[Gnumed-devel] Parsing Data--Data Entry /// Encounter Wizard /// GUI Design

[Michael Bonert]

Sian ([Gnumed-devel] RE: Gnumed-devel Digest, Vol 7, Issue 18 --- Jun 19,
2003):
>so a lazy way with Oscar would be to have
>some sort of reviewer to classify the free text entry , automated or
>human (does Michael know of such a design in Oscar?)
David did talk about the parsing of text in the encounter window.  He said
it is very tough (to do by computer) -- 'cause people use different
conventions (e.g. one doctor may abbreviate blood pressure as "bp" another
as "BP" a third as "b.p.").  I don't have the impression the OSCAR team is
attempting to write a text parser.

---
I tend to think the text-window encounter entry-box approach isn't a good
idea and that physicians really do have to parse the information they feed
the computer.  Writing computer code to parse information is IMHO
difficult at best and dangerous at worst; words and abbreviations often
depend on the context.

Generally, I don't think you get something for nothing.  IHMO physicians
have to change a bit the way they take notes/recorded medical
information--that will be pain in the short term (for those used to other
ways)... gain in the long term.

---
One thing I like about the 'Encounter Screen' in OSCAR (see attached
screenshot) is that the essentials are all on screen at once.  The
'Encounter Screen' consists of 6 data entry boxes:
1. social history (reads: Smokes 2 ppd)
2. family history
3. medical history
4. on-going concernss (reads: Anxiety)
5. reminders
6. text-window encounter entry box (a running encounter summary/notes) --
roughly equivalent to GnuMed's "Scratch Pad" in the "Clinical" tab.

In GnuMed's GUI it is more difficult to gain an overview (without flipping
between views).

---
In GnuMed a person that isn't familiar with the different modules/elements
has to spend some time figuring out where for example the prescription
dialog is if they think a patient needs antibiotics or... how to enter a
person's blood pressure if they are doing a physical.

I think it might make sense to examine the possibility of building a few
wizard type interfaces to ease the transistion.

---

IMHO all the text in the 'Encounter Screen' ought to be generated
automatically--from information entered in entry forms.

If I were to use OSCAR's GUI design as a starting point... I'd just add a
7th frame that covers the bottom part of frame #6 (refer to
screenshot)--one that can be a number of different entry forms and is used
to enter the data into the other frames.  The entry forms would look
similar to the upper portion of the GnuMed ones in the Clinical tab --
"Measurements", "Family and Social History", "Immunizations" et
cetera... and a 'Scratch Pad' function.

I think that it is advantages if we engineer the GUI to display an
on-screen summary while the physician is entering data.  Doing this would
allow the physician to see what forms they have used (what information
they have entered) during the encounter.

---
I think a narrative/summary is important; prescriptions, for example,
don't tell the whole story as many drugs are prescribed for different
conditions.  Also, I imagine that a new problem may be treated with a
'wait-and-see' approach... but later dealt with a Rx (this sequence of
approaches would appear in a clinical summary--in GnuMed I'm not sure the
connection would be so clear with the GUI as it is).

---
I'm starting to respect OSCAR a lot more... there are a good number of
things I think they have done right.

Michael

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