Hi,

I would also concur with your statements about
            the ENTRY sub
            types, as Sam mentioned we have built an INSTRUCTION index
            that tracks the current
            state/care flow step of instructions and their associated
            ACTIONs providing
            efficient access to this information.
This complexity may be tackled with a good Service Model ,when it's completed. 
I think that we are looking too much at the model to solve all our problems, 
but we have a Service Model in draft status that can help to solve issues on 
the using of the model.

The effort required
            to implement
            this would have been much greater if these classes were not
            specifically modelled.
Obs., Eval., Inst. & Act. are a great ontologic division of the clinical 
information, with them it'seasy to understand and easy to map to real concepts, 
I doubt that removing them from the model can help in any way. If these classes 
weren't modelled, we have to model them in all of our implementations, that's a 
waste of good modelling.


    just a couple of opinions.

Kind regards,
Pablo.
                                          
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