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[Gnumed-devel] schema changes requested


From: Ian Haywood
Subject: [Gnumed-devel] schema changes requested
Date: Wed, 30 Nov 2005 16:11:42 +1100
User-agent: Debian Thunderbird 1.0.7 (X11/20051017)

I would like to request some schema changes

- forms_data seems to double up with the fields of 'real' tables that hold this 
data
such as referral, lab_request, medication, etc., I would get rid of it.
Instead each of these tables links to form_instances
with the data in form_instances and the fields of the table the form can be
re-created and re-edited as required.

- put clin.medications and clin.referrals in separate files, which can
be loaded via the australia  config files for the time being.

- remove constituents completely: IMHO we're not going to use it.

- lab_request needs a foreign key for the form generated
   fk_form integer references clin.form_instances (pk),
can be NULL for electronic results where no form exists.

- clin.reviewed_root should have a flag
      unread boolean,

false means the clinician referred to in fk_reviewer hasn't seen it yet.
Let me re-iterate why I keep on banging on about this: all information
that comes into an EHR must be in two categories: either information
entered by a clinician, or information that has been "signed off" by
a clinician to take responsiblity for it (in paper systems this is done by 
physically
signing the bit of paper)
Here is AU a doc would be roasted alive for running and EHR without this 
feature,
it's difficult to see how you could get away without it elsewhere too.
So, we need a way of presenting a list of documents/results which haven't been 
signed
yet.
As this stands this means search for test_result and doc_obj rows with no
matching reviewed_root row: far too slow, the simplest solution is to
insert flagged rows for documents pending review.
the alternative is to duplicate the review_root and descendant tables but this 
seems a
bit pointless.

Ian




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