Clinical modelling workshop at Medinfo?
Hi Heather, I will add some update to localization in Japan at workshop. We now have regular meeting to discuss archetype. Regards, Shinji. 2012/12/5 Heather Leslie heather.leslie at oceaninformatics.com: Hi everyone, I'm afraid that I'm a little confused about the outcome of these emails. I hear that people will attend, but not receiving clear offers to contribute to the workshop or, more importantly, to take on the organisational role. I'm not likely to have time to pull something together, and given that I've already indicated my attendance is unlikely it seems to be not quite appropriate. I'm willing to help. If I've misconstrued offers pre-existing for help, my apologies - please clarify for me. If we can't establish clear intent for contributions ASAP, it seems like our opportunity may have passed but happy to be proven wrong :) Regards Heather -Original Message- From: openEHR-clinical [mailto:openehr-clinical-bounces at lists.openehr.org] On Behalf Of Koray Atalag Sent: Monday, 3 December 2012 7:56 AM To: For openEHR clinical discussions Subject: RE: Clinical modelling workshop at Medinfo? Ditto - funding will not be possible for me. I guess I'll be spending this year's allocation for the Japanese workshop Cheers, -koray -Original Message- From: openEHR-clinical [mailto:openehr-clinical-bounces at lists.openehr.org] On Behalf Of Jussara macedo Sent: Thursday, 29 November 2012 6:12 a.m. To: For openEHR clinical discussions Subject: Re: Clinical modelling workshop at Medinfo? I?d like to take part of that, but also have minimal chance of being there, due the lack ot time. BTW the one we held last week in our national health informatics congress was a huge success of audience. many groups of experts with real implementation were there. We discovered that there is a dental EHR which developed ca 50 archetypes and that now it?s a propriety o DELL! Of course they didn?t share with our community. I told them on the CC license, but it seems it?s not very well understood the collaborative space we?re trying to create. I think it?s time for us to organize a panel on archetypes governance. Apropos many, many people want to be more involved with archetype design but I think that language is a barrier here. We definitely need some local ambiance to foster this kind of work. Jussara R?tzsch Md, MSc Director, OpenEHR Foundation Owner, Giant Global Graph ehealth Solutions On Wed, Nov 28, 2012 at 3:07 AM, Heather Leslie heather.leslie at oceaninformatics.com wrote: Hi everyone, Shinji has kick-started a wiki page to support the proposed developer's workshop at Medinfo in Copenhagen next year - http://www.openehr.org/wiki/display/resources/MEDINFO+2013+-+Copenhage n%2C+Denmark Deadline for submissions is December 10, I believe. Who would like to be involved in the development of a Clinical Workshop? I have no guarantee and only a small likelihood of being able to attend, given the distance J I'd suggest it being along the lines of an introduction to openEHR modelling still. Whenever we run these courses at conferences or privately they usually very well attended. I don't think we should focus much on more advanced ideas - Ian and I ran an advanced workshop at MIE in Pisa in August, focusing on the ins and outs of clinical knowledge governance, which we thought topical, but most of the audience were absolute newcomers and we had to tone it down and simplify in mid-workshop. Regards Heather Dr Heather Leslie MBBS FRACGP FACHI Director of Clinical Modelling Ocean Informatics Phone (Aust) +61 (0)418 966 670 Skype - heatherleslie Twitter - @omowizard ___ openEHR-clinical mailing list openEHR-clinical at lists.openehr.org http://lists.openehr.org/mailman/listinfo/openehr-clinical_lists.opene hr.org ___ openEHR-clinical mailing list openEHR-clinical at lists.openehr.org http://lists.openehr.org/mailman/listinfo/openehr-clinical_lists.openehr.org __ Information from ESET NOD32 Antivirus, version of virus signature database 7753 (20121201) __ The message was checked by ESET NOD32 Antivirus. http://www.eset.com __ Information from ESET NOD32 Antivirus, version of virus signature database 7753 (20121201) __ The message was checked by ESET NOD32 Antivirus. http://www.eset.com ___ openEHR-clinical mailing list openEHR-clinical at lists.openehr.org http://lists.openehr.org/mailman/listinfo/openehr-clinical_lists.openehr.org ___ openEHR-clinical mailing list openEHR-clinical at lists.openehr.org http://lists.openehr.org/mailman/listinfo/openehr-clinical_lists.openehr.org
Usage of Blood glucose archetype for self-monitoring
by the diabetic himself, or if you suggest to introduce a new archetype for Blood glucose self-measurements. Thank you for any hints and comments. Hans Demski Helmholtz Zentrum M?nchen Deutsches Forschungszentrum f?r Gesundheit und Umwelt (GmbH) Ingolst?dter Landstr. 1 85764 Neuherberg www.helmholtz-muenchen.de Aufsichtsratsvorsitzende: MinDir?in B?rbel Brumme-Bothe Gesch?ftsf?hrer: Prof. Dr. G?nther Wess und Dr. Nikolaus Blum Registergericht: Amtsgericht M?nchen HRB 6466 USt-IdNr: DE 129521671 ___ openEHR-clinical mailing list openEHR-clinical at lists.openehr.org http://lists.openehr.org/mailman/listinfo/openehr-clinical_lists.openehr.org ___ openEHR-clinical mailing list openEHR-clinical at lists.openehr.org http://lists.openehr.org/mailman/listinfo/openehr-clinical_lists.openehr.org ___ openEHR-clinical mailing list openEHR-clinical at lists.openehr.org http://lists.openehr.org/mailman/listinfo/openehr-clinical_lists.openehr.org -- next part -- An HTML attachment was scrubbed... URL: http://lists.openehr.org/pipermail/openehr-clinical_lists.openehr.org/attachments/20121206/a27987b2/attachment-0001.html
