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Make "encounter document" the center of the model + index the properties and obs of this
Does encounter become the center of the model?
Currently, observation & orders are the "key" pieces of information.
An encounter-centered model would center around "documents" about events that happen to the patient.
Bharat: If encounter were at the center, and was a document, you could index things like chief complaint, diagnoses, drugs. This could make queries across multiple of these a lot easier. (Today it's hard because of lots of nested joins.)
Burke: "documents are fine as long as we maintain the reusability and codification/discoverability of discrete data elements"
i.e. Concept Dictionary should still be the foundation
Darius: imagine doing this approach in parallel to the current view (i.e. implement it via strangler pattern)
Instead of xyz_attribute, have xyz.extraJsonData
(though, you probably still need XyzAttributeType, and handlers, etc)
Bharat: Postgres native support for json datatypes has improved a ton. We can use some of it in the current model
Darius: e.g. when we implement Notes, which will have lots of text, this could be nice
Bharat: or for attributes (as Burke mentioned above)