Hi all, As things currently stand I would agree with Rong that guidelines are not best modelled in archetypes. There are already a plethora of candidate formalisms for computable guidelines and their requirement goes well beyond what the current OpenEHR Ref model provides.
However, I have a current interest in adapting formal guidelines so that they can be used as semi-structured data entry templates i.e some of the content of the guideline can be used to populate the EHR - in this case it may well be appropriate to embed archetypes within guidelines e.g a guideline which contains some suggested instructions and actions such as drug therapies or referrals which can act as triggers in the EHR. Ian On Nov 8, 2007 10:08 PM, Rong Chen <rong.acode at gmail.com> wrote: > On 11/8/07, Chunlan Ma <chunlan.ma at oceaninformatics.com> wrote: > > > Hi Rong, Sam and others, > > > > > > > > *From:* openehr-clinical-bounces at openehr.org [mailto: > > openehr-clinical-bounces at openehr.org] *On Behalf Of *Rong Chen > > *Sent:* Wednesday, November 07, 2007 10:34 PM > > *To:* For openEHR clinical discussions > > *Subject:* Re: Evaluation Archetypes and assessment protocol > > > > > > > > If one chooses the first option one should fill out the criteria each > > and every time, when writing down a diagnosis. Of course this can be > > automated by the application that is used. Thing is that the knowledge will > > be stored locally at application level. My feeling is that your suggestion > > to use the GuidelineID is in conjunction this option. Point is that if I > > refer to an external guidelines, data in that guideline isn't 'archetyped' > > and can't be used for computational purposes. So I have to translated those > > into an archetype. > > > > > > > > Guidelines can be computerized as well. There are published guidelines > > representation formats, e.g. GLIF for instance and their execution > > engines. Being rules based and decision trees like, personally I think they > > are not best modelled as archetypes since archetype model are designed to > > represent more 'static' clinical content model. In applications, EHRs and > > guidelines should work hand-in-hand: 1) guidelines need to query EHRs > > through standardized EHR representation format and query language; 2) EHRs > > need record what guidelines are used etc. > > > > *[Chunlan Ma] * > > > > * * > > > > *I'm personally very interested in how clinical guidelines are used > > within an openEHR-based EHR system even though I'm new in this field. In my > > understanding, the **guidelineId** in CARE_ENTRY is used as a reference > > to an external clinical guideline; the **protocol** attribute in > > CARE_ENTRY is used as local guideline/protocol definition. Please correct me > > if this is wrong.* > > > > * * > > > > *Because the type of **protocol** attribute is **ITEM_STRUCTURE**, it > > means the local protocol/guideline definition is archetyepable. Archetypes > > are very good to record facts, but don't know how it can be used to record > > rule criteria, such as when HbA1c is greater than 9%, do such. * > > > Hi Chunlan and others, > > The limitation is from the underlying information model not the archetype > formalism. The archetype formalism is very generic so it can be used to > constrain any object model. My thinking was limited to EHR model when I made > the statement that guidelines are not best modelled as archetypes. If the > underlying model is a good object model for representing guidelines, of > course it's possible to model guidelines as archetypes. > > Back to protocol attribute, quoted from the EHR Information Model, "This > may take the form of references to guidelines, including manually followed > and executable; knowledge references such as a paper in Medline; clinical > reasons within a larger care process ". It seems to be intended as a > reference to a guideline instead of the guideline itself fully archetyped > in-line. > > /Rong > > > > *Cheers,* > > > > *Chunlan* > > > > * * > > > > > > > > Cheers, > > Rong > > > > _______________________________________________ > > openEHR-clinical mailing list > > openEHR-clinical at openehr.org > > http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-clinical > > > > > _______________________________________________ > openEHR-clinical mailing list > openEHR-clinical at openehr.org > http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-clinical > -- Dr Ian McNicoll office +44(0)141 560 4657 fax +44(0)141 560 4657 mobile +44 (0)775 209 7859 skype ianmcnicoll Member of BCS Primary Health Care Specialist Group ? visit http://www.phcsg.org for membership details. -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.openehr.org/mailman/private/openehr-clinical_lists.openehr.org/attachments/20071108/ae1876da/attachment.html>