Usage of Blood glucose archetype for self-monitoring
glucose archetype for self-monitoring Hello, i am involved in a project that supports diabetics in self-monitoring their health status by collecting observations of daily living (http://www.empower-fp7.eu/about/collecting-observations-of-daily-living/). We are currently defining the knowledge models by using the archetype methodology. I think the archetypes for Body weight, Blood pressure and Medication action can be reused without problems for the purpuse of self-monitoring by the patient. As far as Blood glucose is concerned I am not sure if the labtest archetype (openEHR-EHR-OBSERVATION.lab_test-blood_glucose.v1) is appropriate for self-monitoring as it was defined as a labtest originally. In contrast to the labtest that is performed on serum of the blood, the patient measures blood glucose by using hand-held meter using test strips and capillary blood. Therefore I doubt that the two measurement methods are comparable. Moreover the whole Protocol section of the existing Blood glucose archetype is dedicated to labtests and not applicable to the self-measurement. I would like to hear your opinion if the existing Blood glucose labtest archetype should be used for collecting measurements done by the diabetic himself, or if you suggest to introduce a new archetype for Blood glucose self-measurements. Thank you for any hints and comments. Hans Demski Helmholtz Zentrum M?nchen Deutsches Forschungszentrum f?r Gesundheit und Umwelt (GmbH) Ingolst?dter Landstr. 1 85764 Neuherberg www.helmholtz-muenchen.de http://www.helmholtz-muenchen.de Aufsichtsratsvorsitzende: MinDir?in B?rbel Brumme-Bothe Gesch?ftsf?hrer: Prof. Dr. G?nther Wess und Dr. Nikolaus Blum Registergericht: Amtsgericht M?nchen HRB 6466 USt-IdNr: DE 129521671 ___ openEHR-clinical mailing list openEHR-clinical at lists.openehr.org mailto:openEHR-clinical at lists.openehr.org http://lists.openehr.org/mailman/listinfo/openehr-clinical_lists.openehr.org ___ openEHR-clinical mailing list openEHR-clinical at lists.openehr.org mailto:openEHR-clinical at lists.openehr.org http://lists.openehr.org/mailman/listinfo/openehr-clinical_lists.openehr.org ___ openEHR-clinical mailing list openEHR-clinical at lists.openehr.org http://lists.openehr.org/mailman/listinfo/openehr-clinical_lists.openehr.org ___ openEHR-clinical mailing list openEHR-clinical at lists.openehr.org http://lists.openehr.org/mailman/listinfo/openehr-clinical_lists.openehr.org -- *Dr. Sebastian Garde* /Dr. sc. hum., Dipl.-Inform. Med, FACHI/ Senior Developer Ocean Informatics Skype: gardeseb -- next part -- An HTML attachment was scrubbed... URL: http://lists.openehr.org/pipermail/openehr-clinical_lists.openehr.org/attachments/20121206/43301c64/attachment-0001.html
Usage of Blood glucose archetype for self-monitoring
Hi Hans, Andr?s, Very interesting question. We faced this issue when modelling for a paediatric hospital and after some discussion decided to use the standard lab_test-glucose archetype but considered adding a Method element to protocol, to carry 'Test strip - visual; Test strip - automated; Laboratory analyser' as internal coded tests. It is certainly clear that we may need to identify the methodology, and according to the guidance paper that Andres provided, we many also need to specify whether this is a whole-blood or plasma / plasma-calibrated measurement. My own feeling is that we should try to incorporate these within the same archetype. The general archetyping philosophy is try to try to model the clinical record and not the device or methodology. @Hans - I agree that there is a fair bit of lab-related overhead in protocol but this would just be templated out, so that would not debar use of the archetype for this purpose. I look forward to hearing other opinions. I willtry ot get some opinions from clinicians and other lab/diagnostics experts On 6 December 2012 06:51, andres gamboa andreshgamboa at hotmail.com wrote: Hi Again! Well first i would like to say that this kind of discussions are very enriching for me since I can learn so much, from all of you. I?m young and very curios and with lot of things to learn. Don?t want to seem like I?m arrogant. Regarding to EHR there are still lot of issues not resolved yet and one of the main problems resides in the difficulty of consensus in clinical concepts when one is trying to model the medical knowledge. I think that despite the possible controversy about the concepts (clinically speaking), what it is important in my personal opinion (And I would like to add that Im not an expert in the area, just very interested in this matter) is that the concept represented in the archetype must be clear enough to allow an accurate assessment. Since glucometers are biosensors they could have error, that depends of the device used to measure (and there are several) and sometimes they must be calibrated and so forth in order to make this measure more accurate and close to labtest