Re: [Gnumed-devel] Synopsis (AOE?) attaches to the prior encounter?

[Busser, Jim]

On 2012-12-10, at 5:21 AM, Karsten Hilbert <address@hidden> wrote:

> <gm-emr_by_mod_time-qeUi5P.txt>

Having now had a chance to look at the output, it's maybe useful to confirm 
what it is telling us and the consequence if the Journal would (in production) 
take this new approach.

If we would focus attention on the portion of the output (recopied below) which 
begins at line 81 about Episode … Bildnotizen

1. we see several occurrences of 

        Kontakt: in Praxis 2012-12-03 13:24 - 13:37
          BA: wants to see Dr.McCoy for scar problems

… can I know whether all of them would have been shown in Journal-by-clin-when ?



2. the dates shown at right within Kontact lines include clin_when dates, 
correct?


3. The risk of being misinformed would be when users would newly create (or 
else would revise previously-created) clinical entries which pertained to 
events some time before. So for example if a patient had a myocardial 
infarction in 2010 and the original entry said "right coronary artery stented" 
but it is now (2 years later) realized that that is wrong and is now corrected 
to "left coronary artery stented" then if we adopt a change to the structuring 
of the Journal output, the soap row of which that information is a part will 
show up at the bottom of the output.

On the positive, it will be seen that information was recently either newly 
inputted (or newly revised to include) the fact that the left coronary artery 
had been stented.

We only will not know from the lines (as currently formatted) the associated 
clin_when.

I still have the feeling that this offers some value because it informs 
whatever someone was most recently working on about a patient's record even if 
the problem being worked on was an old problem. The management of the patient 
remains best guided by a few things:

1) Per problem, the information that is available for *that* problem and which 
is organized according to clin_when

        Question:

        In the current EMR tree right-side "Journal"
        --> what is the hierarchy of organization?

        i.e. 
        

2) Across problems, the ability to see what was going on at each contact (an 
Encounter-based view which makes available all of the content from any one 
encounter).

        Encounter (clin _when)

                Problem 1 soap rows, sorted (within each cat) by clin_when 

                        U  ( ibid )
                        S  ( ibid )
                        O  ( ibid )
                        A  ( ibid )
                        P  ( ibid )

                Problem 'n' soap rows ...

        

=========================================================

2012-12-03 13:28 |      LMcC | D | Episode (abgeschlossen): Bildnotizen; 
2012-12-03 13:30 |      LMcC | … | Deletion of document:
                               … |  2012-12-03 13:28 "visual progress note"
                               … |  #1: ""
                               … |  
/tmp/gnumed/gm-FCdhFW/gmScannedObj-I9RjmG-001.png
                               … |  
2012-12-03 13:38 |      LMcC | … | Kontakt: in Praxis 2012-12-03 13:24 - 13:37
                               … |  BA: wants to see Dr.McCoy for scar problems
                               … |  BE: Bildnotizen; 
2012-12-03 20:42 |      LMcC | … | Kontakt: in Praxis 2012-12-03 19:39 - 20:42
                               … |  BA: wants to see Dr.McCoy for scar problems 
2012-12-04 17:00 |      LMcC | … | Kontakt: in Praxis 2012-12-04 16:52 - 17:00
                               … |  BA: wants to see Dr.McCoy for scar problems 
2012-12-04 18:05 |      LMcC | D | Episode (andauernd): test; 
2012-12-04 18:05 |      LMcC | A | S oap 
2012-12-04 18:05 |      LMcC | B | s O ap 
2012-12-04 18:05 |      LMcC | D | so A p 
2012-12-04 18:05 |      LMcC | T | soa P 
2012-12-04 19:07 |      LMcC | … | Kontakt: in Praxis 2012-12-04 18:59 - 19:07
                               … |  BA: wants to see Dr.McCoy for scar problems 
2012-12-05 12:42 |      LMcC | … | Kontakt: Akteneinsicht 2012-12-05 12:42 - 
12:42
                               … |  BA: wants to see Dr.McCoy for scar problems 
2012-12-06 11:21 |      LMcC | … | Kontakt: in Praxis 2012-12-06 11:20 - 11:21
                               … |  BA: wants to see Dr.McCoy for scar problems 
2012-12-06 11:33 |      LMcC | D | Episode (andauernd): wants to see Dr.McCoy 
for scar problems; 
2012-12-06 11:33 |      LMcC | A | fd fasd
                               A | 
                               A |  adf as
                               A |  as
                               A |  asd as  
                               A | 
                               A | 
                               A | 
                               A |  asdf asdf a
                               A | 
                               A | 
                               A | 
                               A | asdf ass df
                               A | a 
2012-12-10 11:13 |      LMcC | … | Kontakt: in Praxis 2012-12-10 11:06 - 11:13
                               … |  BA: wants to see Dr.McCoy for scar problems 
=======================================================
-- Jim