Re: [Gnumed-devel] Notes editor 0.4.6-1 feedback and suggestions

[Karsten Hilbert]

On Sun, Jun 21, 2009 at 04:07:50PM -0700, Jim Busser wrote:

> On 21-Jun-09, at 3:31 PM, Karsten Hilbert wrote:
>
>> We need to be careful to not confuse our encounter with what
>> insurance companies want us to believe happens in
>> healthcare: They only allow us to bill them for what *they*
>> think is a contact worthwhile paying for...
>
> Yes, for example my medicare system will so far pay for no care by  
> phone, except a modest amount for responding to an INR result, but not 
> the work involved when the patient over the telephone says
>
> "by the way, I had a headache yesterday, it is better now, but it was  
> the worst in my life -- I never get them -- such that on my way biking 
> home yesterday, I had to pull off the road and lie down on the grass for 
> 30 minutes, on account of feeling incapacitated and vomiting twice, but I 
> eventually made it home, and felt better by bedtime, and I am fine today. 
> So... nothing to worry about, right? And I continue taking my warfarin, 
> right? The main reason I am asking is ... I am supposed to go on vacation 
> in 2 days..."

Aaah, the days. Well, yeah, precisely !  There's not a hint
of doubt an encounter worthy of note is taking place here.

> I think we should develop a collection of such stories. I am sure Horst 
> has many ;-)

Those are "user stories" (potential use cases) which have a
place in guiding functional development. They could be
collected on the wiki. Eg. the above gives plenty of hints
on what a Patient Overview Widget should contain:

- previous history
        - known aneurysma ?
        - previous headaches ?

- most recent lab
        for easy access to INR trend

- active medication
        for easy access to warfarin schedule

- primary address w/ phone number
        for sending ambulance

- abbreviated docs listing
        - previously had cephalic MRI ?

Karsten
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