Re: [Gnumed-devel] Should patients have a "status" ?

[Jim Busser]

On 2011-07-04, at 8:02 AM, Karsten Hilbert wrote:

> 1) "delete" the patient -- which in effect will all but set
>   dem.identity.deleted to true

Yes, this could allow scripts (for example results importers) to handle such 
patients differently, for example leaving their results unsigned since 
presumably .deleted patients are excluded from views. Their results could this 
be filtered out from the inbox (or, the script could auto-sign such results 
with a virtual provider whose "job" this is).

*** However *** this creates a problem if the praxis receives a call about this 
person, who would (as a consequence of being .deleted) "disappear" from the UI 
in GNUmed. Therefore risking to misadvise callers "I am sorry, we have never 
provided care to that person".

Therefore, the above suggestion is inappropriate to this real problem of 
whether or not the praxis is *currently* responsible for the care of this 
patient.

I think that tracking (prompting the user on patient activation) when the 
patient is inactive vs active (the latter tying a praxis to responsibility for 
care) is of *** fundamental importance ***. It warrants to be a primary 
attribute and really should be included into dem.identity table.

On patient activation, GNUmed currently warns when a patient lacks a date of 
birth, therefore limiting the extent of clinical decision support. it is IMO 
equally important to warn of a patient having an inactive status.

Status over time is tracked in

        audit.log.identity

however the above schema is currently restricted to gm-dbo access. Therefore if 
the history over time is intended to be accessible, it would need to be 
normalized to into

        dem.identity.status

Is there disagreement whether "status" is of fundamental importance? Or only on 
its implementation?

> 2) set an appropriate tag on the patient

(only) as an interim workaround pending a better solution above, sure. 




-- Jim