[Gnumed-devel] Inputting substances for as-yet-undefined indications

[Busser, Jim]

Hi,

Can we add, inside the Medication (Substance) "Add" dialog, the ability to add 
a new problem?

Issues:

1. Sometimes, when seeing a new patient, or when updating the medications of a 
patient who has gotten care elsewhere, it is in the process of inputting 
medications (substances) that the not-yet-existing disease episode is learned 
about.

2. I am further thinking that if a patient happens to consume a lot of 
grapefruit juice, which is relevant to drug interactions, or if the patient 
consumes 2-3 servings of alcohol daily, which might be important if they would 
be prescribed sedatives or metronidazole, GNUmed does not allow these 
substances to be inputted except by first having to create a (problem) 
"episode" to which to then associate the medication (substance).

Options:

1. Inside the Medication (Substance) "Add" dialog, shorten the space allocated 
to the Episode and provide a button 'Add problem'

2. Figure out whether it should be permissible to input a substance without 
having to associate it with a reason. Should we remain required to create a 
fake problem for every substance, even substances that we are not ourselves 
prescribing? Sometimes we lack the reason why some other clinician has started 
the patient on a medication. We should not be guessing. It is both valid, and a 
practical clinical necessity, to be able to list a patient as taking a 
substance even when we do not know why they are taking it. Too often, the 
patient is not even sure.

If the patient asks me to re-prescribe (to "refill") something that has been 
provided by someone outside the praxis, it would be better that I can see in 
GNUmed that no-one in the praxis has yet figured out exactly why the patient is 
taking this substance. I would be more likely to refuse to provide it in this 
circumstance, than if someone else in the praxis estimated (absent having 
proper information) what that external episode might be.

-- Jim