Hi, Imho the grass-roots editors need to (as you write) - A set of generic patterns to start with. Patterns for any: Observation, Evaluation, Order, Action, for use in documentation of Medical aspects and Administrative aspects about the Patient System. Including generic concepts like (Diff) Diagnosis Lists, Episodes, (Family, Social, …) History, Problem List, Orderlist, ActionList, … - Guidance, handbook, on how to use the patterns - Model one set of coherent archetypes dealing with a clinical domain/speciality (such as: medication, physical exam eyes, ENS, breast exam, clinical pathway, …)
The generic Patterns need to be created, maintained by IT-modelling experts. The medical professions need to model and maintain the Archetype packages. Local healthcare providers will create Templates to be used in their context. Gerard Freriks +31 620347088 [email protected] Kattensingel 20 2801 CA Gouda the Netherlands > On 16 Aug 2018, at 13:41, Thomas Beale <[email protected]> wrote: > > A few thoughts come to mind: > > sets of archetypes could potentially be developed closer to completion by the > grass-roots level, before submission to CKM, which would reduce editorial > time, if better guidelines on development rules, patterns, etc i.e. the > fabled handbook existed > consider a set such as for ante-natal care + birth + post-natal (6 weeks) - > there might be 50 archetypes implicated here, with (we hope) at least half > being generic (e.g. lab tests used in pregnancy are mostly not unique to > pregnancy) - there is a lot of work here. > It might be a better approach if development teams were to try to develop > whole packages to a reasonable level, rather than just submitting single > archetypes and wait for results of review > whole package generally would be based on some process, care pathway etc, not > just a data-oriented view. E.g. pregnancy; chemo+ monitoring; etc > if the fabled handbook of patterns and criteria for good archetypes existed, > more editors could be trained. > is there any reason not to have just more people on the editorial group, e.g. > 10? > is it time to agree a set of major clinical sub-specialties (< 20) and > designate an owner for each one (i.e. an editor; some editors could own more > than one area)? > we possibly need to distinguish two layers of archetypes, which would > potentially change how editorial work is done: Level three is the Template level for the local context. > generic all-of-medicine archetypes: > vital signs > many signs and symptoms > a reasonable number of labs > general purpose assessment / evaluations, i.e. Dx, problem description etc, > many things like lifestyle, substance use > ?all of the persistent managed list types: medications, allergies, problem > list, family history, social situation, consents, etc > the specialties, for each: > specific signs and symptoms > specific physical exam > specific labs > specific plans > more than one relationship between specialty archetypes and generic ones is > possible, e.g. some are just new; some are formal specialisations in the ADL > sense. > My guess is there is a number of issues to consider. Whether any of the above > are the main ones I don't know. > > - thomas > > >
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