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Re: [Gnumed-devel] Encounter overlaps in GNUmed in future 1.2


From: Karsten Hilbert
Subject: Re: [Gnumed-devel] Encounter overlaps in GNUmed in future 1.2
Date: Sun, 01 Apr 2012 13:00:33 +0200

Supposing in a praxis

- you had an educator coming periodically to give diabetic teaching
- a patient is scheduled to come into the praxis at 1000h for such teaching
- two days before, the patient had gone to the hospital and had their 
previously ordered echocardiogram
- at 0900h, while doing an errand before the scheduled appointment, the patient 
slips and falls
    --> lands on an outstretched wrist
    --> lacerates it sufficiently badly to require suturing
    --> comes into the praxis early, at 0920
- the wound is sutured, but there is a question if there could be a fracture
    --> patient is given a requisition
    --> patient prefers to keep their scheduled teaching, and *then* go to 
radiology
- at 1010h the automated importer pulls in the echocardiogram report (or it 
could be any lab data etc) which does not relate clinically to today's 
encounters
- at 1100h the patient goes to the radiology facility and gets their wrist 
Xrayed and
- at 1145h the patient returns to the praxis


I understand the scenario but the concern ("the importer pulls in ... data
which does not relate clinically to today's encounters") does not line up
with what an encounter is in terms of GNUmed.

There is contact between the patient's chart and health care agents
(surgeon, educator, importer, ...) from 9:20 until 11:45. Said contact
IS the encounter. The praxis may choose to re-arrange that in other
ways but that's what GNUmed thinks by default.

Surely, the tools to afford re-arrangement may want improvement.

Karsten

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