Social web of the patient

In Primary Care tracking the social web of the patient is of good value. In fact, the very definition of it includes "managing/coordinating the medico-social patient affairs".

A patient has relations to many other people:

  • his primary GP(s)
  • secondary doctors
    • within the praxis, maybe temporary, as part of a care team
    • external to the praxis, consultants, GPs at the place of work, etc
  • nurses
    • home wound management
    • within the praxis
  • dieticians, physical/oocupational therapists, other -ists
  • family members, spouses, significant others
  • medico-legal representatives

(note that not necessarily all of those need to be explicitely modelled)

The GNUmed person concept stipulates that all of the above - at least with regard to their human identity - be managed as dem.identity rows in the database. There will be a need to extend those attributes with properties specific to the purpose. We need to establish

  • private relationship management (family etc)
  • professional relationship management (providers)

Basically we need to establish roles per relationship.

A person in the database will become an external professional virtue of being linked to an organisation record.

For that we'll have to set up handling of "generic" organisations. Not all levels of all types of organisations can be satisfactorily handled in a database schema so we probably want to resort to a three-strikes structure:

  • the logical definition of an organisational entity, a class if you will
    • this will include things like the "main" name of an organisation, say, Notfallzentrum Thonbergklinik - whatever it takes to uniquely distinguish (well, within reasonable constraints) this organisation from any other
  • the "branches" of an entity, instances of the class, so to speak, IOW, where/how this organisation manifests itself
    • several branches can exist per organisation
    • if need be there could be some indication of the status (head branch, headquarters etc) attached to each branch but
    • no explicit tracking of hierarchial sub-relationships of branches amongst each other needs to be attempted IMO
    • in the many cases of single-location GP practices there will be only one "branch"
    • such branches will include things like
      • locations (links to an address record)
      • staff (links to persons with roles)
    • the computationally most important branch will be the local GNUmed praxis from which will flow things like
      • local staff
      • praxis location
      • GNUmed client timezone
  • the linking of persons to branches or (and ?) organisational entities will make them staff thereof

Then links between persons as patients and persons as staff can be established together with a role for (or type of) said relationship. GUI management of this linkage would happen in one or several new pages of the demographics plugin's notebook.

Organisations and their staff would be managed under Master data from within the GNUmed menu.
Topic revision: 18 Dec 2009, KarstenHilbert
 
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