On Sun, Jun 26, 2005 at 11:18:51AM +1000, Richard wrote: > I've got your 2.4 code running successfully in 2.6 now Good.
> and I will gradually > change the non-critical gui-code which prevents various windows from running > under 2.6 to make it compatible over the next week or so Thanks. > Latest CVS + running gnumed via: > > sh gm-0_1-from-cvs.sh > > I've a question - one I've always been confused about, however as the > functionality of this program seems atrocious, I notice that you seem to be the only person on this list using derogatory terms when characterizing work someone else has done. > perhaps if someone will help > me understand how it is meant to function and what things mean, Sure, we'll have to explain that many times over. An attempt is in the Wiki in the User Manual but it needs improvement. Please do read it and suggest amendments. http://salaam.homeunix.com/twiki/bin/view/Gnumed/BasicEmrConcept I am improving it as we speak. > I may be able > to help improve it for the ordinary user. That would be helpful. > 1) IN my attempts to use it I'm confronted by an active problem list, which > contains both annotated 'health issues', and 'episodes' - what is the > difference and conceptually just how is one meant to use them The important concept or "thing" is the episode. The episode is what most would think is a problem in the problem list. An episode of illness is a circumscribed span of time in which a problem with the patient's health is dealt with. The problem is - so to speak - the name or label of that episode. OTOH, health issues are facts about the patient's health. Now, there are thousands of such facts. And most of them are only of temporary interest and importance. However, some facts are of long-term importance and significance. Such facts are often categorized into past medical history, operations, etc. In fact, we also count past medical history items as health issues. However, our definitions is a bit more allowing: "A health issue is a fact about the patient's health that is of long-term significance". In most cases this will be something that amounts to a chronic illness/disability the patient suffers from. Perhaps an example may help: Patient has coag level (Quick/TPZ ?) of 20% - clearly a fact of poor health (unless intended) - may be an "active problem" - an episode name - as long as we don't have an explanation ethyl-toxic cirrhosis of liver - clearly a fact about the patient's health of long-term significance, likely the cause of the above - episode can now be renamed to "liver cirrhosis/c2h5oh" - it may be turned into a health issue if desired Eventually it turns out that in this patient it is very hard to get the coag levels under control. First this may become prominent as - an episode of "decompensated coags factors" - later to be recognized as part of the health issue "liver cirrhosis/c2h5oh" - but perhaps found to be important and frequently enough to warrant it's own health issue "poor coag controllability" or demanding an amendment of "liver cirrhosis/c2h5oh" into "liver cirrhosis/c2h5oh/poor coags" This is about evolution of case knowledge. Now, the list of active problems show *open* episodes plus *clinically relevant* health issues. Both are clearly "problems" with the patient's health. The annotation in the problem list shown in the progress notes section only serves to make it less suprising when an episode selector will be presented and when not -- once you understand the concept. > 2)I note that double clicking on something referenced as a 'episode', brings > up a new tab to allow the entry of clinical notess As we want it. > 3)I note that double clicking on a health issue, brings up a prompt asking > for > a tag for an episode ?? don't understand the sense of this. Clinical data can only ever be part of an episode. If you double click a health issue you either want to select an existing episode or create a new one within that health issue. That's what this widget is for. If you want an unassociated new tab use the appropriate button at the bottom left. > in any event - all these - health issues + episodes seem to end up on the > same > active problem list? No, only those that *are* problems. Eg neither closed episodes nor the (currently) clinically not relevant episodes. > Any attempt to review the patients progress notes anywhere dosn't seem to be > very easy - eg the EMR tree is ambiguous How is that ? > and hard to navigate How ? I do agree the tree has quite some room for improvement. It isn't yet the best tool for answering "What happened during the last 3 encounters ?" and such. > the EMR Journal which seems to be the best It is a) very ugly, b) totally ignores the benefit one could draw from grouping into *at least* episodes, c) does not display when an encounter crosses the date boundary. It's main purpose in life is to allow doctors to get some idea of the EMR in a view they used to see. > isn't updated unless you close down the > program and re-load it. This issue is still unresolved. No one came up with a solution so far. > the EMRDUMP ?what is the purpose of this??? The EMRDUMP is not part of the release 0.1. What are you referring to ? > Also saving an episode took an inordinately long time. Which number do you attach to "inordinately" ? > BTW, I'm not trying to be picky about this. I genuinely want to help and > understand this, otherwise I wouldn't have spent nearly two hours of my > sunday morning attempting to see how this works. I know. I am truly thankful that you do put up with my "explaining away" your concerns :-) Karsten -- GPG key ID E4071346 @ wwwkeys.pgp.net E167 67FD A291 2BEA 73BD 4537 78B9 A9F9 E407 1346 _______________________________________________ Gnumed-devel mailing list [email protected] http://lists.gnu.org/mailman/listinfo/gnumed-devel
