Hi everyone,

Seeking advice from the broader community regarding an important modelling 

At present the Medication Order (INSTRUCTION.medication) archetype is 
undergoing community review.

The primary author has proposed that the scope include IV and other parenteral 
fluid administration which is regarded as therapeutic item by many as even 
fluids such as Normal Saline or Glucose infusions need to be prescribed. This 
was not clearly represented in the metadata in previous review rounds and it 
appears that the archetype will cater for this, albeit with the very 
medication-specific data elements alongside.

This is the question posed to reviewers, within the current review:

"A significant question has arisen as to whether this archetype should be used 
for fluid orders, particularly parenteral (IV, IM, SC) orders. Predecessors of 
this archetype have been used in production to order fluids, where in some 
settings is normal practice to consider fluid orders as 'prescribables', and 
therefore considered a 'therapeutic good'. Others have disagreed and feel that 
'fluid intake orders' ( to include oral and parenteral fluids) should be 
handled by a separate INSTRUCTION archetype. It is quite possible that both 
approaches may have to be supported, reflecting difference in practice but your 
views and practical experience would be helpful in resolving the scope of this 
archetype. A further question is the order of 'blood transfusions' - current 
thinking appears to be that this should be a separate archetype."

So the options are to create an additional archetype (effectively a more 
focused subset of the INSTRUCTION.medication) that could cater purely for 
parenteral fluids or use the Medication Order to cover both, which is not 
intuitive if ordering IV fluids is regarded as a separate process to ordering 

Perhaps having both is also a reasonable answer and allow implementers to make 
their own choice - atcodes/paths could be closely aligned.


Instead we ask that you participate via the Clinical Knowledge Manager as soon 
as possible in either of these two ways:

1.       If you have already been invited to the review, please complete it as 
soon as possible; OR

2.       If you have not been invited so far but would like to participate 
please ADOPT the archetype by following these instructions - 

The review is due to close in the next few days, so your timely response would 
be much appreciated.


Heather Leslie (EDITOR)

CCIO, Ocean Informatics<http://www.oceaninformatics.com/>
Clinical Programme Lead, openEHR Foundation<http://www.openehr.org/>
p: +61 418 966 670   skype: heatherleslie   twitter: @omowizard

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