Re: [Gnumed-devel] clinician input wanted: how to implement "coding"

[James Busser]

> I am still looking for more use cases defining genuine
> *medical* desires.

I was also thinking about disease-drug interactions. My first thought was 
kidney or liver disease, hoever I quickly realized the kidney disease need not 
be coded if one would just base the rules around the creatinines together with 
weight and age. OTOH liver disease is less reliably defined by the lab tests, 
and alcohol intake is sometimes also an important consideration to drug 
therapy. Likewise the possibility of getting pregnant when a female is 
premenopausal and not on contraception. There is also, in the case of 
hemophilia, a reminder of which (if coded) may be better than trying to code 
all the factor VIII and any other abnormalities.

These were causing me to realize that the presence or absence of any number of 
conditions could cause us to regard patients as in a variety of "states"

is at risk of pregnancy
has impaired hemostasis
has impaired renal function
has impaired hepatic function
has impaired cardiac function
has impaired lung function
has impaired cognitive function
has impaired mood or judgement
has impaired communication
has impaired mobility
consumes alcohol
consumes tobacco

It seemed to me easy to lose sight of these things when they might eb buried 
among a complicated list of chronic conditions which sometimes are overlooked 
when we are busy and deciding a treatment for an unrelated condition. I almost 
think that at the point of prescribing, it could be worth having any 
"positives" from such a list to be easily viewed by the prescriber.