be seen... therefore it is possible that for the normal results to have been acknowledged inside a patient visit (potentially meaning "patient aware") presents a useful distinction

- might it be useful to split the presentation of results between patients who have one or more abnormal results (with or without normal results) from patients who have purely normal results, and may it be useful to split based on whether patients have a followup appointment within a useful time frame (say 1 or 2 weeks) or, if not "splitting" in this way, having presented to the user on the screen the date of the patient's next appointment?

- if a "covering" physician *had* initiated an action as a result of a test (even if it had been normal, maybe the patient had asked to be contacted about it), maybe it would be desirable to be able to "see" that

- if the lab should phone a critical abnormality, the call might be routed to a convenient doctor within the group, even though the actual ordering doctor would have processed it at their next session on the computer within minutes or hours (I am not sure if it qualifies as a special case, may depend on the nature of documentation required)

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