results (gold standard). So comparing its results with labtest results can be misleading. That?s why in a previous email I suggested to treat them as different concepts. Now I suggest that maybe this matter should be discussed by clinicians that work in diabetes and reasearchers, and reviewed by engineers in order to find the most convienent solution, and in some way to standarize the concept. There?s a lot of people dealing with the same issue in diabetes.I think this link could be useful http://care.diabetesjournals.org/content/26/suppl_1/s106.long There you can find the recomendations of the American Diabetes Association for blood glucose monitoring. Lot of regards Andr?s Date: Thu, 6 Dec 2012 16:26:59 +1100 From: sam.heard at oceaninformatics.com To: openehr-clinical at lists.openehr.org; Ian.McNicoll at oceaninformatics.com Subject: Re: Usage of Blood glucose archetype for self-monitoring Hi I would be interested in Ian McNicoll's point of view. Personally, I do not find the measurement of blood glucose different for home monitoring as long as it is clear that this is the method. Self or carer entry of data, a device suitable for near patient testing - these could be at a clinic or done by a nurse or doctor. I would use the blood glucose measurement for all measurements of this as I think it is the same thing. Others? Cheers, Sam On 6/12/2012 12:49 PM, andres gamboa wrote: Hi, I agree with that. Indeed the test aren?t comparable. This creates the necessity of re-defining the concept of Blood glucose. I suggest to create an archetype such blood glucose monitoring, that includes the different technics for glucose blood measurement , as serum glucose measurement mainly known as Glycemia, Home blood glucose monitoring (with glucometer) and Glycosylated hemoglobine, or something like that. Andres Gamboa M.D, Msc Biomedical Engineering Date: Wed, 5 Dec 2012 16:32:37 +0100 From: demski at helmholtz-muenchen.de To: openehr-clinical at lists.openehr.org Subject: Usage of Blood glucose archetype for self-monitoring Hello, i am involved in a project that supports diabetics in self-monitoring their health status by collecting observations of daily living (http://www.empower-fp7.eu/about/collecting-observations-of-daily-living/). We are currently defining the knowledge models by using the archetype methodology. I think the archetypes for Body weight, Blood pressure and Medication action can be reused without problems for the purpuse of self-monitoring by the patient. As far as Blood glucose is concerned I am not sure if the labtest archetype (openEHR-EHR-OBSERVATION.lab_test-blood_glucose.v1) is appropriate for self-monitoring as it was defined as a labtest
Just a thought: Usage-Writing of own archetypes
On 12/06/2012 09:23 AM, Sebastian Garde wrote: Whatever we do, I think we need to be guided by the One archetype per concept-principle! Sorry to break in on a detail, but I think it is important. I changed the title. Who is we? Is that the same as they? I think so. I don't think that such a restriction does right to the complexity of health care-organization around the world, different cultures around the world, different business models, different users, different levels of education. It is also my daily experience, people, companies do not let themselves restrict, they write archetypes whenever they want, and find for interoperability a message-format, like in the Netherlands, we have well defined HL7 messages. And this is only the Netherlands and western Europe. If in such a small piece of Earth, there is already dissatisfaction about, rebellion against, ignoring of this restriction, how will this be if other countries want to use the OpenEHR concept? I think it will not work. I think OpenEHR then will isolate itself, because that is not what many people want. And also, regarding to multi-level modeling, there is no modeling at all, because the community does not allow the users to design. The leading community (we) wants the users to use their archetypes, not write their own. What is then the difference with a classical software company where a product and data-structure is received, and requests for change from the customers, are impossible, or bring up many dollar signs in the eyes of the vendor. I don't think the customer wants to know how a product is designed, if that is of no consequence for him/her. Why the customers, if they would agree with this, would ever need an archetype editor is not clear to me. It is the flexibility, and independence, no vendor-dictatorship, which are important reasons people in my environment use OpenEHR. It works different in my environment, where maybe ten different software projects are using an OpenEHR kernel, people get inspired by the archetypes from CKM, the experience of the writers helps them, but they don't let themselves control by the philosophy of restriction behind. I think, that we/they will lose the concept of a single-managed archetype repository. The kernel-concept allow the use of other archetypes and write own archetypes, and that is what people will do. When we/they recognize this, than we/they can take measures to guide this process, because if it will not be guided, automatically, we/they get out of control. That would be a pity, wouldn't it? Have a nice day Bert Verhees
Clinical modelling workshop at Medinfo?
