Quite a number of the documents being worked on as part of the NHS modelling work present themselves as checklists e.g Pre-op systems checks or Risk Assessment questionnaire. To date these have mostly been modelled as simple boolean or short termlist laden archetypes but it is my impression that there are a variety of styles of checklists some of which may merit different degrees of expansion below the top-level simple boolean and may have wholly different functions within clinical recording. For example the Pre-op checklist is often a simple last minute check that the patient has no contra-indications to surgery, the expectation is low that there will be positive findings and it is unlikely that a detailed elucidation will follow if a positive finding is happened upon. e.g If a pre-op patient responds positively to "Do you have asthma" it is unlikely that a more detailed history will follow within the same recording circumstance or that such a recording will trigger a formal diagnosis of asthma. In contrast, a Risk assessment for suicide which elicits positive findings is much more likely to be the start point of more in depth history taking and recording. Whilst this type of checklist, I think merits full and detailed archetyping, I wonder if the other style, a 'throwaway' assessment merits individual archetyping, as we may end up with a very large number of overlapping artifacts, essential to patient safety but with little real longitudinal value in the clinical record.
One of the constructs that has been used by the NHS clinical modelers is a generic 'checklist' name/value pair construct. Currently this is being'instantiated' within archetypes but I wonder if we can differentiate some (perhaps frequent) use cases where specific archetyping is unnecessary and a generic Checklist container should be used with all constraints being applied at template level. I came across this discussion of checklists in the biomedical community http://mibbi.sourceforge.net/misc/MIBBI.pdf Nothing else I could find on the meaning and utility of clinical checklists in medical records - nice bit of research for someone, perhaps. Ian -- Dr Ian McNicoll office +44(0)141 560 4657 fax +44(0)141 560 4657 mobile +44 (0)775 209 7859 skype ianmcnicoll Consultant - Ocean Informatics ian.mcnicoll at oceaninformatics.com Consultant - IRIS GP Accounts Member of BCS Primary Health Care Specialist Group ? http://www.phcsg.org -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.openehr.org/mailman/private/openehr-clinical_lists.openehr.org/attachments/20071218/b47f4aa9/attachment.html>
