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Re: cannot insert or paste signature file to PDF-have to stamp
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Alexander Caldwell
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Oct 03, 2007 21:59 PDT
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Jerry,
I will ask my sister in law in more detail exactly what the Blue Cross lady wanted to see as it pertains to the EMR. I believe you are right, there are many things the CCHIT would want that Blue Cross does not get into.
You are right, I have had several women who have gotten married and divorced more than once. I have one lady who I saw when she was single, then got married, divorced and remarried again, so I've had her under 3 different names since I started Tkfp. You can change the main filename, moving all the files to the new name, and then change the name in the demographic. But it does not have a way to automatically record a trail of all the former names or former demographic information. Except I just have left the old names in all the old progress notes, and then just pick up the new name with the next note, so you could see a trail of the former names by reading the progress notes.
You could use one of the backup files to extract former demographic information, but the main key filename would be under the former name if it was a backup prior to the name change.
XML by nature is sort of flat file based. But I think it wasn't really intended to be so much for storing data like a database, but rather more to allow some structure to a stream of information you would send over the network to another computer in a serial fashion and to be platform and programming language neutral. Of course, on the receiving end, you could translate the structure of the XML data into some other type of non-flat file database like SQL in a OS or programming language specific nature for storage or manipulating in some other ways, then put it back in XML again if you were going to send the data to someone over the web, especially if they are going to do something else with the info other than putting it back in the exact same program or operating system you had used for your original data storage.
Alex
Jerry Park <park.-@gmail.com> wrote:
Alex,
Hey, that's pretty cool. I suppose the BC/BS lady wouldn't know all
of those CCHIT guidlines (like all 140 pages of them) to test your
EMR, but I think Tkfp can do quite a lot of them.
When I read throught the CCHIT guidlines I saw some stuff that I
wasn't too sure if Tkfp could do. For example, they give your EMR a
test where a patient signs up with your practice, changes her name,
then becomes divorced. Your EMR is supposed to be able to show the
history of all names and all addresses that a patient ever had. Tkfp
can change names alright, but I have to go back and manually edit the
name inside the patient's /progress_notes file and /drug_refills (plus
a couple more) files if I move a patient's files to a new name. I
don't think Tkfp can track a patient's address or employement history,
can it?
Another thing I just noticed on the web the other day was a new flat
file relational database system programmed in PHP called the Gladius
flat file database. It says it's compliant with a subset of SQL92 and
a good chunk of MySQL. If you get interested to see what it's about,
here's the URL:
http://gladius.sourceforge.net/
I see the developer is part of the Drake CMS system (which I
investigated) on sourceforge, so he is apparently intending Gladius to
be a kind of "poor mans" RDBMS for a webserver. He says he doesn't
consider it to be a "professional database" and lists it's
limitations, but it appeares to me that it has a lot of SQL
capability.
It just made me wonder, Hmmm......, That's exactly what Alex has done
.....program his own flat file database system in Tcl/Tk. So maybe a
flat file system can be made a bit more robust than we all think.
Jerry
| | Jerry,
That sounds good. On another note, yesterday we had this inspection visit by
Blue Cross to my office. They check things like your charting, your office
set up, call coverage, business hours, length of time it takes to get an
appointment for physicals, length of time for more urgent visits etc. They
looked at some sample "charts" on Tkfp. I didn't tell them anything about
what EMR we used. Actually, I didn't even talk to the lady, my sister in law
showed her whatever she wanted to look at. Anyway, we passed and I don't
think she even knew we did not have some type of commercial EMR.
Alex
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