Christopher Feahr wrote: >. but my understanding was the the SNOMED people had >already modeled complaints, signs/symproms, diagnosis, treatment plans, >prognosis, outcomes... the whole 9 yards. If that is true (seems too >good to be true!) then it may only require a (simple??) mapping of >SNOMED CT to a collection of EHR Archetypes. > this is a bit question. The key thing to remember is that:
- terminologies/ontologies (attempt to) model reality, e.g. their model of symptoms related to tropical parasite infections will/could be a detailed semantic net of nodes describing in great detail the symptoms at every point of e.g. plasmodium lifecycle during malaria infection - textbook stuff in other words. - but the doctor in a hospital is interested in recording observations about the patient, ordering tests, making decisions, following progres and so on. The information he/she wants to record and read is to do with the observation and care process, not with the scientific description of the life history of plasmodium. This is the area of archetypes and templates - providing highly configurable models of this information and processes, during the clinical care path. - terminologies are necessary as a knowledge base during the use of archeytpes - they provide names of things of course, but more importantly, semantic networks support inferencing. So one can imagine a doctor recording symptoms and signs in their info system, and thinking that so far, it could be malaria or some other fever-inducing infection... if they have detailed enough observations, it may be that the ontology can provide some guesses as to what the patient has. So - we have two kinds of models here: terminology/ontology is about modelling the real world, and facts we have learned and appear to be dependable; archetypes and templates are about modelling patterns of information *in use*, and they depend on ontology for meaning of items they mention. Archetypes provide for a lot of optionality, whereas this is not part of ontology (except ontologies modelling decision making processes themselves perhaps). - thomas beale - If you have any questions about using this list, please send a message to d.lloyd at openehr.org
