Ok, Karsten et al, You know from my numerous correspondances on the progress notes stuff for a long time that it has not sat well with me, but I've never been able to articulate why.
As I'm a visual person and not understood how the underlying data was organised, I think in some ways I've mis-judged it by looking at the current attempts to reproduce what has been put in (eg emr-journal/emr-dump), felt they looked hideous, and threw up my hands in judgemental horror. Looking a bit deeper at this today, its obvious that the emr-journal is actually pretty good, and that it is only a matter of re-organising some of its display and converting it to html to make it easier to understand. The only current problem I can see with it is that it does not display separate episodes on the same day - it meshes them all in together ie all lines of say three consultations on the one day are grouped with all the Subjective lines/ the object lines/the assessment lines/the plan lines, stacked on top of one-another, rather than three separate SOAPs. Probably a mere detail of re-organisation I suspect in the display. I still don't see the point of the EMR dump perhaps you can explain it to me, and the EMR tree doesn't work on my machine. I've played with the progress notes module a bit and I think I can now understand why the data input side doesn't make sense to me, and it is around my workflow and how I would normally record notes (and how Australian GP's organise their notes - not just me - because we swap medical records continuously and we all record things in a very similar manner. At one extreme of a medical records system you would keep only free text and the system would be intelligent to either concurrently or later through queries, organise and present information to you in a slected manner. Eg in this system, finding all the text occurrences of 'headache' would bring up a html file listing all consultations containing that key board etc. At the other extreme you try and enforce some sort of tagging on all consultations, which is what I think (correct me if I'm wrong) you have been doing with the gnumed clinical records backend. There-in lies my difficulty. IE as many many consultations in practice are undifferentiated, and not linked, we may or may not write a summary or episode name for them, whereas the system as it stands is enforcing this for each face to face episode, and it is this I find unweildy as you unless I am mis-understanding it (if so correct me) you are enforcing the user to write a clinical note which may or may not reflect the content of the episode. Does that make sense? I've some other comments to make on the data-entry wigit itself, but will post that in a different thread. Richard _______________________________________________ Gnumed-devel mailing list [email protected] http://lists.gnu.org/mailman/listinfo/gnumed-devel
