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Donald - I'm going to post this to the L since there are others involved in 
this discussion and hopefully Meditech will pay attention.

A relational database would not be set up as the NUR.NOTE indexes are set up, 
and additionally the bulk of Meditech indexes are not set up in this manner.  
Suppose this (and the situation gets worse as notes are more robustly used):

1)  You have 10,000 patients who have 1 or more notes
2)  You enter 5 notes for today on 5 different patients
3)  You write an NPR report to list notes for a specific date

Seems reasonable, right?  And since you are interested in notes for a 
particular date you use the index note.x - the NPR name when you do a lookup on 
the index field is nur.note.date.x - and on your screen you have a prompt PRINT 
NOTES FOR DATE: - and the user enters T and runs the report.

The note date index physically is :NOTED[aa,nod,etc] - where aa is the patient 
urn, nod is the date of the note, and etc are subsequent subscripts.

When you run this report the primary (first subscrpt) loop will be on aa.  This 
means that the report will look at all 10,000 patients in the index first, and 
then, for each patient, it will look at the date.  This is really not an index 
at all!  It amounts to the same thing as running through the entire main 
database of patients (the main database is ?NOTE[aa]) and doing a check on date 
EQ mydate (the date I entered to search for).  The same is true for the 
category index.

Had Meditech coded this index correctly it would have been :NOTED[nod,aa,etc].  
In this case - when the report is run - it would look at only 5 records rather 
than 10,000 records.  That's a significant difference.  And, I would offer, the 
programming/database concepts applied are amateurish.


>>> "Stewart, Donald" <[EMAIL PROTECTED]> 05/17/06 3:15 PM >>>
The notes are all tied to individual patients. So patient is the primary
key and depending on the index, category, etc. are secondary, tertiary,
etc. keys. A relational database would actually be set up similar. I
have written several reports in NUR.NOTE and the indexes seem to work
fine. Use the index that has the field(s) you want to select on or sort
on closest to the beginning. Just having a field indexed makes a
tremendous difference. I have many reports that there are suitable
indexes and they take 'forever' to run, especially in BAR and ABS.

Donald 

-----Original Message-----
From: Robert White [mailto:[EMAIL PROTECTED] 
Sent: Wednesday, May 17, 2006 2:13 PM
To: Stewart, Donald
Subject: RE: [MEDITECH-L] NUR.NOTE

Donald - given a note category and date range I'd like to print out
patient notes (new page for each patient).  The indexes all start with
patient (aa).  So to get at the selected data (category and date range)
I would have to loop through every patient who has had notes.  The
indexes (NUR.NOTE) should really be turned around:

For date index ->  [date,aa,etc]  instead of [aa,date,etc] For category
index -> [cat,aa,etc] instead of [aa,cat,etc]

In my view this is a major design flaw.  I have looked all over and
there does not seem to be an appropriate index.

>>> "Stewart, Donald" <[EMAIL PROTECTED]> 05/17/06 12:55 PM >>>
Hi Robert,

What are you trying to do?

Donald F. Stewart
Sr. Programmer Analyst
Upson Regional Medical Center
801 W. Gordon St. 
Thomaston, GA  30286
(706)647-8111 x1696
[EMAIL PROTECTED] <mailto:[EMAIL PROTECTED]> 

 

-----Original Message-----
From: [EMAIL PROTECTED] 
[mailto:[EMAIL PROTECTED] On Behalf Of Robert White
Sent: Tuesday, May 16, 2006 9:18 AM
To: [email protected] 
Subject: [MEDITECH-L] NUR.NOTE

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I am looking at the index files for NUR.NOTE and they all begin with
patient (aa) as the first subscript.  This means that for a particular
date range or note category one would have to loop on all the patients
who have notes - not a very good design.  Is there some other index I
have missed?  I did check NUR.PAT and I did not see anything there.


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