Andrew and William, > > For me encounter and medication list are definitely not archetypes: > > they differ too much in each circumstance, they are templates that > > will hold several to many archetypes. > > I don't understand the distinction you make here - archetypes > can hold other archetypes and so I'm not sure why templates > are introduced. For instance, from the openehr sample archetypes
Encounter and Medication List are Compositions in openEHR. Templates are used to further constrain these into a particular context such as a Diabetes Review Encounter or a Current Medication List. Again you don't want to specialise the composition archetypes for every possible context in every country otherwise you won't have semantic interoperability between contexts and jurisdictions. > If this summary was 'included' as the content of a higher > level 'discharge' archetype, you would have a flexible > definition of a discharge summary. Where does the template > come into it? Clinically a neonatal discharge is not much different to a maternal discharge or a day stay discharge except for the context and the data it contains. So you don't need different composition archetypes, just a different template to constrain (or hint towards) the type of data to be record for each context. > What everyone seems to be saying is that clinicians need a > lot of flexibility in how they put together things such as > encounters and referrals. I 100% agree - which is why I would > think each jurisdiction would have its own compositional > archetypes, suited to its own particular use cases (maybe in > a hierarchy of australia discharge summary -> australia natal > discharge summary etc). See above. But perhaps a specialisation of Discharge composition is not out of the question but not on the basis of jurisdiction except within the archetype governance framework. > Instead my reading of the situation is that everyone wants to > just have a single global > > openEHR-EHR-COMPOSITION.discharge.v1draft.adl > > which seemingly adds no useful constraints at all, and then > instead constrain everything with templates (of which we > haven't yet seen a spec?). As you noted, these are draft archetypes and need work. Composition archetypes can specify the sections (or entries) that they contain as content but will also specify the category of the composition and the other_context data that is associated with the composition. For example you will not find any content constraints in the openEHR-EHR-COMPOSITION.report.v1 archetype but will find an other_context item structure. The discharge archetype is the placeholder for the concept of a discharge composition, it is still to be determined what globally acceptable constraints we can specify on discharge content and what context data is required. Ocean has identified one data element (encounter ID) that is a candidate. Heath _______________________________________________ openEHR-clinical mailing list openEHR-clinical at openehr.org http://www.chime.ucl.ac.uk/mailman/listinfo/openehr-clinical
