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Re: [Gnumed-devel] Storing text communications


From: Karsten Hilbert
Subject: Re: [Gnumed-devel] Storing text communications
Date: Sun, 16 Feb 2014 12:42:24 +0100
User-agent: Mutt/1.5.21 (2010-09-15)

On Sat, Feb 15, 2014 at 12:20:52AM +0000, Jim Busser wrote:

> I am sometimes in a situation where an email sent to me by
> a patient or a doctor needs to be stored, and am wondering
> how best to handle this in GNUmed.

I have done so myself and have felt the pain stemming
from the dichotomy:

- emails naturally belong to potentially different
  encounters (in the GNUmed sense)

- however, emails are best viewed in a threaded mode

There's two main standards for storing mails:

        http://en.wikipedia.org/wiki/Maildir

        http://en.wikipedia.org/wiki/Mbox

the former of which typically better handles large
amounts of mails while the former is better suited
for BLOB like storage.

I have usually stored mbox files as parts of one
document, each of which would contain one or
more messages. All things considered it'd probably
be "best" to store a document with one mbox file
containing the entire thread and *replace* that
should another email relating to the thread
arrive. That won't blend in with the encounter
concept, however.

It'll depend on the circumstances which way to go.

> - an email from a patient asking about a test result
> - a review of the test result
> - a phone call to the patient to discuss the result

In *this* case I'd either copy/paste the email (say,
with headers) into the Soap note or else attach
a one-mail document to the encounter.

> which I might end up categorizing as a phone
> encounter, because that represents the
> most-intensive interaction with the patient.

It might even be two encounters, depending on
circumstances:

        1) review chart after receiving request
        2) discuss with patient on the phone, at
           a much later time

> I think it would be reasonable to define a document type called "Email".

Sure.

> Here are some of my questions:
> 
> 1. If each of a couple of emails were temporarily saved
> (out of the email client) onto the filesystem as a separate file,

        all of them into one mbox file, I'd suggest

> and these were all "picked" using the "pick
> file(s)" button,

        which could then be dragged onto GNUmed

Karsten
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