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Re: [Gnumed-devel] Re-kindling the debate on the database structure

From: Karsten Hilbert
Subject: Re: [Gnumed-devel] Re-kindling the debate on the database structure
Date: Sun, 21 Jul 2002 13:33:51 +0200
User-agent: Mutt/

> Whatever the case I propose we try and get it going again and choose a 
> segment, and I propose immunization because it doesn't have to have 
> proprietry data in it and is probably relatively consistant across the world. 
I agree with this the assessment that immunization could be one
of the things we start our EMR with since it seems (!) rather
clear cut but still allows for the entire complexity we want in

I'll make some notes and I hope people will comment:

It must be possible to store arbitrary numbers of immunization
"acts" per patient.

For each immun. a timestamp, the immun.type (reason:
prevention, travel, exposure, ...), the exact name of the
vaccine, the charge/lot/batch ID, the injection site/type
should be recorded.

Certain vaccination types should be able to trigger GNUmed
"request" events (check HepB titer 10 years post vacc., prompt
for boosters/repeat vacc. on multiple base immunisations, alert
for overdue vacc.s).

Those mechanisms should be based on pluggable guidelines.

It may be beneficial to be able to "link" vaccinations to
particular lab results.

Vacccine type <-> patient age should be checked if possible.

Recording a vaccination should create an event in the patient
state tracking time line (where major things like hospital
admissions, major diagnoses, off-work, pregnancies, etc. are
linked together to form a coherent picture).

Vaccinations should be linkable to Episodes (PneumoVax well
after hospital admission in order to prevent recurrence).

Anything else comes to mind ? Comments ? Additions ? We will
get tables going for this but we need input. _This_ is your
time to make yourself heard.

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