>All this sounds like what OpenEHR does. We don't, however, have 
>a metamodel, that is to mean we *implement* actions instead of 
> 
>Karsten 
 
Your right, 
on second thoughts, maybe just have a issue_script clin_root_item sub class, 
and have a lnk_precendent_root_item table that refers to precedent and 
consequent root_items ,  and this would take care of medication change, 
which would be a clin_medication that has a lnk_precedent_root_item 
that exists with it as a consequent link, and another clin_medication 
as a precedent link. 
it would also track causative/rationale links between root_items. 
 
clin_request covers things like radiology, colonoscopy, gastroscopy,  
nerve conduction study, lung function testing  ,audiology,  doesn't it ? ( in 
au, 
these are non-consultation 
direct specialist procedural requests issued by gps) . 
 
As well as all the paramedical stuff ( I'd still call physio, podiatry, 
dietician,  
district nursing , consultations though). 
 
 


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