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Re: [Gnumed-devel] Medication viewing

From: Jim Busser
Subject: Re: [Gnumed-devel] Medication viewing
Date: Fri, 30 Oct 2009 15:11:29 -0700

On 2009-10-29, at 11:05 AM, Karsten Hilbert wrote:

At discontinuation, the row could be updated
to reflect when a patient last used it, as well as the reason for
discontinuation which could be any combination of not needed, not
tolerated or not effective.

While I agree this seems desirable it does stray away from
the "current state of substance intake as best known to
date" design decision.

Actually, now that you clarify / reaffirm that current medication rows (substances)

- were only ever intended to be present in the table for as long as each was in the state-of-believed-to-be-used and not-yet-confirmed-to- be-stopped (because there may have been no intent to stop, maybe the supply lapsed or maybe they got more medication from a spouse or another doctor)

- are to be deleted upon recognition / confirmation of no-longer- currently-being-used

Then there is at minimum a deletion step that is required. So the options for this step are:

1) simple:
- provide a Delete button which would apply to item(s) highlighted at the time:
        "Remove item(s) from the Current medication list?"
- if confirmed, the items are deleted in the same transaction as they are copied into the Audit table in a row that records the datetime without any further user interaction except should users first edit to make each row as currently-informative/accurate as possible and *then* delete? Maybe the button should be Remove and maybe it should warn the user if any selected rows were carrying old information i.e. if modified_when was within the past 6 or even 24 hours maybe it is accurate
        if modified_when is null then it maybe deserves the above warning?

2) better:
- make it possible to confirm/enter details like last_used and the state of discontinuation

        - tolerability issue
        - lack of finances -- not a subtype of tolerability?
        - insufficiently effective
        - combination of above
        - not needed

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