Hi all,
Sorry. Coming late to the party. I think the Contsys 'Health Issue
Thread' has this correct (similar) to the HL7 Concern structure, which
expresses a need to restructure , re-prioritise or re-frame a list of
originally recorded problems, diagnoses or issues to reflect a
specific clinical context and requirement. So Health Issue Threads
appear in Care Plans, Discharge documents, episodic Problem lists (as
per Larry Weed) and, of course the longitudinal holistic Problem list
as would be carried in a GP system.
The main problem we have in openEHR is that these are often tree-like
structures, reflecting groupings of conditions by episode or clinical
relevance
e.g.
Ischaemic Heart disease
2004 Angina
2006 MI
April 2006
June 2006 readmission
Although we can, of course, create these structures with LINKS, we do
not have an easy way to model thos kind of construct or to query it
generically.
This might be useful
http://www.openehr.org/wiki/display/healthmod/Problem,+Issue,+Diagnosis+and+Concern
A have built a wee Health Issue thread archetype to act as the container but
Dr Ian McNicoll
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Director, freshEHR Clinical Informatics
Director, openEHR Foundation
Director, HANDIHealth CIC
Hon. Senior Research Associate, CHIME, UCL
On 19 November 2014 14:42, Thomas Beale
<thomas.beale at oceaninformatics.com> wrote:
> On 19/11/2014 14:04, Karsten Hilbert wrote:
>>
>> On Wed, Nov 19, 2014 at 01:35:06PM +0000, Thomas Beale wrote:
>>
>>> Consider: the proof that something
>>> really is considered a 'problem', out of all the non-problems and trivial
>>> problems (e.g. one-off throat infection) is that some clinical
>>> professional
>>> wants to create a care plan, to define ongoing treatment and track
>>> interventions (all medications, other interventions etc).
>>
>> While I agree that that's something to consider I am creating
>> "care plans" all day, for both "complex" and "trivial"
>> problems. It is very much in the eye of the beholder what's
>> trivial and what's not. My patients are so much the happier
>> for their "plan" for "one-off throat infection".
>>
>> It's an interesting point of view.
>>
>
> well that's my point actually. If a doc wants to create a care plan for X,
> then X for patient P is by definition a 'problem' in that doc's opinion, and
> consequently in P's care. So there it doesn't matter what the problem is -
> fractured toe or cancer, it's up to some health care professional to decide.
> I am just thinking of abstractions that can be usefully concretised to
> provide a good framework for applications to enable the patients care team
> to do their work, and to find & create information in a natural way.
>
> - thomas
>
>
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