Philippe AMELINE wrote:
>Hi,
>
>Sorry to come late on that point.
>
>I think you have better have a look at the european pre-standard ENV 13940
>related to continuity of care : the terminology applies to real world, but
>(sorry if I already said it 10 times on the list) no information system can
>forget continuity of care.
>
>In ENV 13940, the terminology looks like :
>
>Contact : contact of a health professionat to patient file (patient is there
>or not)
>
hm. That's interesting. But it's still not a transaction: the health
care agent (a CEN ENV 13606 term) responsible for adding to the record
miught be a piece of software or a device.
>Encounter : contact, patient is there
>
agree
>Health issue : superset of "problem" in POMR (Problem Oriented Medical Record)
>
Here in Australia, this is taken to mean: what the patient feels is a
problem. So an issue for a patient might be "difficulty breathing",
while the problem (fro mthe point of view of the clinician) is "asthma".
>Episode : part of a contact related to a single health issue
>and much more...
>
>ENV13940 is a very important document (and I don't only say that because a
>french guy - Dr Fran�ois Mennerat - is at the starting point of that
>pre-standard) : it is really the begining of the concept of "continuity of
>care" instead of "document workflow" in medical information systems.
>
I think the general approach is right - it is certainly the basis of
what we in the broad GEHR/EHR community have been doing for some years.
Maybe some of these terms need to be aligned across continents soon...
>I think that the word "Transaction" belongs to workflow (group of documents
>you should always publish together), while "Contact" is related to
>continuity of care.
>
So I suspect you would argue for "contribution" or "submission" ....
>Maybe I am deeply wrong, but I am certain that transition from "data
>management" to "knowledge management" and from "document workflow" to
>"continuity of care" are the 2 keys to worth using medical systems.
>
By the way, I don't think workflow is irrelevant; but whether it is
document -centered is another thing.
- thomas beale
