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Re: access to review audits (was Re: [Gnumed-devel] encounter edit befor

From: James Busser
Subject: Re: access to review audits (was Re: [Gnumed-devel] encounter edit before final save)
Date: Sat, 16 Aug 2008 10:16:06 -0700

On 16-Aug-08, at 3:43 AM, Karsten Hilbert wrote:

Jim, do you think we should invalidate a test results review
when said result is modified ? (this would, in turn, notify
the responsible clinician courtesy of the then-lacking review)

I agree that if the person who had *last* reviewed a result is *different* from the individual who is currently modifying a result, the prior results review should be invalidated and the fact that patient results lack a review does need to be signaled somehow.

Whatever previous review had been made as to abnormality, importance, and comment may remain valid despite the modification (e.g. Kalium / potassium level report of 5.9 corrected to 5.8 may justify preservation of the prior review). Therefore it might reduce the pain of there were an option for whoever is modifying the result to simply re-confirm, or at their option alter/update, the last review.

I wonder if we can avoid an unnecessary notification if whoever would modify a result would also, in the same session, mark it as reviewed? I cannot remember whether the appearance of items in an inbox is the result of the writing of "notification records" records (which would need to be deleted after the review was done), or if the notice is not in fact a "record" at all, just a dynamic indication of the result of a query, which could have the ability to immediately refresh and would go unseen unless some other provider happened to concurrently activate the patient.

The intended reviewer, if different than the provider who last reviewed, or if there is no valid review on account of failure of the person who modified the result to take responsibility, would still detect an unreviewed result, right?

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