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Re: [Gnumed-devel] Clinician call of judgement

From: James Busser
Subject: Re: [Gnumed-devel] Clinician call of judgement
Date: Fri, 04 Apr 2008 08:52:24 -0700

On 4-Apr-08, at 3:53 AM, Karsten Hilbert wrote:
However, it now seems to me that a) the previous information
isn't really lost (of course) due to auditing (and could
thus potentially still participate in informing on-screen)

yes... the benevolent/knowledgeable (or even plain everyday) colleague is more often helping than hurting the patient's usual doctor by signing and flagging the test results expected to be of interest to the returning colleague, who when themselves signing could simply accept the current values when this would be fitting.

One engineering piece may remain, namely that if the ordering-but-not- usual doctor had failed to reassign the results to the usual doctor, and the usual doctor (upon their return or at any later time) would update any results as to their abnormality or significance, these updated values would then become visible to the ordering doctor as needing to be again signed. This would make it important for the reassignment function (in place of the originally-proposed "Take over") to be part of the signing widget.

This would mean we should move (earlier in the roadmap) the ability to designate which among existing clinician-users is a patient's usual or principal or default clinician.

b) we could *notify* the previously-signing clinician
when a change was done to the flags

Yes. The way I would see it working is that if user A is not the usual doctor, but has ordered tests in the absence of usual doctor B, and these tests return and have not yet been signed by anyone, then from the points of view of anyone and everyone (even the secretaries) the tests would be flagged with "?" or whatever we have chosen to denote "unsigned"

- if user A signs, then (until the capacity to reassign is implemented) no users would see "?"

- if (instead of A) it would be B or C who first sign, then it will only be A (by virtue of still being fk_intended reviewer) who would still see "?" which is what I think we would want. I consider it only a small drawback that A could not easily see that some had already been signed by someone else... it is evident when any among the set of results has been flagged as clinically significant, and the info is in the tooltip.

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