Re: [Gnumed-devel] encounter edit before final save

[James Busser]

Sorry... I was rushed (no excuse) and had not fully thought through  
my last post, which (to make it worse) had mistakes. Reposting:

On 8-Aug-08, at 4:02 PM, Jerzy Luszawski wrote:
> For now - it is almost unusable for me and my friends
> Karsten - would be it much work if you were to change it?

Are progress notes, even while not yet signed, currently "alterable"  
only while in memory i.e. until written into the database?

Permitting a note to be committed into the back end in an unverified  
form --- if such a note could be viewed by others, prior to its being  
"verified" --- poses risks.

I understand the competing use case, which may be one in which an  
important clinical entry remained unsigned on account of being called  
away, or maybe the clinician had to leave town without fully signing- 
off their entries, and during their absence a "covering clinician"  
may truly need access to that note.

On this basis, I would suggest:

- the ability to define a time interval or event, prior to which only  
the author could view an an unverified (unsigned) entry, but after  
which others could view the entry
- the caveat to the above would be the need to make clear to the user 
(s) which if any entries are signed
- the method by which to make it clear could include, as mentioned, a  
filter which by default did not display unsigned entries, or maybe  
did still usefully display the *existence* of a note, and just did  
not display the content (perhaps it would just display "unsigned")

Overlapping the above is the concept of "limbo" entries which AFAIK  
has not yet been agreed, and therefore not yet incorporated into the  
schema design nor software:
        http://lists.gnu.org/archive/html/gnumed-devel/2003-01/msg00133.html

If I understand the above correctly, the limbo flag would subvert the  
audit system until such time as set to unlimbo after which control by  
the audit system becomes non-optional (i.e. not possible ***to  
circumvent***) --- is that right?