I would have thought this would be a frequently used pattern for
recording pre-EHR notes into a patient history, and "Duplicate" would be
more exactly expressed as "Data extracted from primary record"
Since that data would be used by a query, the query should return both
sections and leave the application (and user) to decide which to
display.
Regards,
Colin
-----Original Message-----
From: openehr-technical-bounces at openehr.org
[mailto:openehr-technical-bounces at openehr.org] On Behalf Of Sam Heard
Sent: Wednesday, 20 August 2008 8:25 AM
To: For openEHR technical discussions
Subject: Re: Differential display
Hi Andrew
In Australia it is the MD2 use case - but not only MD2. We will
see this amplified with CDA where sections have the text and there is no
effort to display the duplicated structural information. You are correct
- if the textural note kept a link to the structured content then it
would allow us to determine which was duplicate.
The problem has arisen as the degree to which information is
duplicated in the textural note differs - sometimes it is 100% (eg MD)
and in other applications it is not. So some want to display the text
and non-duplicated data.
It was my feeling that we would do well to have a section that
people can display as they wish that allows this to be expressed.
I am not so concerned about the section name - my real point is
that we need to agree:
Do we have a section which contains the non-duplicated and
duplicated data - so there is a link between them (even if the
application cannot maintain this or it has come from CDA) or do we just
have a simple section for duplicated structured data. The problem with a
simple section is we will not be able necessarily to validate what the
issue is if it is free standing.
So the two options would look like this:
Option one (Compound section)
SECTION: Duplicated
SUBSECTION: Primary
Document: "Saw JJ today and seemed OK. A cough for 2
weeks. Temp 36, BP 146/82"
SUBSECTION: Duplicate
Symptom "Cough"
duration "2 weeks"
Temperature 36 C
Blood pressure
systolic 146
diastolic 82
OR
Document: "Saw JJ today and seemed OK. A cough for 2 weeks. Temp
36, BP 146/82"
SECTION: Duplicate
Symptom "Cough"
duration "2 weeks"
Temperature 36 C
Blood pressure
systolic 146
diastolic 82
As you can see, I favour the former.
Cheers, Sam
Andrew Patterson wrote:
Actually the use case is as follows:
We can call it the MD2 use case! :)
This may not seem idealistic but this the
reality of what existing systems
do and existing users are used to. If openEHR
is to be taken up by existing
system vendors and accepted by their users, we
must support this existing
non-idealistic paradigm in a way that does not
too much overhead on the
system and its implementers.
I don't understand why this requires anything special at
all regarding
archetypes? Surely it is a composition with some
sections, and in
those sections might be an uncoded 'story' about the
encounter, and
then some other coded archetypes.
If there is duplication of information, then IMHO
they will need to see the duplicate information - once,
as you say, they have
copied the structured content into the note as text it
has indeed lost its
connection to the original data. I can't see how you
could in good
faith then indicate that any of the coded structured
data is
'duplicate' information unless you could
actually ensure that the text is also still present in
the uncoded
story - and if you can do that strong linking check with
any degree of reliability then the whole problem doesn't
really exist?
Andrew
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--
Dr Sam Heard
Chief Executive Officer
Director, openEHR Foundation
Senior Visiting Research Fellow, University College London
214 Victoria Avenue
Chatswood, NSW, 2067
Phone: +61 2 9415 4994
Mobile: +61 4 1783 8808 21 Chester Cres
London E8 2PH
Phone: +44 20 7249 7085
Mobile: +44 77 9871 0980
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