Hi Pablo,
Actions are absolutely necessary and can carry different/additional information 
than the instruction.

An instruction is actually useless without an action. It is the action that 
puts the action into a particular state at a particular time. When an 
instruction is created it should also be accompanied with an action otherwise 
the instruction workflow is not yet invoked.

Take a medication ( I am not clinical so please excuse my ignorance but 
hopefully this demonstrates the intended technical solution), a clinical 
pathway may suggest a class of drug to be taken at a particular dosage, 
frequency and duration. This may be recommended by a decision support system by 
creating the instruction and an action to put it into the planned state. The 
doctor can then prescribe a generic drug using an action indicating particular 
form and strength and the state is transitioned to active with a care flow step 
of prescribed. Next the pharmacy dispenses the particular product and indicates 
administration instructions to the patient. The new action is still in active 
state but now has care flow step of dispensed, the time is the dispense time. 
The patient can now enter the administration of each dose, each action is an 
active step. Finally the system can optionally create a completed action when 
it determines each dies has been taken or the expires under some other criteria.

Personally I disagree with the original post indicating that action archetypes 
are not being developed of used a lot. They are absolutely essential in any 
system recording instructions such as our care planning systems. If they are 
not then there are fundamental misunderstandings of the instruction/action 
model.

Regards

Heath

On 7 Apr 2015, at 6:50 pm, "pazospablo at hotmail.com<mailto:pazospablo at 
hotmail.com>" <pazospablo at hotmail.com<mailto:pazospablo at hotmail.com>> 
wrote:


Hi David. A medication taken should be an action or an observation? What 
matters more, the event of taking the drug ot yhat thr drug eas taken? I think 
the latter can occur when a doctor asks the patient for medication taken. I 
agree the real time record of the event can also occur.


Thanks!


Sent from my LG Mobile

------ Original message------

From: David Moner

Date: Tue, Apr 7, 2015 03:41

To: For openEHR clinical discussions;

Cc: openehr-technical at lists.openehr.org<mailto:openehr-technical at 
lists.openehr.org>;

Subject:Re: ACTION just as event trigger

Hi Pablo,

Think that an ACTION can happen without any previous instruction. For example, 
a medication taken without a previous prescription. That information has to be 
stored not just as a log, but as proper clinical data. So it seems OK that 
ACTION includes part of the clinical record.

David

2015-04-07 4<tel:2015-04-07%204>:06 GMT+02:00 pazospablo at 
hotmail.com<mailto:pazospablo at hotmail.com> <pazospablo at 
hotmail.com<mailto:pazospablo at hotmail.com>>:

A couple of week ago someone mebtioned that ACTION archetypes are not being 
developed or used a lot, and maybe is because we actually don't need to put 
data on ACTIONs as part of the clinical record, but maybe only as event trigger 
and logs of ehat happened. With tgis I mean: ACTION recording might be used ti 
send notifications to other statems (like whe a lab test is done, the results 
are sent or queried), or to keep the log of real world events that happened and 
may change the status of another entity (i.e. INSTRUCTION/ACTIVITY).


What is the opinion of the community about the role of the ACTION ENTRY in the 
openEHR Information Model and as a EHR entity, from the point of view of it's 
use in current systems?


Thanks,

Pablo.


Sent from my LG Mobile

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--
David Moner Cano
Grupo de Inform?tica Biom?dica - IBIME
Instituto ITACA
http://www.ibime.upv.es
http://www.linkedin.com/in/davidmoner

Universidad Polit?cnica de Valencia (UPV)
Camino de Vera, s/n, Edificio G-8, Acceso B, 3? planta
Valencia - 46022 (Espa?a)
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