Patient (Person) status and deactivation? was Re: [Gnumed-devel] Patient details plug-in

[Jim Busser]

On 19-Jun-09, at 4:12 PM, Karsten Hilbert wrote:

On Fri, Jun 19, 2009 at 03:42:50PM -0700, Jim Busser wrote:

Within the Patient details (to be Person details),

Renamed to "Demographics" as previously suggested.

We already acknowledge some people are staff but not patients, and it is in fact via the EMR menu (or plugins) and not through the Patient menu that a person is made into patient. If we are flexible, the Patient menu can (should) be renamed to Person and, within it, "Merge patients" should be "Merge persons".

--> low priority?

Menu item "Deactivate record" can apply to people who previously worked as staff (but do not any longer work as staff) in the praxis. 

However, for anyone who had been a patient, it can be important that we not disable such ex-patients' records, because the praxis receives questions about such people. It must remain possible to "find" them. Therefore, maybe the menu item to "Deactivate record" should check whether the person-in-focus has been a patient, and this should be part of what the user is aware of, before they would click to confirm to disable this patient. In other words, the purpose of "Deactivate record" is to weed out the records of persons who were created in error and/or did not get care.

The related question is the concept of the "status" of a patient.

- are they a current patient of the praxis? (meaning that, as far as we know, they are still alive, and did not communicate that they will get their care somewhere else?)

- did they leave the vicinity (for example to go to university) or otherwise in a situation where, even though we may be happy for them to return, the patient is "off to Galactica" and we will therefore not "chase" them, but instead wait some communication from them?

- was the patient difficult or unreasonable so some agreement was reached that they would not be returning for care (the so-called "fired" patient) so that the staff should not agree to make appointments unless one of the doctors un-fires the patient (maybe such a caveat is an allergic state between the patient and doctor?)

- is the patient deceased? When a deceased patient is brought into focus it would be a good idea for the client to understand this and to give a sound alert (beep) in addition to making this known in the status line.

When a patient has moved-on, do we have forwarding information, not only where the patient may have moved, but also to which doctor(s) the patient has instructed us where (to which new doctor) the patient may wish any new medical information redirected?

Maybe for such patients we disable the EMR portion, instead of disabling the person themself? In other words, a status that prevents the creation of new clinical entries unless the status of the patient is suitably altered / updated?