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re: [Gnumed-devel] Possible development opportunity (was Gui-Designers w

From: sjtan
Subject: re: [Gnumed-devel] Possible development opportunity (was Gui-Designers was the id_name debate)
Date: Mon, 13 Sep 2004 09:52:06 +1000
User-agent: Mozilla/5.0 (X11; U; Linux i686; en-US; rv:1.7) Gecko/20040616

Lab results are obtained in a variety of ways, some by fax or by mail. Around 90% of the results are available electronically but, as the clinic does not presently have an EMR into which to download them,

prints these from a web-based portal

Results are copied by hand onto a worksheet, as are the dosage changes and the next test date.

for those who are out-of-range, to batch them together and by phone obtain from the cardiologist a dose revision and advice on the next due INR.

Just my 0.01 cents ( i.e. using this for practice in requirements gathering):

The current schema looks like it can hold demographic and lab data .
I don't know if there is a specific messaging code, but to get the 90% inr results (+clinical notes) in,

may see if there are specs of how/if the results can be downloaded from the individual path labs. ( e.g. as csv files , simplest). These can
be put in the test_result table collaboration.

otherwise , perhaps the results have a web .xml form that can be easily parsed ( perhaps the path companies are using xml + xslt to generate the web pages). Do they have dummy test web pages for developers?

You could also have a hand entry screen, perhaps a table form resembling the work sheet, and each row linked to patient search for linking with a patient. This work sheet also allows nurse to enter dosage change, clinical notes and next test date entry, after it has been written down on paper as usual after discussing with cardiologist, and the patients' have been rung, as usual. In other words, the nurse stilll writes it down on paper and the original workflow isn't changed too much.

Someone can modify the schema to accept planned actions in general, or just dosage change specifically, and I think the current schema has lab_request table which can be used to store the next test date entry.

A application trigger can be used to scan for lab_requests with id numbers newer than before the worksheet was invoked, and generate mail to be sent the path company ( possibly signed as well) and also publish to a web (?xml files) directory on your web server as further confirmation. Scheduled , sent and confirmed mail can be recorded in a table and viewed as a report.

Reports can be generated joining the demographic detail, lab_request, lab_result , and a cardiologist recorded recommended dose and recommended next test, and comments, which should probably be double checked by nurse and cardiologist each day.

Makes for a good exercise in requirements discussion anyway.

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