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Re: [Gnumed-devel] another vista at abnormality/relevance flags
From: |
Karsten Hilbert |
Subject: |
Re: [Gnumed-devel] another vista at abnormality/relevance flags |
Date: |
Fri, 11 Apr 2008 15:17:05 +0200 |
User-agent: |
Mutt/1.5.17+20080114 (2008-01-14) |
On Wed, Apr 09, 2008 at 04:37:40PM -0700, James Busser wrote:
> On 9-Apr-08, at 1:35 PM, Karsten Hilbert wrote:
>> 3) No, because neither am I responsible nor am I the first
>> to see this result (and they did sign it). In which case
>> I still *can* sign if I choose to.
>
> But there wouldn't be a point... wait... I think above you are using
> responsible to denote the doctor who ordered the test.
No, I am referring to whoever is recorded as
intended_reviewer. Which most likely will still be the
ordering doctor, yes.
> I f I am neither
> of the above but the patient sees me for a related or unrelated problem
> (say in the absence of the usual GP) after the results had already been
> signed, the question is whether I somehow want to make a record of having
> seen the results.
Recording that I have seen them and incorporated them into
my clinical decision can be achieved by a free text SOAP
note if there's a real desire (say, "thanks to Dr.Busser
ordering ureic acid last week which was just above normal I
don't have to order it again today in this suspected bout of
gout"). Note that this is would not prompt me in any way to
re-sign the result particularly when I do not disagree with
your review status.
> However if there is no disagreement with what had been already entered
> for whether they were abnormal or clinically significant, I don't see the
> point of recording "I have seen those specific results and was aware of
> and agreed with the recorded interpretation"
There is no point, indeed. And we don't talk about making a
point of it either.
> however are we then going to
> document every read-activity like the review of documents by re-signing
> already-signed documents?
Surely not as I explained earlier.
> To me, the answer would be no. At most you would enter into a ***
> progress note *** something like
>
> "documents <optionally identified> and results <optionally specific
> ones> noted"
>
> if those would have been important to updating a clinical assessment.
Exactly.
This still begs the question whether there is any value in
enabling users to record differing judgements on test
results should they *wish* to. The argument that clinical
consensus should be sought and a single call of judgement
informed by possibly multiple opinions should be formed sure
sounds attractive. I wonder, though, whether there's any
multi-review use cases we don't think of.
Probably a good way forward would be to have a single
amalgamized review status per result and auto-forwarding a
note to the previous reviewer if any change to the review is
recorded thereby invoking consensus-seeking in cases of
disagreement.
Karsten
--
GPG key ID E4071346 @ wwwkeys.pgp.net
E167 67FD A291 2BEA 73BD 4537 78B9 A9F9 E407 1346
- Re: [Gnumed-devel] state of test results handling, (continued)
- Re: [Gnumed-devel] state of test results handling, James Busser, 2008/04/04
- [Gnumed-devel] Clinician call of judgement, Karsten Hilbert, 2008/04/04
- Re: [Gnumed-devel] Clinician call of judgement, James Busser, 2008/04/04
- Re: [Gnumed-devel] Clinician call of judgement, Karsten Hilbert, 2008/04/08
- Re: [Gnumed-devel] Clinician call of judgement, Elizabeth Dodd, 2008/04/08
- Re: [Gnumed-devel] Clinician call of judgement, Karsten Hilbert, 2008/04/08
- [Gnumed-devel] another vista at abnormality/relevance flags, Karsten Hilbert, 2008/04/09
- Re: [Gnumed-devel] another vista at abnormality/relevance flags, James Busser, 2008/04/09
- Re: [Gnumed-devel] another vista at abnormality/relevance flags,
Karsten Hilbert <=
- Re: [Gnumed-devel] another vista at abnormality/relevance flags, Karsten Hilbert, 2008/04/11
- Re: [Gnumed-devel] state of test results handling, Karsten Hilbert, 2008/04/15
- Re: [Gnumed-devel] state of test results handling, James Busser, 2008/04/16
- Re: [Gnumed-devel] state of test results handling, Karsten Hilbert, 2008/04/17
- Re: [Gnumed-devel] state of test results handling, Karsten Hilbert, 2008/04/18
- Re: [Gnumed-devel] state of test results handling, Karsten Hilbert, 2008/04/16
- keyboard shortcuts (was Re: [Gnumed-devel] state of test results handling), James Busser, 2008/04/17
- Re: keyboard shortcuts (was Re: [Gnumed-devel] state of test results handling), Karsten Hilbert, 2008/04/18
- Re: [Gnumed-devel] state of test results handling, James Busser, 2008/04/17
- Re: [Gnumed-devel] state of test results handling, Karsten Hilbert, 2008/04/25