[Gnumed-devel] Schema question about clin.lnk_result2lab_req

[James Busser]

referencing

	http://salaam.homeunix.com/~ncq/gnumed/schema/devel/gnumed- 
schema.html#clin.table.lnk-result2lab-req

this table makes it possible to link foreign keys

        clin.test_result.pk
        clin.lab_request.pk

Which I agree could facilitate navigation between a list of tests  
that one had *requested* for a patient, and the (multiple) results  
that may have eventually come in.

However in the case where (copies) of results were received without  
them having been ordered within the praxis, we may need to support  
results in the results table without there having been a record in  
GNUmed of these tests having been requested.... unless we are saying  
that we would wish the request to be created retroactively by the  
import, perhaps to capture who is was (externally) who had ordered  
such tests. Is there a position on this?

As I think about it, in the case of receiving copies directed to us  
by an outside physician (or by ourselves from medical work outside  
the praxis) I realize that in receiving such tests there would not  
yet exist any encounter or episode in GNUmed to which to attach them  
in either

        clin.test_result.pk
        clin.lab_request.pk
        
and yet in both cases those foreign key values are defined in the  
schema to be NOT NULL --- which is a problem.

So unless the NOT NULL constraint is removed, there may be no choice  
but to have to spawn clin.lab_requests from the incoming data when no  
request existed against which to match the incoming data. Maybe that  
is OK because as soon as the org and the patient were identifiable in  
the incoming stream, the request could be created and simply marked  
according to whether that request (initiated elsewhere) still had  
anything pending, or did not.

I suppose the episode/encounter could be free-standing and marked not  
relevant so that we would not have too many of these, and I suppose  
the doctor could attach the unsolicited request to a particular  
health issue if for example a specialist sharing care with you had  
ordered tests on your patient.