Hi all. I am developing for a clinic that has different levels of clinicians. For example, there are times when a LMSW moves to an LCSW. When the user profile is changed, it changes this title for all encounters that the person has done in the past. This is not good. Other than creating a whole new user when someone changes roles, is there a way to preserve this?
Another scenario is when a user changes their last name. Has anyone been asked to handle this kind of issue?
I’d say no Dan. Once that user is save in anything, most all lookup’s will use their username or uid. I put in a fix awhile back for if Facility changes it will update users profile. However, I don’t see an issue with pass encounters as long as the user of record for the encounters aren’t changed. Their credential should not be an issue.
Yes, recently. Did not look into.
A possible fix to this would be introducing point in time architecture. This would definitely require some planning and some overhead on the queries but it would solve the issues at hand
From what I am reading and what little I know about the way data is stored. This suggestion may not help. The credentials of a provider are not stored with the document. It is simply looked up when producing the document.
In my peewee brain, I could only think of writing a point in time script. Save the credentials outside the users table and associate the credentials to the user (of course). Then in the document script, use the time when which credential would be used to generate a document. That way using the documents date creation, the right credential can be selected to display on the document.
It’s just my two cents. I’m very low tech.
Not a clinician but is this really necessary ? Where is this regulated that a providers past credentials must become part of chart history? If necessary to do this then maybe add the appropriate credential to a column in the encounter itself. Imagine doing date range compares lookup every time a provider is needed in reports or views…Don’t know how many places provider credentials are reported but, still!
Every legal document I sign as a nurse must include my credentials. But if advance my professional licensure from RN to APRN and accidentally sign RN instead of APRN for something out of the scope of the RN licensure I’ve committed fraud and theoretically legally signed that I committed a felony 
Proper indexing shouldn’t be a problem. Even dumping data to an archival table would be viable. I’m a big fan of PIT architecture
I have to bow to you folks that are the medical professionals on stuff like this.
No bowing needed, healthcare is a team sport! 
Okay, a curtsy then 