Gil,
And the thread is about problem lists and so I will repose the question Counselor: You did not follow your diabetic's problem list item with a hemoglobin A1c. Is the A1c not important?
That is my point. To you it is not important enough to list, but to another physician it is. So you decide what to list because it is your list and no one else's list. If you suffer a protracted illness and a partner takes over and he views that problem list, his first job is to either assume it must be normal, or that it's never been done, or it's been done many times and always > 9.0 and not worth posting because the patient will never do anything about it, or....
If your problem list is only for you, then you decide the relative importance of each modifier. If you alone decide, then it is difficult to make the modifiers automatic and computable. Thus, Medtuity allows just what you have now with one exception. Medtuity allows a user to hover a problem list item and add one or many modifiers to the list. These include simple point and click modifiers (acute, chronic, improving, worsening, stable) or an editbox for freehand typing. Medtuity adds the users name and date. It puts it into a table and reversed ordered by date. Thus far, it can do all that your list can do, except to see the modifiers you must hover over the list. That keeps the list clean for quick reviewing, but the modifiers are available for viewing without any click.
Regarding too many "hovers" to see modifiers on each problem list item, not every physician will want to review every problem list. Do you really need to hover over "wheelchair for weakness". Also, as long as any item in the problem list is editable, any user can make it longer and more descriptive. That alone will not make your style popular because frankly, most EMRs have an editable problem list, I would guess.
The thread's topic is the problem list and I introduced a thought with some recent anecdotal evidence that tracking a disease process, depending upon the specialty, might require not the problem list, but a longitudinal list of values. I don't think I trampled too much on your thread with that thought.
I wholeheartedly support your concept of seeing some key points (problem list modifiers, as I refer to them) in the problem list. I think that you add significant value to your charting. My problems are several fold:
- To allow this for every user requires some generalization of the problem
- Aiding the user by adding info automatically to the list would increase the liklihood of this concept growing in popularity (and actual use!)
- If it is to be used by some, it cannot be a hindurance to many others. Some might shudder at trying to read your list. There must be some way to hide the modifiers because your modifiers might be my clutter.
So I ask, what is so awkward in the "right click to modify, hover to see" concept?
Perhaps we could add a facility-wide flag under Utilities: "Alway show problem list modifiers". Would that satisfy your criteria for usability?
I appreciate your thoughts and zeal for the topic,
Matt Chase
www.medtuity.com
"Practice medicine, not paperwork" ™