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Re: [Gnumed-devel] - Comments please from LOTZ OF PEOPLE

From: David Guest
Subject: Re: [Gnumed-devel] - Comments please from LOTZ OF PEOPLE
Date: 04 Aug 2002 15:39:34 +1000

On Sat, 2002-08-03 at 22:56, richard terry wrote:
> Some general comments re this one, and please could I get feedback from 
> multiple people, I'll explain below why, as there are many options in the 
> design.

> You can see how flexible this screen can be to make our lives easy.
> Q)Do you think the on screen editing should be allowed, or should we just 
> have 
> a single street line, and only allow entry of person and organisation details 
> via the contact manager?
Allow on the fly entry. 

> 2)This format allows this 'referrals' section to also carry out the function 
> of writing reports, legal letters etc for the patient.
> 3)Referrals_savedletters.png shows the result once the letter is saved. My 
> code created a rich text file and saved it with the specialists 
> name/organisation name and date. As I constructed the rtf files myself I 
> stripped most of the junk out of the rtf header so that only a font such as 
> timesnew roman was encoded. An entire 1page printed letter occupies about 
> 1-2k and the maximum letter size I've ever had is 3k. Very small overhead. 
> Clicking on one of the names in the list re-displays the letter in the left 
> hand side of the screen in it's entireity, where it can be re-read, or 
> re-printed, or edited and resaved under a different file name.
I think this is a great idea. I am always amazed at how much baggage
there is my letters. Formatting, id data for sender, receiver and
patient, other medical data (SH, previous consultations, meds, etc.). I
would like to strip more than the formatting but I wonder if the other
data does have to be statically recorded, if only for medico-legal

> 4)Where the letter is short, as in the example shown here (referrals.png), 
> the 
> area under the editing area suffices. Where a longer letter, or where one 
> wants to edit the pre-formatted clinical data e.g delete a non relevant part 
> of say family history or past history, then clicking preview shows the letter 
> full page and one can type/edit at will.

> 5)Default behaviours need to be configured eg always set the firstname 
> checkbox if you want the letters to automatically say 'Dear fred, instead of 
> Dear Doctor Whatsyourname. Similarly if a config file contains an 'include 
> all clinical information' then all 6 checkboxes pertinant to the patients 
> history are checked upon selecting the referrals page.
Looking at it from the receiver's end, I dream of the day when I receive
a compound document where this other pathology information is viewed as
a link. Stephen Crawshaw and I kicked this idea around about 6 years
using HTML. These days I guess it'll be XML. (More baggage :-)

> 6). The Save and print icons on the patients tool bar will always be context 
> sensitive. ie when in the referrals section and one clicks print, it just 
> prints the letter, not any other outstanding say scripts, requests etc. 
> 7). In this electronic age one also needs the facility to email the letter 
> via 
> say a context sensitve email button on the top bar (which I'll have to stick 
> on) - hey - we could have a built in email client - I know there is a project 
> going to have one in wxPython!!) on another tab
This is where we should be heading and it has to be encrypted of course.
This part is trivial now that Tony Lembke has setup a pksd server on a 
Berkeley sleepycat database. This alone could easily handle all the
medical public keys for Australia and Europe
( It's open source fare so mirror
sites can be easily set up. 

> I've left off the 'Department/branch label. If we are going to allow on 
> screen 
> editing this will need to be included.
> The copy to line I didn't include in my original, however often one gets 
> letters from specialists which have a cc to one or more people so I think 
> this needs to go in.  The date text box is there because sometimes one has to 
> backdate a referral because the patient forgot to get one prior to the 
> consultation. 
<Off topic> 
At least in Oz this is not legal. I usually find that the specialist
fixes it up at their end. ;-) Better they go to jail than me. I tell the
specialist's' receptionist that I will be happy to backdate a letter
once I get a letter from the HIC saying this is OK. :-)
</Off topic>

> It's not strictly necessary and if screen real estate is at a 
> premium it can be omitted and the user just change the date which is auto 
> inserted in the letter at the time of its generation.
> The gui is a little rough, I'll adjust the proportions of the prompts to make 
> them match the text boxes, and also the width of the right hand boxes to 
> allow more room for say email address.
> Ok, comments please. I'll post the code later tonight to the CVS.

David Guest
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