Hi Silje,

Each admission note will likely have it's own content priorities and level of 
details, so there will be many templates - maybe not 'hundreds if not 
thousands' of templates if business logic drives some of the display of each 
template, but still many - that will be the reality. The templates have IDs, 
COMPOSITIONS can be renamed to 'Neurosurgery outpatients - Dr ABCD'. We could 
consider creation of a specialisation of COMPOSITION.encounter for Neurosurgery 
but then we would have to consider every specialisation and govern them all - 
not sure that there is value here. And we definitely don't want to create a 
COMPOSITION archetype that is specific to Dr ABCD consulting in Neurosurgery 
outpatients at XYZ hospital'.
Querying will occur at different levels - eg 'any BP in any template, including 
consumer entered as well as hospital records' through to 'all Antenatal 
encounters during Pregnancy #1' etc.

I think we need to create use-case related archetypes, COMPOSITION or other, 
only where we can identify informatics, quality or querying benefits. And from 
first principles I suggest that we should keep the number of archetypes to a 
sensible, pragmatic minimum and let the power of terminology and querying 
within archetypes/templates play their very important part in letting us 
identify and retrieve the different types of documents. You can see that in 
action with our latest iteration of INSTRUCTION.request - it will subsume all 
of the current specialisations, rendering them redundant. I think this is good 
modelling UNLESS we determine that specialising INSTRUCTION.request-laboratory 
might be of value to simplify querying, but I'd never agree to a specialisation 
for every type of request - use terminology here. Otherwise the overhead on 
governance and maintenance of the extra archetypes becomes orders of magnitude 
greater and distributed authoring of templates in a consistent way which will 
support interoperability will become more confusing with a multitude more 
options. (Funny how that reminds me of the confusing array of options when 
using post-coordination to represent the same thing - everyone seems to do it 
differently.)

Your question about 1:1 archetype development needs to be applied to all 
concepts not just the COMPOSITIONs and I think the solution becomes easier to 
decide.

Regards

Heather


From: openEHR-clinical [mailto:openehr-clinical-boun...@lists.openehr.org] On 
Behalf Of Bakke, Silje Ljosland
Sent: Friday, 12 February 2016 1:17 AM
To: For openEHR clinical discussions (openehr-clinical@lists.openehr.org) 
<openehr-clinical@lists.openehr.org>
Subject: Architectural choices: One composition archetype per document type, or 
not?

When implementing an openEHR based system for a large hospital, there will be 
hundreds if not thousands of document types. Examples of these are admission 
notes for different departments and specialties, outpatient notes, nursing 
documentation, check lists, discharge summaries, etc ad infinitum. Each of 
these could either have its own COMPOSITION archetype, or they could reuse 
generic compositions but have a separate template for each document type.

What's the smart architectural choice to make here; 1-1 document type - 
COMPOSITION, or reuse of generic COMPOSITIONs in specific templates? Why? How 
can you query a specific document type if it doesn't have its own COMPOSITION?

Kind regards,
Silje Ljosland Bakke

Information Architect, RN
Coordinator, National Editorial Board for Archetypes
National ICT Norway
Tel. +47 40203298
Web: http://arketyper.no<http://arketyper.no/> / Twitter: 
@arketyper_no<https://twitter.com/arketyper_no>

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