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Re: [Gnumed-devel] EMR Journal plug-in improvement suggestion

From: Karsten Hilbert
Subject: Re: [Gnumed-devel] EMR Journal plug-in improvement suggestion
Date: Sat, 28 Jun 2008 22:52:27 +0200
User-agent: Mutt/1.5.18 (2008-05-17)

On Thu, Jan 17, 2008 at 10:52:57PM -0800, James Busser wrote:

[progress note editors]

> - the button "Reset" seems destructive... it does not reset the text to 
> its value immediately before the last cursor insertion and typeahead, it 
> only clears *everything* in the editor, so can we call it Clear?


> - right now, if inside the soap widget the user clicks "Save"
>       - they are prompted for a descriptive name (defaults to the assessment 
> text)
>       - although they are positioned inside a dialog, they cannot change  
> their mind
>       ... what if they realize they want to fix or add something more?
>       --> suggest a 2nd button "Wait" that allows to return to the encountlet 
> widget


>       - also, the "Save" button does not only mean "write to disk to protect 
> this data" ...
>       ... it also means "close this entry in the soap widget"
>       --> if it remains useful to save individual threads in a Progress note, 
> suggest this button be renamed "Done"
Hm, I'd prefer leaving it at "Save". The tooltip has been
clarified, though.

> - however, is there a value to saving one portion of a note before  
> saving another portion?
Sure. Often times information becomes elicited only later on
while in the meantime I want to work with the data I already
know on all machines in the practice.

> Often in a visit, even when I thought I was done 
> dealing with one issue, the patient again goes back to it before the 
> visit is done. It might be better to lose the Save / Done button in favor 
> of "Save & close visit" ...

"Close visit" isn't really appropriate. It doesn't close the
visit in many situations. It merely commits to the EMR what
is currently known.

> would there be a side-benefit that this gives 
> all parts of the encounter the same time stamp, making the display less 
> disrupted by other changes to the clinical record?
I don't really see this as a benefit. After all, when I
learned of some pieces of information 30 minutes later I'd
rather have it documented later, too.

Say, I initially asked about allergies, patient says "uh, I
think I suffer from diclofenac allergy", so get's
administered Novalmin i.v., but later on suddenly produces
her allergy booklet which states "allergy to

I'd rather have that documented under different timestamps.

Also, when monitoring vitals, I'd prefer to have them stored
when I did the reading.

One can *still* leave open the editor when so desired such
that things get the same timestamp.

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