Hi Sam,
Thanks for the clarification. I guess I have put too much into
archetypes which would better be handled with templates. However I am
sure you are aware of the fact that the documentation and tools for them
freely available at openEHR or Ocean are definitely not sufficient for
self-learning ;) I hope that this will change soon...
As for the SECTIONS, after some rereading I understand your comments.
That would be also useful for adding new endoscopic modalities like
Endoscopic Ultrasound (EUS) and Capsule Endoscopy. The MST for the
former is already published and work is being done for the latter.
Regarding where different parts of MST would fall into openEHR EHR model
there may be many alternatives and I am still far from understanding
them all. However let me make clear again that my primary aim with MST
archetypes is modeling a clinical domain for the purpose of HIS
development and then secondarily try to put parts of the data collected
into an appropriate 'EHR structure'. Clearly the type of approach taken
here is just the opposite (naturally); that is first establishing a
solid framework for EHR record structure and then let other (feeder)
systems to adjust. My primary concern with the type of MST Archetype
Model was to preserve the original structure and semantics depicted in
MST. And for doing so I knew of no other way than using a COMPOSITION
structure - now I do :). I am sure that much more can be achieved by
using templates and I am looking forward to learning and then having a
hand on experience.
Best regards,
Koray Atalag, MD, Ph.D.
Sam Heard wrote:
> Hello All,
>
> I just thought I should add a couple of points...
>
>> I fully agree. Yes all of the archetypes are indeed subtypes of the
>> ENTRY type.
>>
>>> And because endoscopy is used for Observation, Diagnosis and Therapy,
>>> archetypes will be divided into "Observation entry" and "Action entry".
>>>
>> Yes for the Observation. However the diagnosis would be an EVALUATION
>> archetype. The therapy (plus diagnostic procedures) will better be
>> modeled by ad hoc ACTION archetypes (No INSTRUCTION type). You can check
>> the schematic representation of the whole MST model in my thesis
>> document on page 135 (You can find it under publications=>archetypes
>> section of openEHR Website). Just ignore the INTERVENTION and use ACTION
>> instead (an error).
>>
>>> However because there are various endoscopies, e.g. EGD, Colonoscopy
>>> and ERCP, I think these will be "Section".
>>> In summary, if you make MST archetypes("Observation Entry" or "Action
>>> Entry" level) and these are used in "Section"s (EGD, Colonoscopy,
>>> ERCP, etc.), it will be satisfy reusability.
>>>
>> Well, the structure of the MST model has been a hot debate during my
>> thesis. We discussed it many times with the experts and could not reach
>> a clear result. My proposal is to assemble all different archetypes
>> representing different parts of MST under a single COMPOSITION.
> This is done using templates - so we can have a composition which is
> Colonoscopy which can be named.
>
> Seung Jong is right - if a number of 'oscopies' are done at one time,
> then it would be appropriate to enter these within sections. This is
> not uncommon and has influenced our approach to different templates.
> One example is the obstetric 'view' as part of an antenatal visit - if
> the person raises other issues at the time it is appropriate to record
> these in the same encounter record. The idea of a section as an anchor
> for a pattern is useful in many situations that have a number of
> issues that may be dealt with at the same time.
>> This
>> would be useful for a report generator software (which most of the
>> implementations of MST are indeed this kind including mine). The
>> SECTIONS perhaps would form different parts of the EHR such as LAB
>> results, Progress Notes, Physical Exams and so on.
>>
> Two things here - you can use Folders for hand made collections of
> compositions - such as those listed above. But you can also use
> queries to return sections or compositions which contain say an
> endoscopy or laboratory observation. The idea of a progress note is
> more related to a document in my mind - so would relate to the context
> of composition.
>
> Cheers, Sam
>
> Ocean Informatics
>
> Director, openEHR Foundation
> Adj. Professor, Central Queensland University
> Senior Visiting Research Fellow, University College London
> Aus: +61 4 1783 8808
> UK: +44 77 9871 0980
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