" I would focus on intra hospital longitudinal lists since it is very difficult to reach agreement in the enterprise."
I agree. These decisions are partly technical but largely down to the level of commitment/ consensus you can get in your clinical community to jointly curate these lists over time. The value of longitudinal persistence only accrues if everyone has commitment to the on-going curation process and is prepared to work within a common governance framework, rights and responsibilities. http://www.bcs.org/content/conWebDoc/17923 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 3 April 2016 at 09:07, [email protected] <[email protected]> wrote: > Good info and the criteria makes sense. > > > I would use episodic for things like hospitalization and treatments that are > not a knee time thing (event), maybe with help of folders. Also I would > focus on intra hospital longitudinal lists since it is very difficult to > reach agreement in the enterprise. And when that time comes, I would just > implement a new set of rules for the enterprise :) > > > Thanks! > > > Sent from my LG Mobile > > ------ Original message------ > > From: Ian McNicoll > > Date: Sat, Apr 2, 2016 15:50 > > To: For openEHR technical discussions; > > Subject:Re: Composition commit and change types > > Hi Pablo,When I am advising implementers on this, I use the following > categories ...## Composition Commit StylesDepending on the clinical > requirement, 3 styles of commit strategy aresuggested.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 corrected2. **’Episodic’**Create a new composition via > POST for each Period of Care i.e anadmission. If it needs to updated, use a > PUT to modify i.e Eachpatient has a single instance per Period of Care.3. > **’Longitudinal’**Create a new composition via POST for each patient. If it > needs toupdated use a PUT to modify i.e. each patient has only a > singleinstance over their lifetime. This will be unusual in a hospitalrecord > where there is generally limited ability to curate the patientrecord in this > way.So your persistence uses cases are either 2/3. Currently to > manageEpisodic persistence, you need ot set the composition category > toevent, as the RM currently forces a 'persistent' composition to > becontextless i.e. the context attribute is 0...0. This will change inan > upcoming RM revision.The decision about when/where to maintain > persistent/curated lists isone which will vary between implementations. I > would generally expectMedication lists, Allergies and some documents such as > Resuscitationpreferences to be maintained as single, persistent instances. > AlthoughProblems and Procedures should also probably be maintained that > way,there are valid situations where departmental problem lists e.g > Renalmedicine have validity.There are strong arguments, at least in UK > practice, for maintaining asingle cross-organisation outpatient/community > medication record buteach inpatient medication list should be separately > maintianed foreach instiution/episode of care.IanDr Ian McNicollmobile +44 > (0)775 209 7859office +44 (0)1536 414994skype: ianmcnicollemail: > [email protected]: @ianmcnicollCo-Chair, openEHR Foundation > [email protected], freshEHR Clinical Informatics > Ltd.Director, HANDIHealth CICHon. Senior Research Associate, CHIME, UCLOn 2 > April 2016 at 06:59, [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 > [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
