Re: [Gnumed-devel] idea (Part 2) for improved narrative representations in EMR Journal and EMR tree

[James Busser]

On 12-Oct-08, at 2:26 PM, Karsten Hilbert wrote:

> IOW, you want the encounters in the Journal to be sorted
> chronologically the way they were *entered* rather than the
> way they *happened* ??

There perhaps already exists agreement that two different kinds of  
views each have value.

I am concerned that if you saw a patient last night, and I see them  
this morning, and I make decisions based on what is available to me,  
and you then come in later, and add an entry which is clinically  
backdated to last night (but information which I did not have  
available to me), but which will seem to others as "the way it  
happened", then what I did will not only risks me medico-legally  
(which is not my biggest concern if the patient knows it wasn't my  
fault) but more importantly what I did will seem to make no sense.

What options to we have to be able to present information

a) in a meaning sequence of *documentation* (including its subsequent  
alteration) and
b) in a meaningful sequence according to our backdating of when  
clinical events were experienced (or medical care was received) by a  
patient?