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[Gnumed-devel] Test results imports, and encounters

From: Jim Busser
Subject: [Gnumed-devel] Test results imports, and encounters
Date: Wed, 24 Jun 2009 10:05:45 -0700

When a daemon / importer etc would, in one process, import many- results-per-patient, how would this be recorded in the database in terms of encounters and how would / should these be shown in the EMR tree?

In asking the question, I am setting aside that the component tests may individually relate to different health issues... I am only (at the earlier stage of import) wondering:

- even if a patient has an open encounter "in praxis", the import would not be recorded as having been part of the same encounter, would it? After all, the encounter may still be open at a time when the visit has been concluded and the patient has departed and the doctor is no longer interacting with a gnumed client

- would each import process create a single per-patient encounter which may be of type "results <importer>" and could this encounter be permitted to have a start datetime and an end datetime that falls inside the time frame of an already-open encounter? The logic would just recognize any existence of a still-open patient encounter and, in this situation, would auto-close the newly-added results encounter? If there was no already-open encounter, perhaps imports would still be auto-closed? Maybe any clinician review (at a time when there was no open encounter) could still be a new encounter of type "chart review" ?

- how would such "results <importer>" be handled in the EMR tree? Would there exist, under "Unattributed episodes", an episode "Results" with the various closed encounters listed within? Over time, that would be a lot of results, but maybe even for "active" patients there might be only one record per week, 50 per year inside such a folder. The alternative would be to allow test results import to be entered (stored) under a special encounter type that simply adds more and more datetime stamped administrative soap rows although maybe there is a downside to doing this?

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