Dear all, It is all about patterns for documenting.
I agree that inspection of the present collection of openEHR archetypes and those produce by the NHS are a nice resource. But we must realize that these were produced for demonstration, testing, learning or the collection of information requirements. The Templates and Archetypes we need must be designed for semantic correct, reusable, patient safe recording, retrieval, exchange and archiving in mind. A complete new set of scopes that need explicit requirements. - Patterns are to be re-used and aggregated in other archetypes or templates. Question: What are the rules to be applied to make that decision? - A pattern will need a new specialization only when new things have to be added to the original pattern. Question: What are the rules for to decide when to specialize or when to add a new item to the original archetype and create a new version? - What patterns do we have to have in order to be able to document what we need to document? Will we find the answer when we look at the language aspects of what we document? - Some Archetypes document complex notions. For example: the Barletts Index. It is a collection of Observations about a patient system. Each of these observations can be recorded using a documentation pattern. The aggregation of observations is expressed as a number using an algorithm. This aggregation is named the Bartletts Index. All of the observations can be documented using separate archetypes using semi-quantitate patterns. The algorithm can be documented in whatever format. The result is documented using a semi-quantitative pattern, either on its own as the professional opinion of the healthcare provider, or as the result of the application of the algorithm, as substitute of the healthcare providers subjective estimation. So the Bartletts Index can be a subjective statement of the class of Evaluation Archetypes based on Observations, or the a subjective statement (Evaluation) by a healthcare provider without any reference to feeding observations, What will we do when new observation elements are added to the Bartletts Index? What will we do when a new algorithm is used to do the calculations? Is this line of reasoning not leading to the following statements: Observations are observations and end up in Observation Archetypes and are recorded in the EHR, as such. The Bartlett Index is a derivative that either is an Evaluation of Risk expressed as the ARchetype Index as perceived by the documenting healthcare provider, or, the Bartletts Index is a formalism (algorithm) applied to a set of documented Observations leading to a risk index that has to be documented as an Evaluation. I might even argue that the Bartletts Index is an agreed Common Template to express risk for the new born, that could change over time as it is the result of present opinions that can change. This means that there are two versions of the Bartlett Index that express the same notion. One is the professional opinion of the risk for the newborn by the healthcare provider is a certain number. And that the risk is calculated by a specified algorithm using a defined set of observations. Question: Is the Bartlett Index an Observation or an Evaluation? Question: Are there two kinds of Indexes? Question: Is the Bartlett Index an Archetype or Template? Or more general: Are Archetype about recording patterns? Are Templates about context (location, time and culture) dependent collection of constituting archetypes? Gerard On 14, Jun, 2008, at 15:55 , Thilo Schuler wrote: > Looking at the openEHR archetype repository, there is a generic lab > archetype and several specialiced ones based on it. However, it seems > to me that the specialisations were done mainly to create "battery" > type lab results structures (e.g. laboratory-liver_function) I think > keeping the lab archetype to one analyte and aggregating them in a > template would be cleaner and better from a query perspective. > Specialisations of the generic lab archetype should only be used to > add a field that is missing for an unkonventinal lab test. > > What do you think? > -- <private> -- Gerard Freriks, MD Huigsloterdijk 378 2158 LR Buitenkaag The Netherlands T: +31 252544896 M: +31 620347088 E: gfrer at luna.nl Those who would give up essential Liberty, to purchase a little temporary Safety, deserve neither Liberty nor Safety. Benjamin Franklin 11 Nov 1755 -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.openehr.org/mailman/private/openehr-technical_lists.openehr.org/attachments/20080614/1a2f5da0/attachment.html>
