Thom, It seems we are in agreement.
Gerard -- <private> -- Gerard Freriks, arts Huigsloterdijk 378 2158 LR Buitenkaag The Netherlands +31 252 544896 +31 654 792800 On 04 Dec 2004, at 12:54, Thomas Beale wrote: > Gerard Freriks wrote: > >> Dear all, >> >> Am I correct to conclude and propose that: >> >> - *episode:* situation considered to occupy a time interval >> >> - there are at least 4 context's in which the term 'Episode' is >> defined: >> disease related (point of view of the patient), > > this kind of episode often has vague boundaries, and I think we have > to rely on following LINKs in the EHR to find all its pieces. If I get > bronchitis that seems to get better before it gets worse every two > weeks, is this a single episode or many? I don't think it matters - > what matters is being able to find all the information items relating > to a given problem. > And relating data in a specific context for a specific purpose that some times is defined in a group and sometimes defined by one actor for his own purpose. Episodes likes these are more general and NOT depended on business rules. >> treatment related (point of view healthcare provider), >> adminstrative contact related (point of view of healthcare >> institution), > > these two are I think possible to identify as being delimited by known > points in time, as long as the provider has a clear rule for when they > are providing health care, versus when they are not. They might be > providing care in parallel with other providers of course - e.g. Dipak > had a good example of patients on weekend leave from a mental health > institution, who become the responsibility of the local GP for the > weekend, but don't really stop being the responsibility of the > institution. episodes like these are depended on (local) business rules that vary from place to place. > >> insurance related (point of view payer) > > How re-imbursing institutions want to define episodes is something I > don't know much about, but Tim Churches or someone may have something > to add here. How does that work in NL, Gerard? I know there is a > mixture of government and private payors. I don't know them either. But think of mergers between firms and new insurance products and updates within one firm. > >> - sometimes the period is real and enumerated (/dd-mm-yy, ISO 8601 : >> 1988Data elements and interchange formats - Information interchange - >> Representation of dates and times/), >> sometimes indefinite (/one week ago, some weeks ago, ongoing, during, >> before, etc, as defined in CEN/TC251 EN1238 Time standard for health >> care specific problems/) > > I think such vague times can only be for clinical use (patient had an > "episode" of bronchitis about 2 weeks go, lasting about a week). For > billing or other computable purposes such as statistical studies, you > have to be able to know which things are in and which are out. > I agree. > - thomas > > > > -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: text/enriched Size: 3103 bytes Desc: not available URL: <http://lists.openehr.org/mailman/private/openehr-technical_lists.openehr.org/attachments/20041204/72403de6/attachment.bin>
