Re: access to review audits (was Re: [Gnumed-devel] encounter edit before final save)

[James Busser]

On 16-Aug-08, at 3:43 AM, Karsten Hilbert wrote:

> > > Jim, do you think we should invalidate a test results review
> > > when said result is modified ? (this would, in turn, notify
> > > the responsible clinician courtesy of the then-lacking review)

I agree that if the person who had *last* reviewed a result is  
*different* from the individual who is currently modifying a result,  
the prior results review should be invalidated and the fact that  
patient results lack a review does need to be signaled somehow.

Whatever previous review had been made as to abnormality, importance,  
and comment may remain valid despite the modification (e.g. Kalium /  
potassium level report of 5.9 corrected to 5.8 may justify  
preservation of the prior review). Therefore it might reduce the pain  
of there were an option for whoever is modifying the result to simply  
re-confirm, or at their option alter/update, the last review.

I wonder if we can avoid an unnecessary notification if whoever would  
modify a result would also, in the same session, mark it as reviewed?  
I cannot remember whether the appearance of items in an inbox is the  
result of the writing of "notification records" records (which would  
need to be deleted after the review was done), or if the notice is  
not in fact a "record" at all, just a dynamic indication of the  
result of a query, which could have the ability to immediately  
refresh and would go unseen unless some other provider happened to  
concurrently activate the patient.

The intended reviewer, if different than the provider who last  
reviewed, or if there is no valid review on account of failure of the  
person who modified the result to take responsibility, would still  
detect an unreviewed result, right?