Andre, Thanks for these links, this resource will be useful in the future. However, it is significantly more in-depth then I am looking for at the moment. It is probably a terminology issue also when I talked about clinical workflow, perhaps I should not have used this term as I wasn't talking about guidelines. Although I have an interest in guidelines my current issue is the day-to-day work of a clinician prescribing medication and writing referrals, and following the state transitions of these instructions through to conclusion by recording them in the EHR. It is mainly the generation of clinical scenarios and content that I am seeking assistance to allow me to simulate the scenarios using the Ocean openEHR suite of tools to test the application of openEHR in the process of medication orders to Pharmacies, and clinical and diagnostic referrals for starters.
Once we get these day to day clinical processes supported then we can look at the more complex work flows like guidelines and care plans. Do you have any clinical scenarios and sample clinical content for your Asthma guidelines? Hope this clarifies. Heath -----Original Message----- From: Andre Duszynski [mailto:[email protected]] Sent: Friday, 15 September 2006 12:17 PM To: For openEHR technical discussions Cc: heath.frankel at frankelinformatics.com Subject: Re: Sources of information on HL7 EHR/OpenEHR Hello Heath, As part of an Australian RACGP/GPCG informatics project, i've made tentative steps into generating a resource for clinicians in migrating traditional paper-based clinical guidelines to their equivalent within an EHR framework; openEHR being the type example. The web resource is an evolving project in that I acknowledge that I've bitten off too much to chew - had hoped to generate both the archetypes and templates for asthma management !! Anyways. This resource which is very much open to comment, refinement and collaboration is available at: http://www.adelaide.edu.au/health/gp/units/medic-gp/openehr/ Being semi-techo and straddling the clinical domain, i've used the Australian Asthma Management Handbook for primary care as the type example. In respect to clinical workflows for asthma management, you may want to look at the following link which aims to abstract clinical asthma workflows from the handbook: http://www.adelaide.edu.au/health/gp/units/medic-gp/openehr/asthma/ I very much believe that a generic set of archetypes would straddle many clinical activities and would act to bind management motifs across disease states (or alternate considerations). Thus very keen to see and add to this domain of knowledge ! Thanks additionally to Gerard for raising CEN/TC251 - interesting. Regards, Andre Duszynski. --------------- Heath Frankel wrote: > Gerard, > Interesting you raise this topic as it is becoming an interest of mine > to start investigating the use of openEHR instructions to support the > documentation requirements of clinical workflows such as medication > prescriptions, dispense and administration, and referrals. The > existing work of ContSys could certainly assist in this but being a > techo, I need some clinicians to assist in developing these > requirements and my Ocean clinician colleagues are already over > extended. As you know, Ocean has and continues to develop the tools > to support a simulation of these kind of clinical workflow scenarios > and are looking for ways to gather more and varied clinical content to populate and test the OceanEHR suite. > Are there people interested in providing clinical scenarios and data > to assist in the requirements and content gathering process to be used > in clinical workflow simulations? How can we initiate and progress > this kind of activity and investigation? > > Regards > > Heath > > Heath Frankel > Product Development Manager > Ocean Informatics > Ground Floor, 64 Hindmarsh Square > Adelaide, SA, 5000 > Australia > > ph: +61 (0)8 8223 3075 > fax: +61 (0)8 8223 2570 > mb: +61 (0)412 030 741 > email: heath.frankel at oceaninformatics.biz > <mailto:heath.frankel at oceaninformatics.biz> > > ---------------------------------------------------------------------- > -- > *From:* openehr-technical-bounces at openehr.org > [mailto:openehr-technical-bounces at openehr.org] *On Behalf Of *Gerard > Freriks > *Sent:* Friday, 15 September 2006 7:39 AM > *To:* For openEHR technical discussions > *Subject:* Sources of information on HL7 EHR/OpenEHR > > Dear all, > > The 'next frontier' will be the various types of "workflow" and the > interaction with the EHR and other components in an EHR-system. > > Before rushing into quick decisions and quick fixes I call for a study of: > - CEN/tc251 System of Concepts for Contuity of Care, ContSys. > - CEN/tc251 Health Information Services Architecture, HISA. > > The first contains the set of concepts dealing with co-operation > between healthcare providers around the care of a patient. > Several concepts dealing with care plans, clinical path ways in > various sorts are defined. > The second can help us think about the various levels where types of > workflow take place because it defines in a generic way EHR-system > components,their inter faces and behaviour. Each type of workflow will > use its own model and behaviour of its components. > > The whole exercise needs to start with a validated set of requirements > and the study of some important literature. > It is my expectation that En13606/openEHR, ContSys and HISA contain > more than enough ingredients to find a good solution. > > With regards, > > Gerard > > > -- <private> -- > > Gerard Freriks, arts > > Huigsloterdijk 378 > > 2158 LR Buitenkaag > > The Netherlands > > > T: +31 252 544896 > > M: +31 653 108732 > > > > > > >> >>> there are two levels of expression of clinical knowledge, >>> guidelines, evidence etc that we can use, namely >>> a1) guidelines etc that are mentioned in an archetype, and inform >>> the design of the archetype. This can be done as I described. In >>> this case, the guideline or other knowledge reference is the same >>> for all data built from the archetype. >>> a2) resources that are referenced on a per-archetype basis, but not >>> in the archetype, rather they are referenced from the archetype >>> classification ontology that indexes archetypes >>> b) guidelines referenced in data, i.e. on a per instance basis. On >>> the model you see here: >>> http://www.openehr.org/uml/release-1.0/Browsable/_9_0_76d0249_110924 >>> 9648736_872559_12384Report.html >>> >>> the class CARE_ENTRY has the attributes "protocol" (how / why did I >>> create this clinical statement/observation/whatever), "guideline_id" >>> that enables the referencing of guideline that caused this Entry to >>> be created (e.g. maybe some guideline told the doc to measure the BP >>> and also ask questions about smoking); ENTRY.workflow_id may also be >>> relevant, for Entries created due to workflow execution. >>> >>> I would think these go close to supporting today's requirements in >>> this area, although I realise we cannot predict the requirements of >>> the future... >> > > > ---------------------------------------------------------------------- > -- > > _______________________________________________ > openEHR-technical mailing list > openEHR-technical at openehr.org > http://www.chime.ucl.ac.uk/mailman/listinfo/openehr-technical -- ------------------------- Andre Duszynski Research Officer Discipline of General Practice University of Adelaide Adelaide SA 5005 P: 08 8303 6269 F: 08 8303 3511 W: http://www.adelaide.edu.au/health/gp/ ------------------------- Think before you print !! ------------------------- CRICOS Provider Number 00123M ----------------------------------------------------------- This email message is intended only for the addressee(s) and contains information that may be confidential and/or copyright. 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