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[Gnumed-devel] LabJournal

From: J Busser
Subject: [Gnumed-devel] LabJournal
Date: Wed, 29 Sep 2004 12:38:07 -0700

On the wiki it says:

First tab

Under the first tab, where you enter the id for each request, the Journal is for all patients that are having tests ordered? Can it limit the view to a single patient (so that you can see what has been ordered for the one patient) or would this information have to be accessed through a different plug-in after activating a single patient? Maybe if a patient is active, and you then go to LabJournal, it would be useful to show ONLY testst that have been (or are being) requested for the active patient, and by use of a button or menu or keystroke to expand the view to all patients?

Is there also now, or would it in future be useful to present, alongside what has been ordered, whether the result has yet come back, or if it is still pending? Requested but unresulted labs will presumably not show in the PathLab plugin, because the results will not yet exist.

Second tab

In the second tab, shown are those results which have not been successfully matched to a request id, for example if the lab sent you data that was garbled or miscoded or from some doctor outside the practice who ordered the test, but directed that you be sent a copy.

For such results, is it agreed useful to to offer alongside them a list of default matches on a formula like

- last name, first or middle initial, date of birth, and health insurance number or - last name, first name, one among {date of birth or health insurance number} and perhaps one other piece like a phone number

Would it permit the matches that are offered to be accepted singly or in any manually-clicked combination? Work would be reduced by having a button "tag selection/all" or "untag selection/all" before a confirmation step. I am thinking the acceptance/ linking of the result to the patient needs to capture the responsible clinician or is this limited to the "review" step?

What happens if someone copies you the result on a patient that does not yet exist in your system, but that someone else (maybe a doctor outside your practice whose patient you may be willing to see, but no record has not yet been created for them, maybe your colleague has not even had a chance to discuss this with you yet). It would be helpful to see details of the test information including which doctor requested the test, and once you decide if you wish to keep this result you can create a new patient and put in however much information will help the soft match to occur most easily.

What do you do when you decide a result does not belong to your practice for example if you were sent it in error. In Canada, even if you received it by mistake, there is a responsibility to make sure the patient is looked after so it can involve contacting the lab or the ordering doctor or whoever was supposed to have received it, and to get the lab to re-issue it or to forward it yourself. The fact that this has been taken care of also needs to be documented - should I/we pre-empt the use of the field test_result.note_provider or do we need some additional field or does this fall to a workflow table to show what action has arisen from the result?

Also even when it was not your patient but you are now (as in my case) "stuck" with that result, it is going to be difficult to find if there should later be a complaint, for example "Dr Busser you were sent a copy of a result on Missy Jones, verify this, and identify what was done". Therefore I should have to create Missy Jones as a patient if I am later to find this record.

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