Gerard The idea in messaging usually is that there is an attribute that changes the meaning of an entry from an intention to an action. This works for a few things like - I am going to do these tests - or write this letter - to I have done it.
Instructions in openEHR have a state machine - something that can allow you to do this and record the instruction as having been completed - a proxy for completing the act in the situation above. A medication order will be carried out - usually - on many occasions - and the batch number and site of administration (with insulin for example) may be added. An instruction may lead to a notification - at the user level (EHR open) or system level (Recall). Some actions are fully specified as entries already. A BP recording is fully specified as an Observation and does not need to be specified in the instruction to do it. So instructions are not just a different expression of the action. I hope this is helpful? Cheers, Sam > -----Original Message----- > From: Gerard Freriks [mailto:gfrer at luna.nl] > Sent: Wednesday, 4 September 2002 8:01 AM > To: Sam Heard > Subject: Re: Archetype ontology > > > On 04-09-2002 00:19, "Sam Heard" <sam.heard at bigpond.com> wrote: > > > Gerard > > > > As we are working on an EHR this is not such a dilemma. There are two > > things - an instruction to record that something should get > done. A blood > > pressure is fully specified as an archetype so there is only > the need to say > > a BP in this instance. This might be part of the care plan - > but it could be > > to do vital signs every hour. This is an organiser. > > > > I do not see the HL7 or 13606 approaches as appropiate as they > are overly > > complex for an EHR and are appropriate for messaging. > > >>>> > > Explain svp? > > gerard > > > > Cheers, Sam > > > >> -----Original Message----- > >> From: Gerard Freriks [mailto:gfrer at luna.nl] > >> Sent: Wednesday, 4 September 2002 7:31 AM > >> To: Sam Heard; Thomas Beale; openehr-technical at openehr.org > >> Subject: Re: Archetype ontology > >> > >> > >> Sam, > >> > >> Could the following be another example? > >> > >> The Blood pressure. > >> The RR as an act, a measurement, a procedure. > >> And the RR as a set of values, the result of the act, the measurement > >> results, the result of a procedure. > >> > >> The act is one thing, an intention. > >> The value as the result of the execution of the intention. > >> > >> The intention can exist without a real value. > >> > >> In ENV 13606 part 2 there are the possibilities to add modifiers > >> (attributes) to 'things' that can express concepts like these. > >> > >> The question is: > >> Will we need a new Concept Information Model (archetype) to distinguish > >> between the two or is one attribute enough? > >> > >> Gerard > >> > >> > >> > >> On 03-09-2002 22:31, "Sam Heard" <sam.heard at bigpond.com> wrote: > >> > >>> Dear all, > >>> > >>> I have been working hard to get an ontology of archetypes > developed that > >>> will show the health domain mapped into the openEHR > architecture. I have > >>> found a couple of things: > >>> > >>> 1. That there is often a link between an instruction and subsequent > >>> observations - which I think will be more important as > >> knowledge bases are > >>> developed in the future. I have called the link an action > >> specification and > >>> at present it is modelled as part of the instruction. Let me > give a real > >>> example. > >>> > >>> If you prescribe a medicine then there are a number of > >> attributes of that > >>> medication order - dose, form, route etc - and there is the > frequency of > >>> administration. When you record that a medication has been > >> administered - > >>> then you record the dose, form, route etc - but not the > >> frequency. The link > >>> is the specification of the action - but not the conditional > >> elements of the > >>> instruction. > >>> > >>> Many other things may be specified at the time that they are > ordered and > >>> there may be protocols etc that are to be followed. > >>> > >>> For this reason - I have two new subclasses in the ontology (not in > >>> openEHR) - "openEHR Observation - action" and "openEHR action > >>> specification". This allows me to say which action > >> specification applies to > >>> an instruction and which obeservations it applies to. > >>> > >>> 2. It might be necessary to state the sequence of different > >> instructions. > >>> The French oncologists wish to state this for Surgery, Radiotherapy, > >>> Chemotherapy etc. Clearly each of these will have a complex action > >>> specification. How then to make it clear about the order of the > >>> instructions - should one finish before the other starts? > >>> > >>> I welcome your ideas. I have put the zipped (45K) protege files on > >>> www.gehr.org in the Watch this space section. > >>> > >>> Cheers, Sam > >>> ____________________________________________ > >>> Dr Sam Heard > >>> The Good Electronic Health Record > >>> Ocean Informatics, openEHR > >>> 105 Rapid Creek Rd > >>> Rapid Creek NT 0810 > >>> Ph: +61 417 838 808 > >>> sam.heard at bigpond.com > >>> www.gehr.org > >>> www.openEHR.org > >>> __________________________________________ > >>> > >>> - > >>> If you have any questions about using this list, > >>> please send a message to d.lloyd at openehr.org > >> > >> -- <private> -- > >> Gerard Freriks, arts > >> Huigsloterdijk 378 > >> 2158 LR Buitenkaag > >> The Netherlands > >> > >> +31 252 544896 > >> +31 654 792800 > >> > >> > > > > - > > If you have any questions about using this list, > > please send a message to d.lloyd at openehr.org > > -- <private> -- > Gerard Freriks, arts > Huigsloterdijk 378 > 2158 LR Buitenkaag > The Netherlands > > +31 252 544896 > +31 654 792800 > > > - If you have any questions about using this list, please send a message to d.lloyd at openehr.org
