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From: | James Busser |
Subject: | Re: [Gnumed-devel] Re: Can�t change the dates of the encounters |
Date: | Fri, 05 Sep 2008 01:48:23 -0700 |
On 5-Sep-08, at 12:40 AM, Karsten Hilbert wrote:
Data in GNUmed links to two grouping principles: episode: this is the semantic grouping encounter: this is the chronological grouping
Encounter groups chronologically by date & time of the encounter, does it not, which means according to the date and time of the changes being written into the EMR. This permits a chronologically later encounter to record information about things that happened even before the previous encounter, and so while the *record* is chronological, the storyline of the patient illness becomes disrupted. This is what I meant when I indicated that encounters may need some second dimension of time (clinical "attributed" time) to permit a clinically-meaningful sort.
I recognize that there are multiple clinically-meaningful time perspectives:
- the timeline of the patient's illness, which is sometimes only figured out and pieced together after-the-fact - the timeline of any findings, which are sometimes only entered after-the-fact - the timeline of the recording of information, and of signing, and of any edits to these, in the EMR
Episodes, in addition to their top-level semantic grouping, also have (within their top-level) a chronologic order among episode which I expect is mangeable.
The challenge may be to display entries within episodes in clinical chronological order as opposed to when-entered-and-audited chronological order.
Does this well-capture the conundrum?
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