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From: [email protected] [mailto:owner-openehr-technical at openehr.org] On Behalf Of mthakkar at siu.edu Sent: Wednesday, November 24, 2004 9:24 AM To: Thomas Beale Cc: SMK; Christopher Clay; Openehr-Technical Subject: Re: Episodes in openEHR SMK wrote: Greetings: I am new to this discussion but had a couple of thoughts. I am just in the final stages (actually finished) modeling some data for oncology patients. I would like to suggest that an "episode" be centered around a single patient illness, and not dependent on whether that patient was in or out of the hospital. This is speaking from a clinician's viewpoint which involves a continuum of care, hospitalization being one event. In regards to the Mayo model, my suggestion would be that the "episode" for the patient mentioned be the injury, the MI a second "episode" etc. If we speak of "episode" as a course of an illness to a point where no more care is needed for that problem, (i.e. patient is a) returned to health, b) sustainable stabilised (chronic patients) or c) died) you are right...but the Mayo MICS uses the other definition of "episode" for its purposes - a period of care delimited by acceptance of responsibility for care and discharge from care. Let's not get too worked up about trying to have one sole definition for the word "episode". I suggest we refer to the two types as "episode-of-care-delivery" and "episode-of-a-problem" (not a very good name - pregnancy falls under this categygory, and is not a problem for most people....) I suggest that the issues of practical importance are: a) decide if either or both of these ideas of episodes need to be modelled explicitly in openEHR b) if so, name them properly c) define their data (i.e. model them) Maarten Spook's problem is to have something which includes the data: 1. startDateTime: the date-time the episode is started (medically) 2. stopDateTime: the date-time the episode has ended (medically). 3. createdDateTime: the date-time the episode was created (administrative) 4. contributers: care providers and their role (participations?) It would be clear to see who had added info and who is responsible for this episode etc 5. structured annotation: a short description of the content / context of the episode This kind of episode is an episode-of-care-delivery. I come back to modelling this with a Folder. As I stated earlier, the other kind of episode - related to the course of an illness, a pregnancy, or an 'epsiode' of some chronic disease - can be modelled as Links between the relevant Entries, where each Link object can be classified as relating to a particular problem, such as "diabetes" or "pregnancy". How do we want to proceed. Is it likely that there are sufficiently standard ideas of the two kinds of episode that they should be modelled in a more concrete way than with Folders and Links? - thomas beale - If you have any questions about using this list, please send a message to d.lloyd at openehr.org -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.openehr.org/mailman/private/openehr-technical_lists.openehr.org/attachments/20041124/2507e93b/attachment.html>
