On 20/11/2014 12:45, Karsten Hilbert wrote: >> In the other hand, yes, that information is in every MR, >> but you have to read a lot to find all the info relevant to a >> specific problem. What we need to do is to have that >> information linked in an explicit way to avoid that manual >> search, and have all the relevant info at one click of >> distance. IMO that was Weed's idea. > Here we are on the same side of things. > > What I am stressing is that I would really expect any > _information_ model intended for clinical use as a > patient-centric medical record to easily afford the POMR > approach. In my personal view it should really even enforce > problem orientation internally. Otherwise said model would be > a _data_ model (of which being an excellent one is really > desirable). > > So, back to your question, are we looking for where exactly > (and how) OpenEHR turns from a data model into an information > model (as per my attempt at definition above) ? > >
this is my interest as well, and the reason for thinking about Care Plans as computational objects, that include partly computed (queried) contents. Note that the whole design of openEHR is more or less predicated on a POMR idea, fairly equivalent to models like the 'hypothetico-deductive model of problem solving'. That's why we included Entry types in the information model like Observation, Evaluation (meaning: any kind of assessment or opinion), Instruction, Action and AdminEntry. Experience has shown that these are a pretty good match for most clinical information, but that refinements are needed in future generations of the openEHR approach, most notably to decouple the epistemic types mentioned above from being 1:1 with fixed data structures, as Ian McNicoll has often argued. But the general principle won't change - each piece of information committed to the EHR will have an epistemic type/status related to the POMR approach. The current challenge in my opinion is to define computational objects that correspond to higher level entities, like 'medication list', 'problem list' and 'care plan', each of which is at least partly a computed index into the relevant 1st level information items (i.e. the raw obs, Dx, actions etc). There are some good preliminary pieces of work around on this that need to be put together. - thomas
