Re: [Health] How to manage change in the medication dose and its admin times of hospitalized patient

[Luis Falcon]

Dear Khurram

On Fri, 9 Jun 2017 11:29:34 +0500
Khurram Shahzad <address@hidden> wrote:

> Dear All,
> 
> After successful implementation of GNU Health, we are being asked
> about some advance questions by our health professionals. One of
> those questions is how to best manage the change in the dose of a
> medicament of a hospitalized patient? Apparently, following options
> are available:
> 
> 1. Update the current record in the medication plan for the
> medicament. The problem in this option is that the previous dosage is
> lost and also we can not trace when the dose / admin times were
> changed in order to see the compliance by the nursing staff.

True.

Best would be to include a O2M model to record the changes on the
particular med. (similarly to what we do to record the changes on the
person Domiciliary Unit or bed transfer history)

You might want to explore enabling historization at Tryton level (set
_history attribute to True), so it will record the changes. I'm not
very fond of this method since it does not take well into account
relational fields.

> 
> 2. To keep the history, mark the current record as 'Discontinued' and
> add another record for the same medicament with changed dose and
> admin times. The problem in the approach is the doctors have to
> re-enter the same medicament again and also there will be many
> records for the same medicament.

I would not use this option. The "Discontinued" flag is used mostly to
notify a permanent stop on the particular drug, not for modification on
the doses. It would lead to confusion.

> 
> Any thoughts, please.

I propose having a model that records the changes, and contextualizing
them (reason for change, health prof that did the change, etc.. )

Hope it helps !

Bests
Luis

>