Doctors Notes

---

The doctor's notes will be stored in the database as native xml. They will validated against a schema

The notes are divided into sections. The first section is a narrative account of the visit. The second section encapsulates various concerns. These concerns include

• The side effects of the medication
• The current state of the depression
• the general health of the patient
• Any other concerns

Each type of concern can have multiple entries in the document, and each individual concern should be enclosed in seperate elements

In addition there is a section containing directions for the patient and/or the doctor. Each direction should be enclosed in seperate elements.

All elements must appear in sequence at least once, though they can be left empty.

Here is the xml schema for the doctors notes that will be stored in the database:

<?xml version="1.0"?>

<xsd:schema xmlns:xsd="http://www.w3.org/2001/XMLSchema" 
targetNamespace="http://www.soundlakehospital.org/doctornotes" 
xmlns:nts="http://www.soundlakehospital.org/doctornotes" 
elementFormDefault="qualified">

<xsd:element name="doctornotes">
 <xsd:complexType>
    <xsd:sequence>
	<xsd:element name="narrative" minOccurs="1" maxOccurs="1"/>
        <xsd:element name="concerns">
	  <xsd:complexType>
	    <xsd:sequence>
		<xsd:element name="sideeffects" minOccurs="1" maxOccurs="unbounded"/>
                <xsd:element name="depression" minOccurs="1" maxOccurs="unbounded" />
		<xsd:element name="health" minOccurs="1" maxOccurs="unbounded"/>
		<xsd:element name="other" minOccurs="1" maxOccurs="unbounded" />
	   </xsd:sequence>
	 <</xsd:complexType>
	</xsd:element>
        <xsd:element name="directions" minOccurs="1" maxOccurs="unbounded" />
   </xsd:sequence>
 <xsd:complexType>
</xsd:element>
</xsd:schema>

Here is a sample report in its raw xml form.

<?xml version="1.0" encoding="utf-8" ?>
<nts:doctornotes xmlns:nts="http://www.soundlakehospital.org/doctornotes" 
xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
xsi:schemaLocation="http://www.soundlakehospital.org/doctornotes notes.xsd"  >
   <nts:narrative>
	I met with the patient for 30 minutes this afternoon. After the nurse
 had taken the blood pressure and other vitals, I asked how the patient was 
doing on the medication and if she had any concerns. The patient did admit to 
feeling "flat." I asked what she meant by that term and she explained that 
she wasn't feeling particularly depresseed, but that all of her emotions 
seemed to be leveled. Things that used to make her happy weren't effecting 
her any more. 
   </nts:narrative>
   <nts:concerns>
	<nts:sideeffects>
	the patient said she was having some trouble sleeping
	</nts:sideeffects>
       <nts:sideeffects>
	the patients appetite is down, though not gone. She says she isn't 
enjoying food as much as she used to
       </nts:sideeffects>
	<nts:depression>
	  The patient said she is feeling less depressed but not happy
</nts:depression>
	<nts:depression>
	The patient said she has had no thoughts of suicide
	</nts:depression>
	<nts:health>
	the patients general health is good
	</nts:health>
	<nts:other>
the emotional flatness concerns me. Perhaps the base dosage is too large.
</nts:other>
   </nts:concerns>
   <nts:directions>
	Continue taking the medication
   </nts:directions>
   <nts:directions>
	Call with any concerns
</nts:directions>
  <nts:directions>
	Schedule and appointment for next month
</nts:directions>
  <nts:directions>
	I will check on the dosage
</nts:directions>
</nts:doctornotes>

The narrative and directions sections of the doctor's notes will be available to be viewed by the individual patient. The concerns section will only be visible to the researchers and the doctors

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