Oystein > I am not quite aware of the distinction between medication plans > and medications planned, but anyway,
I am not sure how it got here but there are a number of issues. First there are recommendations from a consultant on medication, second there are medication orders that are recorded with no administration record (prescription based or conditional on events that have not arisen), third there are medication orders with administration records. > we are thinking about the "totality of monitoring, education, > reviews" in addition to roles and > delegation of responsibility, with the added complexity of > limiting access to the plan content according > to "need to know", i.e. unless you are in a role that has > responsibility for a specific part of > a multi-problem-plan, you're not allowed to see it. I believe that this approach is fundamentally flawed and will need to be separated by the record rather than the hiding bits of a care plan. Just consider someone with HIV - who has a need to know? What can you know without becoming aware that the person has HIV? What are the safety issues for a person seeing part of a careplan? > More specificly, we are starting a pilot that looks at > requirements for a plan-based "record system" that supports > cooperation across roles and organizations for long-term > psychiatric patients. This sounds interesting. The EHR will not be 'plan based' if it is a good one as it will need to support a wide range of activities. openEHR would aim to support such an approach but not to mean that this record could not be used in other contexts. > You wouldn't want rehabilitation- > people to have access or knowledge about specifics of family > history etc... Don't confuse care plans with health records - they are very different beasts. > And even more: What about goals for treatments? Think > "goal-driven guidelines"... > Is an archetype neutral to the underlying guideline > model/semantics/"execution"... Yes - inherently - but we have a process model in openEHR - it is not so sophisticated but I think enough for the EHR part of this. > How do we go about composition, inheritance and instantiation > wrt. archetypes for plans? > Multiple plans? (After all, it is more than common to be on many > medication "plans" concurrently...) We would not think of a medication plan - this is probably a medication order in our world view - one per medication - it is modelled as an instruction. The care plan itself is a coherent document and is modelled as a 'transaction'. Rambling also....Sam Heard > Just rambling, > --- ?ystein N. > > > > 23.01.2003 10:27:31, skrev Thomas Beale <thomas at deepthought.com.au>: > >?ystein Nytr? wrote: > [...] > >>- has anyone worked with medication in the context of care > plans, just as a very specific example? > >> I have a couple of students that are working on this at the > moment. Any ideas towards > >> archetype representation? > >> > >do you mean medications planned? I presume in the context of a care plan > >you mean with ongoing monitoring, possible education, and reviews. Sam > >Heard and I have done a certain amount of work in this area already, > >using the example of asthma. The medication is just oral > >corticosteroids, but the totality of monitoring, guideline, and other > >factors make it interesting. Would this be the kind of thing you woudl > >like to discuss? > > > >- thomas beale > > > - If you have any questions about using this list, please send a message to d.lloyd at openehr.org
