Re: [Gnumed-devel] encounter edit before final save

[Jerzy Luszawski]

Monday 11 August 2008 20:28:10 Rogerio Luz napisał(a):
> ok Karsten I see your point, but a CLOSE CONSULT button would really improve
> the way a clinician would look at the hole story ...
> 
(...)
> > That can't be true simply because there is no explicit way of "closing a
> > consult". A consult is only
> > ever closed implicitely - by starting another one and considerung the new
> > one the current one.
> >
> > Chronicity defines consultations.

(...)

> > It will not close the encounter. It cannot, because the encounter can well
> > be carried on
> > by another provider. We have this every day. Patient comes in, sees doctor
> > in exam room, is
> > transferred to monitoring unit for a while, sees radiology nurse for xray,
> > back to monitoring,
> > sees doctor again, transferred to septic operating theater - all in the
> > same encounter in the
> > course of, say, 3 hours. During normal office hours. Happened to me just a
> > few hours ago.

Karsten - you just described similar scenario as Rogerio. I could provide my 
own examples. So it is common to many (if not all) of us.
But there must be some person (= provider) who decides to end the encounter and 
sends patient home (or to the hospital, etc.). I would like to review all 
procedures, test, recommendations before letting patient go. This is the moment 
to close an encounter. 

Don't you save/print/give to the patient any report at the end of consultation? 
I do, so sometimes I would like to add or change something in the progress note 
entered at the beginning. This way I can print it and it makes sense. If I 
print a list of progress notes for one encounter, where latter corrects the 
former, it becomes cluttered and hard to read. Here we come to the need of 
editing them, which was the primary topic of this thread. 

From the legal point of view AFAIK you must not modify patient data after 
discharge. Also, while billing is not the issue for me at the moment, I could 
not request billing until I finish the consultation, so there are reason to 
mark encountered "closed" explicitly. From this point of view, "closing" means 
marking it "read-only". Until it is "closed" you are free to add data like now, 
and it would be nice to be able to change data as it is planned.


Jerzy