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[Gnumed-devel] question reg prog note when entering past medical history

From: Karsten Hilbert
Subject: [Gnumed-devel] question reg prog note when entering past medical history item
Date: Thu, 21 Apr 2005 21:41:32 +0200
User-agent: Mutt/

Richard and others,

in your design there's an entry field for progress note in the
past history edit area. Also, in your past history table you
have a comment field. I would assume you would be storing the
progress note in the comment field ?

This would be akin to our storing a Soap row attached to the
new past history item (IOW clin_health_issue). We do this.

However, when entering past history items via the past history
popup in the resizing progress note STC (courtesy of Ian) we
also want to embed a string regarding the past history item in
the progress note for the currently edited medical problem. Do
we want to include the progress note along with that embed
string ?


Consider a patient with Crohn's Disease which I've been seeing
for two months to get the recent flare under control. While
entering notes during today's encounter the patient suddenly
feels like informing me of his last-year bout of heavy NSAID
use due to now-chronic polyarthritis. I decide that the CPA is
a health issue/past history item I want to store in GNUmed.
Hence I type "phx" and up pops the edit area for past medical
history. I enter "chronic Polyarthritis", "age 47", "11/2004
heavy use of Ibuprofen due to acute bout", respectively, for
condition, age_noted, progress_note. This will result in a new
health issue "chronic Polyarthritis" with a proxy episode "past
medical history" and an attached S(oap) row "11/2004 heavy use
of Ibuprofen due to acute bout". However, in the clin_narrative
row created for the Crohn's Disease problem that I am currently
working under we would *also* want to add a short blurb (eg
embed a string) like "relates history of 'chronic
polyarthritis' known since 'age 47'".

Now, the question is: would we want to also embed the
(potentially quite long) progress note or leave that for
storage under the new health issue only ? I tend to think the
latter is better.

BTW, notice that I am talking about existing functionality in

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