bugGNU Health - Bugs: bug #63535, Unused field notes_complaint

 
 

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bug #63535: Unused field notes_complaint

Submitter:  Mathias Behrle <yangoon>
Submitted:  Fri 16 Dec 2022 09:41:07 AM UTC
   
 
Category:  Functionality Severity:  3 - Normal
Item Group:  None Status:  Confirmed
Privacy:  Public Assigned to:  meanmicio
Open/Closed:  Open Release:  4.1.0
Module:  health Component:  Hospital Management

Mon 19 Dec 2022 01:30:49 PM UTC, comment #3: 

Hi, Mathias!

comment #2:

>
> I agree that standards should be adhered to, but sometime standards seem not to be esatblished by real life work.
>


True. Agree many times "standards" are made by bureaucratsthat want to get the clerical work done by health professionals, and do not have a correlation with the medical, day by day practice.
 

> From https://www.aapc.com/blog/42585-chief-complaint-required/
>
> "If the patient record does not reflect a chief complaint, the service is either:
>
>     A preventive service; or
>     Unbillable.
> "
>
> So in the case of e.g. a Corona immunization there is nothing in the CC and it is difficult to write something into HPI, because there is no illness. But yes, a standard is a standard... ;)


Yes. GNU Health has medical visits of type:
- Well-child visit
- Well-[woman|man] visit
- Chronic / followup

In those cases no need for CC or HPI. In any case, they're optional.

For immunizations, best is to use the vaccination model, not the evaluation, although you could use both.

Bests
Luis
 

Luis Falcon <meanmicio>
Group administrator
Sun 18 Dec 2022 08:09:44 PM UTC, comment #2: 


comment #1:

> Thanks, Mathias!
>
> Indeed notes_complaint is obsolete field. We'll remove it on 4.2
>
> The Chief Complaint (CC) and History of Present Illness (HPI) are part of the standard evaluation record. They go together in the "SOAP" note.
> The CC is a very short annotation using the patient's own words, while the HPI is a thorough description of the problem / condition.  We can put a tooltip in both fields.


I think tooltips are a good idea to explain the intended usage of those fields.

I agree that standards should be adhered to, but sometime standards seem not to be esatblished by real life work.

From https://www.aapc.com/blog/42585-chief-complaint-required/

"If the patient record does not reflect a chief complaint, the service is either:

    A preventive service; or
    Unbillable.
"

So in the case of e.g. a Corona immunization there is nothing in the CC and it is difficult to write something into HPI, because there is no illness. But yes, a standard is a standard... ;)

Cheers,
Mathias





Mathias Behrle <yangoon>
Fri 16 Dec 2022 08:38:03 PM UTC, comment #1: 

Thanks, Mathias!

Indeed notes_complaint is obsolete field. We'll remove it on 4.2

The Chief Complaint (CC) and History of Present Illness (HPI) are part of the standard evaluation record. They go together in the "SOAP" note.
The CC is a very short annotation using the patient's own words, while the HPI is a thorough description of the problem / condition.  We can put a tooltip in both fields.

The idea behind the current form is that the very first page on the notebook, should provide a good summary idea about the whole evaluation.

The rest of the pages dive into details of the evaluation (clinical, mental, procedures, ... ).

Hope this helps!

Cheers,
Luis


Luis Falcon <meanmicio>
Group administrator
Fri 16 Dec 2022 09:41:07 AM UTC, original submission:  

On model PatientEvaluation there exist the fields

    chief_complaint = fields.Char('Chief Complaint', help='Chief Complaint',
                                  states=STATES)
    notes_complaint = fields.Text('Complaint details', states=STATES)
    present_illness = fields.Text('Present Illness', states=STATES)
    evaluation_summary = fields.Text('Clinical and physical', states=STATES)

1)

Field notes_complaint is currently unused and could be therefore be removed.

However I would favor a migration of field present_illness to notes_complaint for following reasons:

- not each complaint is an illness from a medical and human perspective, thus notes_compliant provides a less biased version of the intended use of the complimentary field to chief_complaint
- notes_complaint is the logical addition to chief_complaint, if chief_complaint shall make a sense


2)

On a further note I would even find it worth considering if field chief_complaint could not be a function field syndicating the first line of field notes_complaint (or present_illness depending on which field will be used) in the pattern used in e.g. Tryton sale or purchase modules:

    @fields.depends('notes_complaint')
    def on_change_with_chief_complaint(self, name=None):
        return firstline(self.notes_complaint or '')

I think this would simplify the input for the user and provide all complaint related information in a single field.


What do you think?





Mathias Behrle <yangoon>

 

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    Follow 4 latest changes.

    Date Changed by Updated Field Previous Value => Replaced by
    2022-12-16 meanmicio StatusNone Confirmed
        Assigned toNone meanmicio
        ReleaseNone 4.1.0
        ComponentNone Hospital Management

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