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Re: [Gnumed-devel] 5.0rc2 quirks


From: Karsten Hilbert
Subject: Re: [Gnumed-devel] 5.0rc2 quirks
Date: Sun, 28 Jun 2009 12:43:09 +0200
User-agent: Mutt/1.5.18 (2008-05-17)

On Fri, Jun 26, 2009 at 02:35:01PM -0300, Rogerio Luz Coelho wrote:

> > could there be say a tab feature UNDER the encounter view
> > you mean, where it says "Most Recent Related Notes"?
>
> Yes, under this field we could have tabs for the other (not just last) note.
> 
> Example:  friday patient comes in and reports "bad hearing" (this will be my
> RFE) and is diagnosed with Otitis, given an Antibiotic and sent home to call
> us Monday to see if he is better (Sumarry:"Otitis , given Azitrimicin
> 500mg/d for 5 days, should call Monday to state status")
> - Monday patient calls and says "Im better" (RFE) and I explain to him he
> should continue with the prescribed course of 5 days (Summary: "Patient is
> better, maintained ATB course")
> - Monday night he calls you and says he is worried because the ATB will end
> soon and his mother is saying 5 days is too few on a course of Azitromicin
> (she has chronic Otites). I reassure patient and maintain the ATB course.
> - Tuesday he calls again and asks if it is ok to stop, since his mother said
> she took 5 days and then had to take another Antibiotic for the same
> condition (RFE "doubts of treatment" Summary "Explained to patient about
> Otitis and reinforced to stop ATB"
> 
> 10 days afterwards he comes to a new visit and tells you that his hearing is
> great, but sometimes he itches a bit in the other ear. So when you lift a
> notelet you can only see the last entry (on Tuesday)  and miss at-a-glance
> all the pressure he is under with his mom ;)
> 
> This is the seting that could make tabs easier to manage (of course not
> uncomplicated Otitis but say a Warfarin dosing change or Recurrent Chest
> Pain)

I think this is a good example - a user story.

Please add

        make <recent notes" in SOAP entry plugin a notebook
        browsing back in time

to the wishlist items and do include the above story.

> > If you are talking about such things as the new Substances widget (or even
> > in the Demographics) it may be misleading that some columns are so narrow. I
> > do believe many of them will expand as soon as sufficient data is put inside
That's right.

> > I really think we should get it clear what is a RFE , a Summary and what
> > will be displayed where in the Tree view and Journal,

Where exactly lies the uncertainty ?

I would suggest this: Add an issue with the name "issue",
add an episode with the name "episode", add a soap note with
the label of the row inside each of the notes. Edit the
encounter entering "RFE" into the RFE" and "Summary" into
the summary.

Then browse the tree and the journal and see where it shows
up how. If there's something you'd want to improve feel free
to post it.

> > I use Sumarry for guidance in the next visit or final diagnostics
> > i.e. "Deficient PI (spleen) Qi" , "Depression - improvement with
> > Venlaflaxine 75mg/d " , "Stagnant GAN (liver) Qi" , "HAS melhora com Hctz
> > 25mg/d"  --- Please forgive the Acupuncture and Portuguese jargon ... it´s
> > late and these are the examples I have right now ;)

That's fine.

> > Summary has maybe no perfect answer. Each problem has its own Assessment
> > and Plan.

I agree.

> > Karsten's perspective is that the Summary (AOE) is meant to capture mainly
> > "big picture assessment" whereas you are tempted to use it to capture plans.
> >
> > So I when I scan the Tree View both these information are easily available,
> > although the RFE is king of mixed up in the viewer at the moment (still
> > waiting for those future /html enhacements, but no pressure ;)
> 
> Sumarry could just be left alone, each individual can do with it whatever
> they feel like (after all a good program has to have some elasticity or it
> will always be "the way I do it is better")

Exactly.

Karsten
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