I'd be very interested in a detailed explanation apropos to Matias' query. Among other things, this question seems important for home monitoring contexts as well as questionnaires filled out in the doctor's office.
Normally a contact note is attributed to a provider, so that takes care of the idea that Dr X records Diabetes or Nurse J records diabetes. However, if Nurse J is not *diagnosing* diabetes, but recording that the patient *says* they have diabetes - well, that's different. Presumably the entry could be organised under the Subjective component of the contact note (?). Nonetheless, it would seem dangerous to assign the SNOMED or ICD *diagnosis* code for Diabetes (and of what type?), since a subsequent query could pull this out of context as a provider diagnosis. How is the best way to represent that 'the patients says they were diagnosed with diabetes'? All of the above might seem less academic if the disease in question were one where the patient was more likely to be in error, or particularly to give a false positive. I assume that the prompt would NOT be modelled in the archetype, but perhaps implied by the actual code used and otherwise left up to the application to provide. (Again, I'm not sure - please enlighten me!) Jim Warren Assoc. Prof. Jim Warren Advanced Computing Research Centre University of South Australia Mawson Lakes SA 5095 AUSTRALIA -----Original Message----- From: Matias Klein [mailto:[email protected]] Sent: Friday, 5 March 2004 7:54 AM To: openehr-technical at openehr.org Subject: Propositions? Hello All, We are making incredible progress with the openEHR framework! Recently we faced a requirement to create patient-facing data capture tools. Unfortunately we can't seem to find a place in the openEHR model where these types of propositions fit cleanly. For example if I have a patient intake form that has the question, "Do you have diabetes?" Obviously the patient's answer to the question could be modeled as an observation of "diabetes" mapped by the DV_CODED_TEXT datatype to SNOMED or ICD. However what I don't understand is how the proposition "Do you have diabetes?" should be modeled? Should a "diabetes" archetype have a proposition field where a question can be stored as a string? How would multiple perspectives be modeled (i.e. question to patient, question to doctor, question to family member, etc.)? Your assistance in helping me understanding this issue is greatly appreciated. Kind Regards, Matias ============ Matias Klein Ethidium Health Systems 3993 Huntingdon Pike - Suite 108 Huntingdon Valley, PA 19006-2623 USA Office: (215)938-8630 Fax: (215)938-7301 http://www.ethidium.com - If you have any questions about using this list, please send a message to d.lloyd at openehr.org - If you have any questions about using this list, please send a message to d.lloyd at openehr.org
