Re: [Health] evaluation edition

[ronald munjoma]

Hi Sebastian,

On Jul 27, 2013 4:31 PM, "Sebastián Marró" <address@hidden> wrote:
>
> Hi Khay
>
>
> 2013/7/27 Khay Bagus <address@hidden>
>>
>> Dear All,
>>
>> I have been facing a issue with gnuhealth these days.
>>
>> Lets say a patient enters the triage room. The doctor who sees him for the first time is Dr X. He sees that the patient has to do some lab tests. So the patient goes to the laboratory. Unfortunately some tests take 2 hours to be ready. So when the patient returns to the triage room, the doctors shift are changed. So the Dr Y opens a previous evaluation by Dr X edits it and saves it... By the end of then day we don't have a way to know wich doctor really saw the patient and who did what.
>
>
> For the next 2.2 version, we are adding a workflow to the Patient Evaluations. When a doctor completes a medical evaluation, he will click on the button confirm,  and all the fields will change to read only state. So, when other doctor begins an evaluation for the same patient, he will not be able to edit a previous evaluation, the doctor will have to create a new evaluation for the patient.

I see two issues:

1. Continuity of Care

In Khay example Dr. X is waiting for lab results which comes in when Dr. Y reports for duty and attends to same client using the lab tests requested by Dr. X. In this instance Dr. X with the proposed workflow will not be able to close the episode. If Dr Y closes the episode it should be possible to tell that Dr. X first saw the patient and requested the lab tests which leads to second issue: the Audit trail.

(From a non medical background) I propose we have a look at the Encounter, Visits, Episodes concepts [0], each encounter, visit and episode will have a health professional associated with it, a start and end date (the start and end date should work in the same way as in Nursing Rounding)

2. Audit trail

[0] http://www.ehealth.gov.hk/en/doc/briefing_on_eHR_content/3a_Encounter_Ms_Erica_LAU.pdf

Regards

Ronald Munjoma

>
> Regards
>
> --
> Sebastián Marró
> thymbr@
> Converging Ideas for Emerging Realities
> www.thymbra.com