Re: [Gnumed-devel] Overlapping encounters?

[Karsten Hilbert]

On Tue, Nov 22, 2011 at 10:34:34PM +0000, Adrian Midgley wrote:

> I think this is what we would call Episodes of Care, of which more
> than one may be dealt with during one Encounter.

Episodes of Care we already support anyways. They are
orthogonal to the encounter.

It's a good point though - an automatic importer could use a
specifically targeted pseudo-episode "incoming results" to
additionally indicate that no clinician was yet involved in
thinking about those results (at which point they
would/should be repositioned under the relevant encounter -
for which, I agree, better workflow can always be imagined).

> Episodes of care have received considerable attention in the UK and I
> think are more of interest and concern to medical informaticists than
> to jobbing doctors.
> 
> THat's becuase infomraticially inclined doctors understand the point
> of it.  But it needs to be inconspicuous until needed.

In GNUmed one can write a hook script generating an
unattributed episode named, say, "General Care" and/or even
attach it to a health issue "General Care" which runs
whenever a patient is added and/or activated thereby making
sure said issue/episode auto-exists.

Assuming the doctor would always document her SOAP under
said pseudo-episode GNUmed would auto-open an editor on it
the next time around in the SOAP editor plugin.

Assuming the doctor would never explicitely close it and
would set his auto-close age for old untouched episodes to,
say, "3 years" said episode would always be upfront courtesy
of it being the pretty much only open/active episode/issue.

(Other than that the hook script could always re-open it
upon patient activation if that would be site policy.)

Sounds sufficiently inconspicuous ?

(Even I didn't know GNUmed was that programmable already :-)

To improve that workflow someone might write a Poor Man's
SOAP plugin which

- always only uses that episode
- always only concerns itself with S among SOAP
  not bothering the user about that decision

Karsten
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