On Wed, Nov 19, 2014 at 02:00:46PM +0000, Seref Arikan wrote: > Maybe I'm losing some clinical context by adopting a data view of the > setting but would not a problem oriented record be a 'view' on clinical > data ?
Ah, putting it that way makes sense, too: the POMR approach to be a view integrating "data" into "information". My point would be that problem orientation is so fundamental a "view" that it should really be mandatory (even if only internally -- if physicians can't be bothered with thinking about which problem to attribute items to a coarsely grained ordering, say along the lines of ICPC, might get applied based on, say, provider speciality or some such). > The clinical problem is obviously context dependant (cancer, > diabetes etc) so this sounds like a higher order view on top of clinical > data to me. I'd see problem list as a 2nd order construct like you, but I > guess I'd consider problem oriented record at 3rd and Care plan at 4th > level. Interesting idea: "comprehensive" care plan, not necessarily per-problem. Maybe per-goal (for which health goals must not be per-problem ;-) ? > If care plan is what the name implies than it involves actions to be taken > on top of a particular problem view so I'd feel safer having that in its > own layer. So I'd consider something like: > > Say an EHR with ~100 compositions (1st level). IOW, a data store rather than an EHR. > A problem list as a persistence composition (2nd level), The minimum requirement for the data store to become an EHR. Thanks, Karsten -- GPG key ID E4071346 @ eu.pool.sks-keyservers.net E167 67FD A291 2BEA 73BD 4537 78B9 A9F9 E407 1346
