The EHR is about recording observed facts. One of those facts is the "use of substances". This means one has to document: - What - What for - How - How much - When - Prescribed by whom, when, where - Dispensed by whom, when, where - Administered by whom, when, where - Used when - ...
Irrespective of a regular drug, herbal tea, food additive, smog, self medicated, prescribed, or taken by an involuntary action one always want to record the same things. Isn't it? So why not a generic Archetypes: "Observation: Substance Use" Gerard -- <private> -- Gerard Freriks, arts Huigsloterdijk 378 2158 LR Buitenkaag The Netherlands T: +31 252 544896 M: +31 653 108732 On 10-mei-2006, at 15:53, Bill Walton wrote: > Hi Karsten, > > Karsten Hilbert wrote: >> >> Recording "substance use" is more intended to record a >> *fact* about the lifestyle of an individual rather than an >> *intent to treat* as with prescription drugs. >> >> There's a fine line as always: herbal teas, OTC drugs etc >> may or may not have been intended to be treatment by the >> provider. However, disambiguating such in a given case is at >> the discreetion of the provider/patient in question. OpenEHR >> needs to provide facilities for both. > > It seems to me that 1) we want to provide a mechanism for recording > _all_ substances used, and 2) for each, we want to record who > 'prescribed' it. Patients "intend to treat" when they ingest herbal > teas, OTC drugs, etc.. While I definitely see the value in > recording the 'prescriber', I still don't see the value in creating > a seperate archetype for 'substances' that are not provider > prescribed. In fact, it seems to me to create unnecessary complexity. > > Example... A patient is undergoing chemotherapy. The patient finds > that smoking marijuana helps control the nausea. If the patient > lives in California their physician can prescribe the use of > marijuana. It they live in Texas, its use cannot be prescribed. > > Another example... A patient wants to quit smoking cigarettes. The > physician prescribes Nicorette gum. Then the FDA approves > Nicorette for OTC sale. > > What would be the information value of recording this information > with different archetypes? What would seperate archetypes allow me > to do that I couldn't do as easily with a single archetype with a > 'prescriber' attribute that could accomodate a value of 'self'? > > Thanks, > Bill -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.openehr.org/mailman/private/openehr-technical_lists.openehr.org/attachments/20060510/7eb8a429/attachment.html>
