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Re: [Gnumed-devel] Turtorials

From: Jim Busser
Subject: Re: [Gnumed-devel] Turtorials
Date: Wed, 07 Jul 2010 08:14:54 -0700

On 2010-07-04, at 1:09 PM, Karsten Hilbert wrote:

> On Sun, Jul 04, 2010 at 09:15:47PM +0200, Eric MAEKER wrote:
>> SOAP is the key ! It is fully i18n and understand by all practitioner.
>> S subjective
>> O objective
>> A assessment
>> P plan
> I may be misunderstanding your point ? GNUmed is built on
> SOAP which is orthogonal to ABCD, namely at the soAp
> junction:
> soAp
>  B
>  C
>  D

GNUmed proudly (but complexly) supports multiple constructs, and not all are 
factorable into and out of a single view;

- acute / chronic
- relevant / irrelevant
- active / inactive
- attributed to some underlying problem (or not)
- narrative componentization (SOAP)
- level of certainty ABCD

The "Notes" plugin's multi-notelet support enables problem components to be 
split across the EMR tree's various problems. Liz maybe points to this as 
impractical, at least for some patient populations. The implication is that it 
is maybe only practical to generate a single, large SOAP note for any one 
encounter. But we have no easy way to "tag" multiple problems against a single 

Maybe *begin* the encounter in a single new notelet but -- before saving -- 
making a decision as to whether and which parts of the SOAP text (snippets) to 
move into notelets easily raised from among the existing problems.

Perhaps (IMO) even if all of the {Subjective, Objective} were allowed to remain 
in a single note, there would remain value to capturing *some* component 
Assessment and Plan items inside their respective problems?

-- Jim

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