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Re: auditing (was: Re: [Gnumed-devel] HL7 data sample for you.)

From: Karsten Hilbert
Subject: Re: auditing (was: Re: [Gnumed-devel] HL7 data sample for you.)
Date: Sun, 6 Mar 2005 14:11:54 +0100
User-agent: Mutt/

> For any one test_result, only a single .narrative would be stored, is 
> this a preferred place in which a secretary's input "Phoned to Dr X, 
> 2:45pm" could be stored?
It would work.

> Is it better for the secretary to enter a Soap item relating to the 
> health_issue (visit) in which the labs were done, to input "Phoned to 
> Dr X, 2:45pm"?
Depends on the taste of the users.

> And if this action had been stored in test_result.narrative, and then 
> it later happened that the pathologist phone the doctor to say there 
> was an analytical problem and the result may be unreliable, would the 
> clinic doctor audit the result to input this comment into 
> test_result.narrative (resulting in an audited value)?
It could also simply be added to, not overwritten.

> Some might suggest lab results not be audited
I don't see why.

> The question of auditing makes me think a few things:
> 1. I don't believe the log_ (audit) tables have a log_comment into 
> which to enter why the audit was done (Karsten?).
No they don't.

a) It is difficult to fill in this field because auditing
   works with triggers.
b) It may become quite cumbersome to provide audit reasons for
   all the rows one changes in a session.

> 2. Even if such a field were added, might we wish only the briefest 
> information input into this field (i.e. the clinical "trigger", 
> source of info) whereas if there may be a *consequence* to the audit, 
> we would prefer to have the *consequence* information put into 
> clin_narr, for example maybe the patient needs to be contacted and 
> their management changed.

> So maybe it should be automatic that when a 
> record is audited, some entry in clin_narr is also required?
IMO no.

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