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.
PLEASE DON'T RESPOND IN THIS EMAIL THREAD.
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)
Dr Heather Leslie MBBS FRACGP FACHI
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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