Hi Pablo, When I am advising implementers on this, I use the following categories ...
## Composition Commit Styles Depending on the clinical requirement, 3 styles of commit strategy are suggested. 1. **’Event’** e.g Nursing observations, clinical encounters, reports. Each time the composition is committed, create a new instance via a POST. Generally only do a PUT if an error needs to be corrected 2. **’Episodic’** Create a new composition via POST for each Period of Care i.e an admission. If it needs to updated, use a PUT to modify i.e Each patient has a single instance per Period of Care. 3. **’Longitudinal’** Create a new composition via POST for each patient. If it needs to updated use a PUT to modify i.e. each patient has only a single instance over their lifetime. This will be unusual in a hospital record where there is generally limited ability to curate the patient record in this way. So your persistence uses cases are either 2/3. Currently to manage Episodic persistence, you need ot set the composition category to event, as the RM currently forces a 'persistent' composition to be contextless i.e. the context attribute is 0...0. This will change in an upcoming RM revision. The decision about when/where to maintain persistent/curated lists is one which will vary between implementations. I would generally expect Medication lists, Allergies and some documents such as Resuscitation preferences to be maintained as single, persistent instances. Although Problems and Procedures should also probably be maintained that way, there are valid situations where departmental problem lists e.g Renal medicine have validity. There are strong arguments, at least in UK practice, for maintaining a single cross-organisation outpatient/community medication record but each inpatient medication list should be separately maintianed for each instiution/episode of care. Ian Dr Ian McNicoll mobile +44 (0)775 209 7859 office +44 (0)1536 414994 skype: ianmcnicoll email: [email protected] twitter: @ianmcnicoll Co-Chair, openEHR Foundation [email protected] Director, freshEHR Clinical Informatics Ltd. Director, HANDIHealth CIC Hon. Senior Research Associate, CHIME, UCL On 2 April 2016 at 06:59, [email protected] <[email protected]> wrote: > Hi all, I'm testing some cases in the EHRServer and I want to confirn some > grey areas. > > > If the EHR receives a commit of a persistent composition and the change type > is creation, should the EHR create a new composition? > > > i.e. I don't see an EHR having two different medication lists, is that > possible? > > > I guess persistent compos can only be created one time per archetype (one > medication list, one problem list, one vaccination list, etc. per patient), > and after the creation, all commits should be modification. Does this make > any sense? > > > If this is OK, to avoid errors from client applications, I would return an > error when a creation is committed for a persistent compo archetype that > already has a conpo instance. > > > And about the first commit. Should, lets say, the medication list be created > when the first medication is recorded or can it be created empty? What do > other implementations out there do? > > > Thanks a lot! > > > _______________________________________________ > openEHR-technical mailing list > [email protected] > http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.openehr.org _______________________________________________ openEHR-technical mailing list [email protected] http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.openehr.org
