Re: RFE and AOE was Re: [Gnumed-devel] Translation help

[Karsten Hilbert]

On Thu, Jan 28, 2010 at 01:00:52PM -0800, Jim Busser wrote:

> RFE ("Reason for Encounter) starts as either or both of
> 
> - the patient's *stated* agenda and/or
> - what that the clinician wants to evaluate or do

I agree. Ultimately, perhaps even with the lofty goal of
enabling scientific analysis at the GP level, after the
encounter the RFE should contain the answer to this
question:

        "In retrospect, *what was the patient here for* ?"

> but the content of this RFE field can then be edited, even
> while the visit continues, to allow the doctor to make
> themselves a reminder of what needs attention (or action)
> before closing the encounter / visit.

Yes, this is how the above answer could develop over the
encounter.

In fact, the ultimate form of the RFE will probably only be
known *after* the encounter.

> The nice thing about the implementation of the RFE is that
> it remains available above the set of notelets so that no
> matter which of multiple problem notelet editors that you
> may have open, it remains easy to see whether you have fully
> attended to your "visit" (encounter) "agenda" 

That is fully intentional to clearly show the meta-nature of it :-)

> Accordingly, if the above is a shared view, we can
> understand RFE to serve as a text enumeration of the
> one-to-multiple reasons, planned or unplanned, for this
> encounter to "happen"

+1

Shall we improve the Wiki explanation ?

> I would have to check but in a one-problem visit, where your Assessment (soAp 
> row) might be
> 
>       Back pain ?mechanical
> 
> then I think you can choose to leave the AOE blank in cases where to write a 
> "synthesis" is extra work with no value.

+1

> If this is correct (that the AOE can left blank),

It can, yes.

> then the tree display will (in absence of an AOE) display the content of an 
> "A" row.

In fact, the soAp row will supercede the AOE whenever it
exists because the encounters are listed in the tree
per-problem. Such it is fitting to display the soAp for that
problem as the title. Their tooltip, however, contains AOE
and RFE.

> If memory serves, the AOE "auto-offers" a concatenation of
> notelet soAp string(s) which can be user-edited an
> over-ridden.

It does.

Again, in GP scientific terms the AOE should contain the
answer to the question:

        "What was the outcome of this encounter, what do I make
        of it ?"

Notably, this is *less* well-defined than the RFE ! But
that's the nature of GP work.

Karsten
-- 
GPG key ID E4071346 @ wwwkeys.pgp.net
E167 67FD A291 2BEA 73BD  4537 78B9 A9F9 E407 1346