I knew that question was coming ;-)
Firstly, how would you detect an inconsistency? It can only be done by a
human being, or else a quite sophisticated piece of software. Now, what
does it mean if there is a difference?
Firstly they are not quite 'duplicates'. The narrative is a directive to
a human agent to do something, in a slightly coded language that is
supposed to be understood unambiguously by the author and the reader.
The structured representation is just that - a structure representing
the medication order activities, timing etc.
If they don't say the same thing it could mean:
* the software that created the structural representation has an
error, and creates structures different from the clinical intention
* the software that created the narrative has an error, and created a
different text from that required by the clinician
As for any other data in the record, there is no 100% guarantee that any
of it is right. The correct comparison is not just between the two, but
between both of them and the original clinical intention, which is the
reference. This comparison will only be made during testing, where the
purpose is to ensure the software is bug-free.
In routine use, inconsistencies probably won't be detected - the doctor
will just assume the software works properly. So it's just a question of
making sure the software works properly...
- thomas
On 29/10/2013 10:07, Diego Bosc? wrote:
> And if an inconsistency is detected, which one is supposed to be right?
>
>
> 2013/10/29 Thomas Beale <thomas.beale at oceaninformatics.com
> <mailto:thomas.beale at oceaninformatics.com>>
>
>
> Just to re-iterate, the 'narrative' property is meant to carry the
> piece of text that would appear on a medication or with a
> medication as supplied by a pharmacy (including in a hospital).
> When the administering agent is a human - the patient, family
> member or a nurse - this is normally the concrete direction that
> is followed.
>
> The computable form of the order / instruction says the same
> thing, but in a computable form, allowing structured querying,
> analysis, all the usual stuff.
>
> This is probably the only place where there is content duplication
> in openEHR, and as far as I can see, it needs to be like that,
> since there is no standard way to generate the narrative text in
> its correct form from the computable form (i.e. the Activities
> etc) - particularly since the text form can contain quite
> particular words, 'codes' (like '3td po') and so on.
>
> If a 'standard' algorithm could be developed for this purpose it
> would obviate the need for the narrative property, but I suspect
> this is a long way off due to the medically & culturally specific
> content typical in the narrative today.
>
> - thomas
>
>
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