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Re: [Gnumed-devel] Better-supporting staff and other non-patient persons


From: James Busser
Subject: Re: [Gnumed-devel] Better-supporting staff and other non-patient persons
Date: Mon, 15 Sep 2008 13:26:56 -0700


On 15-Sep-08, at 12:24 PM, Rogerio Luz wrote:

So we could make the DB create patients (at least) with only Name LastName ? This seems reasonable to me ... even better if we can flag this patient as "not demografically complete status" 

The last thing I would want to do -- especially with him on holiday -- would be to upset Karsten with objection to his carefully considered views about intactness of information.

In the creation of people who are *patients*, it does very much make sense to have to input the date of birth for clinical reasons, because you want to take the age into account in your decisions... here the age has biologic - clinical importance, even if it would be "off" (inaccurate) by a day... say in the case of a patient who was born in a rural area and it is only known by her family that she was born approximately February of 1922.

The second use of age is as a validity check to disambiguate otherwise-similar individuals or to further provide proof that the individual is who they claim to be. The limitations here are that they have no value unless linkable to the external world by virtue of the person having given that same information to some other source of data, or being registered under that date of birth with some authority (whether or not is was the person's true birthday when this might not have been known). So this is a purpose totally separable from the clinical one.

This is why I would say:

- for persons who would be created in GNUmed *without* any plan of them getting medical care, do not require (as for staff and other persons) the date of birth. Enable it -- sure -- but do not require it, because to do so only places unnecessary constraints.

- for persons who would be patients, I can accept the constraint that a date of birth is mandatory because is it *usually* available at the point of creation. It is not *always* immediately available, which is a problem that I and some others might face, but it could be overcome in two ways:

1) input a ridiculous dob like 1800.01.01 and trust that it will be obvious that it will need to be changed at the first suitable opportunity

2) create the person who was referred, and whose name and contact information must be recorded, because there is a commitment that the patient will be seen, even though the date of birth was not obtained (or which, on the paperwork, is 08/04/07 and therefore ambiguous with the patient not immediately contactable) and make them temporarily a non-patient. Then enlist them as a ptient, providing the missing information.

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