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Re: [Gnumed-devel] EMR tree display of allergy
From: |
Karsten Hilbert |
Subject: |
Re: [Gnumed-devel] EMR tree display of allergy |
Date: |
Mon, 22 Sep 2008 05:06:52 +0200 |
I believe we should document our findings in this thread in the Wiki. It should
be a chapter
in the manual.
> To your point about responsibility (litigibility):
>
> Until the point where the question gets asked, the reasons for
> "unknown" seem rather moot.
I agree. That is modelled as NULL value.
> Inputting "unknown because the record was
> only just created and the patient has not yet been seen in the
> praxis" feels to me to have no value.
Agree. Same as above. NULL value.
> So while I grant (accept) that if you are supplied with information
> about a patient, say on transfer of care, then you could potentially
> know their allergy information without having asked. Yet at the point
> of transferring it into GNUmed you maybe ought to confirm, any way,
> by direct inquiry from the patient. So "unasked" does remain, to my
> mind, the "state" that cannot be left this way.
I agree.
> Once a clinician asks, it is still possible for it to be unknown or
> at least uncertain.
I agree.
> The patient may
>
> 1) confirm what already exists in other form, for example in transfer
> or personal documents
> 2) provide you with the information from memory
Which would then result in allergies being documented.
> So we are not yet fully through the list of possibilities and yet
> have already reached a branch point.
4) indicate that according to current knowledge there is no allergy
> Suppose a patient discloses that
> they are allergic to nuts, but you judge somehow that they are
> holding back something else from you. Do you enter the nut allergy
> *and* put "Undisclosed" if the program logic would even allow this?
...
> 3) indicate that there exists something about their information that
> they are not prepared to (fully) share
OK, that is hard. I would then add an allergy named "undisclosed trigger" :-)
> Next, even if no nut allergy would have existed, removing from issue
> the program logic, do you put "Undisclosed" just on suspicion, or do
> you at least get affirmation from the patient that there is at least
> partial undisclosure
I would try, yes.
> Once you share your view of the above, could you then share how you
> would handle the situation where the patient does recall pretty
> confidently that they did indeed, in the past, have a problem with
> one of their previous medications, but simply cannot remember the
> medication, but they do or don't clearly recall the adverse reaction?
I would enter an allergy - after all very likely there IS one - with an
unspecific name like
trigger = "some previous medication".
BTW, I am fine with symbols in the CAVE field. We may later have to reconsider
them to make them
non-ambigous against "other" therapeutic precautions (pacemaker, on warfarin,
etc).
Jim, when you prepare the post-Japan summary mail may I ask for a split between
"0.3.2-bugs"
and "other" ?
Thanks,
Karsten
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- Re: [Gnumed-devel] EMR tree display of allergy, (continued)
- Re: [Gnumed-devel] EMR tree display of allergy, Rogerio Luz, 2008/09/20
- Re: [Gnumed-devel] EMR tree display of allergy, James Busser, 2008/09/20
- Re: [Gnumed-devel] EMR tree display of allergy, Rogerio Luz, 2008/09/20
- Re: [Gnumed-devel] EMR tree display of allergy, James Busser, 2008/09/20
- Message not available
- Re: [Gnumed-devel] EMR tree display of allergy, James Busser, 2008/09/20
- Re: [Gnumed-devel] EMR tree display of allergy, Karsten Hilbert, 2008/09/20
Fwd: [Gnumed-devel] EMR tree display of allergy, James Busser, 2008/09/20
- Re: [Gnumed-devel] EMR tree display of allergy, Rogerio Luz, 2008/09/20
- Re: Fwd: [Gnumed-devel] EMR tree display of allergy, Karsten Hilbert, 2008/09/20
- Re: [Gnumed-devel] EMR tree display of allergy, James Busser, 2008/09/21
- Re: [Gnumed-devel] EMR tree display of allergy,
Karsten Hilbert <=
- Re: [Gnumed-devel] EMR tree display of allergy, James Busser, 2008/09/22
- Re: [Gnumed-devel] EMR tree display of allergy, Karsten Hilbert, 2008/09/23
- Re: [Gnumed-devel] EMR tree display of allergy, richard terry, 2008/09/23
- Re: [Gnumed-devel] EMR tree display of allergy, James Busser, 2008/09/23
- Re: [Gnumed-devel] EMR tree display of allergy, James Busser, 2008/09/23
- Re: [Gnumed-devel] EMR tree display of allergy, James Busser, 2008/09/23
- Re: [Gnumed-devel] EMR tree display of allergy, James Busser, 2008/09/24
- Re: [Gnumed-devel] EMR tree display of allergy, Karsten Hilbert, 2008/09/25
- Re: [Gnumed-devel] EMR tree display of allergy, James Busser, 2008/09/25
- Re: [Gnumed-devel] EMR tree display of allergy, Karsten Hilbert, 2008/09/25