Re: [Gnumed-devel] on meaningfully signing off reviewed items

[J Busser]

Ian had previously pointed out the need for the original requestor of 
information to sign it off. Which meant that even if it was actioned 
in their absence (by a co-worker) it remains for the original 
requestor to sign.

Over in the lab schema / workflow we had contemplated 
reviewed_by_clinician though I can't recall if we stored *which* 
clinician - guess that could be inferred from the identity of the 
user who updated that value.

So the related thoughts are:

- anything that needs signing must be identifiable as whether signed 
by the *requesting* clinician

- it is also important to clinical care to identify that, in the 
possible temporary absence of the requesting clinician, the result 
has been acknowledged (signed) as reviewed by *some* clinician

- the concept of a requesting clinician will not apply to *all* items 
received into GNUmed as some of these items will arrive without 
having been requested a clinician inside the surgery/clinic group. 
Therefore, the field serving the reviewed_by_requesting_clinician 
function will have to be allowed to be null for some items. Either 
that, or whoever is signing will also sign in the role of 
requesting_clinican even though they did not request it. Unless it is 
intended to denote those items that were unsolicited, for example a 
requested_by field that is permitted to remain null. That way a 
record only needs to be signed by *a* clinician (provided that 
requested_by is null) whereas if it was possible to identify an 
incoming piece of information as requested_by, then 
reviewed_by_requesting_clinician will apply.

- if a doctor departs from a practice, it is possible they could keep 
their access in order to be able to sign stuff that comes back in 
after their last day of work. But at some point they will presumably 
stop logging in, or may have died. So here Ian, would some other 
doctor "take" responsibility for these and sign them "as" the 
requesting clinician?