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Re: [Gnumed-devel] EMR tree display of allergy


From: richard terry
Subject: Re: [Gnumed-devel] EMR tree display of allergy
Date: Tue, 23 Sep 2008 16:28:50 +1000
User-agent: KMail/1.9.9

On Tue, 23 Sep 2008 04:19:49 pm Karsten Hilbert wrote:
I wouldn't be too prescriptive about this personally.

A blank allergies textbox to me as a user means
a) No allergies or
b) No allergies recorded.

As a clinician I would always say to the patient each and every time 'Are you 
allergic to anything" or "I note your allergic to penicillin".

If giving a report it would read either which allergy, or none recorded.

I think a null entry = none recorded and that one does not need to record that 
one asked, unless of course it is important to yourself, in which case you 
type that in the clinical progress notes for posterity (and the law).

My 2c worth.

Regards

Richard

> Maybe we need to think about this again, and differently:
>
> What patient states can there be ?
>
>  - patient is known to currently have no known allergies
>
>  - patient is known to have only certain allergies to the best of knowledge
>
>  - patient is "known" to have allergies but we do not know which
>
>  - there is NO information as to whether the patient has allergies or not
>
> What doctor-data source interaction can have happened ?
>
>  - data source has not been queried
>
>  - data source has been queried
>
> So, a matrix will help perhaps:
>
>
>                     no allergies         only certain allergies     
> undetermined allergies         NO information
>
>
> not queried
>
>
> queried
>
>
> allergy state:
>
> 0 - was asked, no known allergies
> 1 - was asked, only certain allergies
> -1 - was asked, but remains (completely) unknown
> NULL - not yet asked
>
> I do believe this covers all cases. Mixed cases do exist but they will have
> to modelled by allergies named "trigger uncertain" or "trigger withheld" or
> some such.
>
> Re symbolism:
>
> Greek Phi is great for no allergies.
> ? is great for unasked
>
> Maybe "!?" would work for "asked but no data obtained" ?
>
> The tooltip would reveal the long form.
>
> In state = 1 the triggers would be short-listed. Again, the tooltip reveals
> more details.
>
> Karsten






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