Hi all, On Sat, Jun 14, 2008 at 4:41 PM, Gerard Freriks <gfrer at luna.nl> wrote: > Dear all, > It is all about patterns for documenting.
very true! We still have to learn a lot in this respect, and certain design choices will prove inadequate and we (clinicians!) have to come up with better solutions. The archetype formalism and the whole openEHR environment provide a framework to do this evolution organically and clinician-&usecase-driven, since the most technical issues are solved on the RM level. Have talked a lot about this with Ian McNichol at MIE. We also think that certain areas (diagnoses, lab results, procedures) will need more structure (to support DSS), while for others (e.g. physical exam) can stay more narrative. The beauty about the modular archetype approach is that such hybrid setups are possible and don't have to be predetermined. In theory, if there is a use case (added clinical value) certain archetypes and termplates will establish themselves, backed up by a certain group such as a professional college. This will often vary between different user groups. My personal opinion is that worldwide semantic interoperability will be only realistic (commonly required) for very basic information (e.g. emergency data). This iterative, usecase-driven clinical modeling could be called "agile clinical modeling". Obviously, this needs a good governance structure (like oceans knowlege manager environment). And certain basic patterns should be provided as role models to stimulate the process and avoid too many "beginners mistakes". This is what we - early clinical users with some technical insight - should come up with. Cheers, Thilo
