Molly;
The relationships are usually for next of kin. We have veterans who are
parents, grand parents, and children of parents who are next of kin. The
mother and father-side relationships can be implied from their records.
Step-relations and other variants can be implied from some very simple
multiples. Relationships can change with time and circumstance, like the
song about "I am my own Grandpa". Such relationships can be depicted, but
they are maps which require processing time to evaluate. These series of
relationships (finding the maternal great-grand parents with cancer) are
easier to build and find in hierarchical structures (as long as the depth is
kept reasonable). Shallow is better.
One thing to remember about the OYO technology, there is never a claim for
performance. In this example, a Patient Record / Object is a link in a
chain. The query is but the method for walking that chain. The Object can
hold the relationship of parents, spouse(s) with a multiple of children
relationships. Each person needs only point to their immediate
relationships and then the extended relationships are implied by walking the
linked list of individuals who match the query.
Best wishes; Chris
----- Original Message -----
From: "Dr Molly Cheah" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Thursday, November 25, 2004 10:50 PM
Subject: Re: [Hardhats-members] does VistA need a PATIENT FAMILY file?
> Just curious to know what VistA use this relationships list for -
> clinical relevence, administrative convenience or socio-economic
> purposes. Having paternal and maternal distinctions will provide more
> accurate clinic relevence if such relationships are referenced to
> certain types of diseases.
>
> Molly
> Cameron Schlehuber wrote:
>
> >FYI these are the relationships that VistA supports in the PATIENT
RELATION
> >file:
> >
> > SPOUSE
> > SON
> > DAUGHTER
> > STEPSON
> > STEPDAUGHTER
> > FOSTER SON
> > FOSTER DAUGHTER
> > SON-IN-LAW
> > DAUGHTER-IN-LAW
> > BROTHER
> > SISTER
> > STEPBROTHER
> > STEPSISTER
> > BROTHER-IN-LAW
> > SISTER-IN-LAW
> > FATHER
> > MOTHER
> > STEPFATHER
> > STEPMOTHER
> > FATHER-IN-LAW
> > MOTHER-IN-LAW
> > GRANDFATHER
> > GRANDMOTHER
> > GREAT-GRANDFATHER
> > GREAT-GRANDMOTHER
> > GRANDSON
> > GRANDDAUGHTER
> > GREAT-GRANDSON
> > GREAT-GRANDDAUGHTER
> > NEPHEW
> > NIECE
> > UNCLE
> > AUNT
> > OTHER
> >
> >-----Original Message-----
> >From: [EMAIL PROTECTED]
> >[mailto:[EMAIL PROTECTED] On Behalf Of Dr
Molly
> >Cheah
> >Sent: Thursday, November 25, 2004 3:27 PM
> >To: [EMAIL PROTECTED]
> >Subject: Re: [Hardhats-members] does VistA need a PATIENT FAMILY file?
> >
> >This is what we call "lifetime health plan". It's regularly done in
> >child health clinics and ante-natal care clinics. But once clinical
> >conditions change course, it will be more involved to "track" those
> >patients unless the system provides for the "gate-keeper" or the primary
> >care co-ordinator of that particular individual. That essentially mean
> >that a primary care provider is responsible for the health of a defined
> >population group, a system seen in Canada,UK.. but not the US.
> >Organizing patients into family folders is not difficult - just needs to
> >define "head of family" and you can view all family members' summary
> >sheets for example. We had done this for our PrimaCare system which is
> >designed for family practice in Malaysia.
> >
> >Molly
> >Joseph Dal Molin wrote:
> >
> >
> >
> >>....how about some form of inheritance....
> >>
> >>For example, a personal one, I was diagnosed with colon cancer a few
> >>years ago....I was lucky and we caught it early....now I have regular
> >>colonscopies....digressing a micron and a plug for colonoscopies...GET
> >>ONE if you are in the age group or have had relatives with colon
> >>cancer.....believe me when you have had the big C colonscopies become
> >>something you look forward to! My apologies to our US
> >>neighbours....forgot you are having Thanksgiving dinner today....
> >>
> >>Back on track... so what would be great would not only be the
> >>reminders for me.... but that my children's medical record be
> >>automagically flagged with a "birthday present" at the appropriate
> >>time in the future so they will be screened too. Their records would
> >>"inherit" relevant protocols, reminders etc. that are related to
> >>genetically inherited problems etc. We shouldn't have to remember this
> >>stuff ....
> >>
> >>J.
> >>
> >>
> >>
> >>Benjamin Irwin wrote:
> >>
> >>
> >>
> >>>Dr Zimmer,
> >>>
> >>>All I can say for now is, wow, this is a huge idea that would be
greatly
> >>>useful.
> >>>
> >>>My daughter is currently at Oxford University studying Medical
> >>>Anthropology
> >>>and we talk about following the habits of people groups as related to
> >>>general health. Your question brings it down to life with following
> >>>family
> >>>groups.
> >>>
> >>>I will be giving your question a great deal of thought.
> >>>
> >>>Thanks,
> >>>
> >>>Ben
> >>>
> >>>-----Original Message-----
> >>>From: [EMAIL PROTECTED]
> >>>[mailto:[EMAIL PROTECTED] On Behalf Of
> >>>John Leo
> >>>Zimmer
> >>>Sent: Thursday, November 25, 2004 1:42 PM
> >>>To: Hardhats
> >>>Subject: [Hardhats-members] does VistA need a PATIENT FAMILY file?
> >>>
> >>>
> >>>Ok,
> >>>For a diversion from the heavy lifting going on over in
> >>>vista-open-source...
> >>>And for something to think about while digesting the turkey...
> >>>
> >>>I am a <<family>> doctor, ok?
> >>>VistA has never seemed particularly family oriented to me. (Perhaps
> >>>because most veterans do not bring Mom and all the kids along for
> >>>their health
> >>>care.) So, how might we address the task of capturing and using (for
> >>>pleasure,
> >>>profit and the good of mankind) a patient's family ties?
> >>>I do not mean existing next-of-kin fields. I want structured linkages
> >>>among patient records. For example, when one of four children comes
> >>>in for immunizations, the system might be able to present more than
> >>>just Johnnie's record and <<his>> currently needed shots. I want to
> >>>be presented with the fact that MaryAnn missed her last polio update,
> >>>and that Daddy is probably past due for a tetanus booster, three
> >>>years ago. And it might be good to
> >>>know that grandpa is past due for his colonoscopy.
> >>>It is the sort of thing that could get out of hand very quickly, of
> >>>course. But the ability to treat family groups rather than just
> >>>individuals is one
> >>>of the few things that keeps me convinced that I am doing some good
> >>>in the
> >>>world.
> >>>
> >>>OK, so the question is what would one add to VistA's patient records to
> >>>allow such linkages within patient records? I don't want a kludge,
> >>>but something elegant.
> >>>Thanks to all,
> >>>JohnLeoZ
> >>>
> >>>Healthcare, a human right.
> >>>
> >>>
> >>>
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