I agree with Matthew here - that there is a growing amount of “out of scope” discussion.
I believe that we need to keep the scope of this discussion as targeted and restricted as possible. This topic has the potiential to become enormous in a very short period of time.
With this in mind, I have taken the liberty of editing the Wiki (appologies if I have modified or deleted comments you have made - please feel free to edit over my edits!)
what I have done:
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Deleted “tasks” and “issues” from the problem list requirement. I accept that “tasks” are important, but tasks are quite different from “Problems”. We need to keep this topic constrained and deliverable.
a. Tasks or jobs are issues which are best considered as provider centric (compared to patient centric). They also have different requirmenets re notification to others within the team (pushing information rather than viewing) and sign off (a task is signed off when complete, a problem remains a historic clinical matter. -
Added medications and tasks to “out of scope”
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Deleted an in-line comment:
a. * In the long run should aim to have medical, allergies/ADRs and non-medical ‘social’ alerts (as clinicians we often forget the non-medical socioeconomic determinants of health play a big part) ### concur, but what do you mean by “alerts” - do you mean an alerting function, or do you mean a socioeconomic or psychological or community problem that impacts patient - e.g. lives in decile 10, going through a messy divorce, lost access to children, chronically unemployed - I suspect this vagueness on my part is because we need input from non-doctor input (e.g. social work, nurse, pharmacy)
b. - Allergies are out of scope . these are more critical and should be on an their own specific alert list and these should be shared nationally.
c. - Medical history and other previous diagnoses, should be curated in a separate list. This is important but patients with comorbidites can have really longs lists. If we put a lens of things actively being worked on /monitored and tracking we will have a list that will be more useful and as a result more accurate. We also normally prioritise things and may want to focus on some of the comorbidites more so some will be on the list. -
Tidied up statements around number of lists. This question is “how many problem lists do we need?”. i.e. we may well need additional lists for allergies, social issues etc, but that is a separate discussion with separate requirements.
Deleted * 3-4 lists
i. - Medical history ( to keep track of diagnoses, severity and time made)
ii. - The “Problem list” we are are working on defining of all active tasks we are working on aka OCCAMS list
iii. - Social issues or supports available/unavailable to patient (e.g patient has no means of transport and has difficulty getting to appointments, homless etc) -
Added a name option “medical conditions and procedures”
Good to see the lively discussion!