[Gnumed-devel]

[sjtan]

> > > actually, I'm having a hard time trying to work out how to access
the 

> > > gmclinical tables. 
> > One of the problems may be that one needs to understand the 
> > domain at least partially to see how this is supposed to 
> > work. Have you read the writeup on the EMR structure ? 
> >  
> Where's the write-up? 
client/doc/TODO/developer-guide.txt 
 
> I suppose my problem is with the distinction between Diagnosis , and 
> Clin Health Issue which seems to be something to hold arbitrary  
> text of 128 character, and be associated with a clinical episode which
... 
IMHO, to a doctor the whole thing makes sense, semantically. If you need
more explanation after 
reading the writeup please ask again. 
 
> First of all, the doctor 
> would need a pretty good retrospectoscope to figure out which items 
> occuring at an encounter actually were part of a long running episode 
> regarding a particular issue 
No, this type of thing feels perfectly natural to a health professional
(or
should). 
 
Karsten 
-------------------

ok , if the clinical_episode is only just to characterize time place and
 person , an you might be dealing with multiple issues when you see
someone ( hypertension, diabetes, vascular disease) , it might make
sense ( for the examination root item, taking bp relates to the issue
hypertension, doing hba1c relates to diabetes, and checking peripheral
pulses relates to vascular disease) . 
        Clinical episode has a text field,which I'm not sure what its for
(?unstructured progress notes) ,

 but if it's just to aggregate time place person, I suppose it's
acceptable as  a separate table, otherwise
just use a multi-field primary index for clin root item. ( Not
acceptable in some database systems , I suppose) . 

I supppose someone is envisaging the system will be better than , say
than OSCAR or OIO because it will have some sort of knowledge classifier
that will automatically link your clin_root item to a patient issue;
 or like one Australian e-med system, ask what the clinical issue is
after each prescription.
 Luckily, it isn't organized so that a root_item can link to more than 1
clinical issue, or will that feature be required as well? (i.e.
root_item_clinical_issue_link table).

BTW, tone down the Domain Expert put down a bit, I've  suffering from
people with that kind of attitude ( all that night shift for a drift
into GP land).