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Re: [Gnumed-devel] Smoking status - revised.

From: James Busser
Subject: Re: [Gnumed-devel] Smoking status - revised.
Date: Tue, 12 Aug 2008 17:28:21 -0700

On 12-Aug-08, at 3:37 PM, Rogerio Luz wrote:

Just found the PERFECT place to put Smoking status :)))) 

Right next to the CAVEAT field ... make the field smaller and put it there like alergies ... 

Oh and obstetrical information is a MUST - HAVE in the demografics, it might not be mandatory ... but it should be there :) 

Taking the second suggestion first, do you mean information about previous obstetric history (like Gestations Para Abortions Live) or do you mean current gestational information about a pregnancy that is in-progress? In the first case it seems more like a special area of past clinical history information rather than demographics (unless it is the social aspects of who is in this person's social-familial unit). In the second case, this would be a special kind of clinical information (pregnancy-in-progress) that I do not believe we have yet modeled how to manage it dynamically.

As far as the CAVEAT field (or the space next to it) you may be interested to search prior postings on the archive for the term "real estate" which refers to competition for space within the available screen area. :-)

The other problem is how to support the possibility that a long list of things will each have different importance to different doctors to be able to easily see in each patient's record:

- deaf
- blind
- language barrier
- cognitive impairment
- hostile or other threat risk
- smokes
- drinks alcohol
- IV drug use
- other addiction
- other risk factors
- very important person / patient
- risk of abduction or threat from a deranged parent / contact
- currently pregnant
- currently participating in one of many research projects
- currently being managed by a trainee under the supervision of one of the primary providers

I have no answer yet to the above, but only do expect configurability of what is displayed to be preferable over customization.

As far as trying to make certain that certain data is reliably captured, Karsten might remind us whether a form may be able to be engineered to behave as a "wizard" when completing some kind of a patient check-list. As part of the form, positive responses could be translated into active or inactive (past history of) various specific issues such as risks. We must consider that family history can also confer a risk, as much or more as for some behaviours, so some more thinking around this will definitely be helpful. :-)

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