I think people are mixing up some concepts here - and I don't think
it's a great idea to forge on without really narrowing down exactly
what the use cases are and what their variations are. I personally
think that at least 3 distinct use cases have been discussed
in this thread (with albeit quite subtle differentiations) and I'm
not sure everyone is agreeing with the solutions that they think
they are agreeing with.
My taxonomy of use cases would be
a) the MD2 use case (Ocean need to be able to handle the way
Medical Director generates separate progress notes and structured
measurements, but pastes textual copies of the structured data into
the progress note)
b) the simple CDA narrative use case (There is a general interest
in CDA documents and how they might be done in openehr)
c) the strong semantic CDA narrative use case (Ian and others
are interested in how openehr might handle mixed structured
and unstructured content, where there is strong linkage
between the structured content and its place in the unstructured
narrative)
I don't think the solution to all these is the same. I think a
PRIMARY/DUPLICATE archetype is not at all useful for (c),
maybe a good idea for (b), and probably not a good idea for (a)
(but that use case is so broken that it may be the best
that can be done).
Do othere see these 3 cases as distinct? From an IT perspective I think they
are different but I am not clinical.
Andrew
