Re: [Gnumed-devel] clin.operation

[James Busser]

On 6-Sep-08, at 8:05 AM, Karsten Hilbert wrote:

> A first thought that occurs to me that you may be solving one  
> specific instance of a general
> "report on a therapeutic procedure" use case (which is fine). IOW,  
> perhaps your code and/or
> tables may need some generalization as to supporting "something"  
> being done to "someone"
> by "a few actors" with the help of "a few things".

An operation could be a

        health issue past history item

or it could be mentioned in a progress note soap row (perhaps a "P"  
as treatment) inside an episode that gets attributed to the health  
issue attempting to be remedied.

One example might be urinary incontinence, which can receive multiple  
procedures. Another could be inflammatory bowel disease or other  
condition which gets many diagnostic or therapeutic endoscopies.

... leading me to think that the procedures should most often not be  
issues of themselves, maybe only complications or status post, such as

	s/p amputation R below-knee --- in a patient with vascular disease  
who failed multiple revascularization procedures or

	post-splenectomy state --- after trauma (motor vehicle accident)  
which required multiple procedures for the abdominal bleeding, limb  
fracture, skull fracture / concussion

I am imagining that any documents which were imported would get  
attached to a row in a progress note... or is that wrong, meaning can  
documents get attached just to health issue foundational items?