Stefan Sauermann wrote: > Hello everybody, > Let me try if I understand this correctly, : > > An EHR in the openEHR sense holds ALL data about a patient, in archetyped > form. As Thomas mentions you then go and "shape concrete expressions" for > certain well defined purposes, by combining these pieces in a meaningful > way. >
well let's say, all the data of interest to those performing the care delivery process. This includes the patient, and any data from devices they use. But there are lots of data generated in a hospital that relate to the patient that are of no interest to the physicians or nurses - that do not need to be in the EHR - examples: movements of the patient, of drugs from the pharmacy etc. > USECASE A: openEHR type of EHR in communities with close cooperation > In a typical situation today an openEHR type EHR could be situated within a > healthcare organization, where all employees fill in data as they provide > their special bit of care. Many of this is unstable and intermediate, as > caregivers get deeper into diagnosis and treatment, within days or even > hours. There is full detail. Some data is not fact, but assumption, to be > refined and tested further. This data is often not intended to be > communicated outside the own organization. ALL data about a patient is > available within a single organisation without severe data protection > issues. > > Finally, at the end of a treatment phase, someone would typically generate a > "concrete expression", e.g. a discharge summary, to be used by someone else > OUTSIDE the own organization, maybe a resident doctor who continues the > treatment of the patient. > This is where the data protection laws come in. > I should be clearer about what I meant by 'concrete expression' - I meant technically concrete expressions of the RM & content models, such as: - persistence schemas/models - UI form models, e.g. in Xform, XAML etc - UI display expressions, in XML, HTML, PDF - message output definitions - code fragments In other words, the content models should be a single source of definition of all concrete uses of such content, whether in a message, database or on the screen. Stefan, what you understood by 'concrete expression' is something more like a 'summary record content' or so... > USECASE B: "message based", between partners who are more loosely coupled > What we now think of as a typical "EHR" on a national level, for example in > Austria and in the Netherlands, is something different: It does not hold ALL > information about a single patient, it just holds the "concrete > expressions", e.g. the discharge letters that someone generated for a > certain purpose, to be used by someone at a completely different place. > Information must be complete, stable and reliable, filtered, and give the > complete picture, with interpretations, not too much details, more on the > summarizing side. > this is of course normal for an initial version of an EHR - it is not enough on its own to do full care, but it is useful to physicians. - thomas * *