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Just a thought: Usage-Writing of own archetypes
it? Have a nice day Bert Verhees ___ openEHR-clinical mailing list openEHR-clinical at lists.openehr.org http://lists.openehr.org/mailman/listinfo/openehr-clinical_lists.openehr.org -- *Dr. Sebastian Garde* /Dr. sc. hum., Dipl.-Inform. Med, FACHI/ Senior Developer Ocean Informatics Skype: gardeseb -- next part -- An HTML attachment was scrubbed... URL: http://lists.openehr.org/pipermail/openehr-clinical_lists.openehr.org/attachments/20121206/728f9c24/attachment.html
Just a thought: Usage-Writing of own archetypes
Hi Sebastian, On 12/06/2012 12:48 PM, Sebastian Garde wrote: The one archetype per concept principle applies on different levels for me. We were talking about the international openEHR archetypes at present, so what I really mean here is that /within one consistent eco-system/ of archetypes there should only be one archetype per concept. Now, what is needed is a definition for the word concept. Because there is a lot of difference between a low education approach of some measurement at home and a complex measurement in the hospital, and even inside the hospital there can be differences, measurements done at the bed, measurements done in a lab. Archetypes must reflect the need of datastructure at a detailed level that is needed in a specific situation. So the concept blood-pressure is not fine grained enough, it must, for example, also indicate, blood-pressure measured by a home-user. Or you end up with archetypes full of optional structures: If done at home, skip 80% of the archetype. This one consistent eco-system can be anything from the international space via national and regional initiatives or your own system. E.g. nationally, like Nehta, you may want to enable semantic interoperability between various national solutions. That's great. What is also great is that the knowledge gained by Nehta developing / adapting the international archetypes used as a starting point, can be fed back into the international space. What we certainly aim for is that the international archetypes are more than a good starting point, namely that they are of such high quality and so comprehensive that you /want /to use them. Initially, you'll need to make some changes for sure, but the more feedback is incorporated into the international archetypes over time, the better they get (I hope) and over time I believe the requirement for changes diminishes. One of the arguments for Open Source is the Chinese saying: Let thousand flowers bloom. You can only learn from others if you give freedom to others. (Chinese people themselve could learn from their sayings :) And in this perspective, CKM is very good, because a lot of knowledge come together, and the archetypes are very helpful for the people I work with, as examples. I don't write archetypes, but I see a lot of archetypes, and I see people starting to write them for the first time, and I always point to CKM to help them. But there is a problem with the archetype-ID concept. People very fast write ID's with obvious names. I always teach them to add their company-name, or projectname in the conceptname part, so there is some uniqueness in the names, but of course, this is no guarantee. But I don't think we can solve this problem now. I just mention it. You say It is the flexibility, and independence, no vendor-dictatorship, which are important reasons people in my environment use OpenEHR. Absolutely! But one thing: interoperability is on a different level then in comparison to systems that are based on the same set of archetypes, e.g. for decision support based on it, etc. Very true, but I don't see that work, only at a local level, where you feed a decision support system with the use of known archetype-paths inside that location. I am afraid, that is the daily reality, and I tend to think that it is unavoidable. But of course, this is only a personal opinion. But if I am right, then it would be good to do something with the Archetype-ID specification, to guarantee better uniqueness. Best regards Bert Verhees -- next part -- An HTML attachment was scrubbed... URL: http://lists.openehr.org/pipermail/openehr-clinical_lists.openehr.org/attachments/20121206/cc8af219/attachment.html
