Hi,

I haven't done thuis yet in practice. But for question 2 I have considered 
doing both templates. A typical questionare yes/no and the more complex way. 
Were in the background the questionare would propegate the more clean template. 
It hasbenefits:

- easy to create both a write and read user interface
- the complex template you can easy create lists of included and excluded 
decaeses.
- In our case the more complex way fits better for interoperable web service

Best regards,

Wouter Zanen

Outlook voor Android downloaden<https://aka.ms/ghei36>

________________________________
From: openEHR-clinical <[email protected]> on behalf 
of Ian McNicoll <[email protected]>
Sent: Thursday, July 18, 2019 6:18:47 PM
To: For openEHR clinical discussions
Subject: Re: Template for Surgical Pre-Assessment

Hi Grant

1. I'm not sure if you are asking about the groupings in the ui or in the 
models. Non invasive blood pressure could appear wherever it makes most sense 
for you. You can also use section archetypes to group items in the composition 
but I would never want to imply meaning by the parent grouping. A blood 
pressure is a blood pressure whether you consider this locally to be best 
grouped under examination or investigation. Headings are useful but in openehr 
the querying is designed to be able to ignore the section archetypes.

2. Is a tricky question as it partly depends on who is asking the question, why 
and what ought to happen if someone picks up a new diagnosis. Should this be 
added formally as a diagnosis to the patients record.

The pure but more complex approach is to handle this with a set of problem 
diagnosis archetypes to capture positive responses and exclusion archetypes to 
handle the negatives. This has the benefit of the data being collected in more 
reusable and codsble way but is more annoying to hook up to the ui.

The quick and dirty alternative is to create a local archetype with a set of 
booleans that just ask angina yes no. Easy to fit the ui but essentially throw 
away.

Ian.





On Thu, 18 Jul 2019, 09:34 J Grant Forrest, 
<[email protected]<mailto:[email protected]>> wrote:

Hello All, been doing a bit of work (with help from Ian McNicoll) on an OpenEHR 
template for surgical pre-operative assessment.

You can view the results of my efforts (and Ian's) here :

https://github.com/johngrant4est/surgical_preassessment<https://clicktime.symantec.com/3DfgKpDp5iZAmYJcLPPSwoj6H2?u=https%3A%2F%2Fgithub.com%2Fjohngrant4est%2Fsurgical_preassessment>

and I'm not sure how this works in terms of sharing but the working repo is 
here :

https://ehrscape.marand.si/designerv2/#/designer/repos/surgical_preassessment<https://clicktime.symantec.com/3X5d93kE2KouKq3oKd7dxNX6H2?u=https%3A%2F%2Fehrscape.marand.si%2Fdesignerv2%2F%23%2Fdesigner%2Frepos%2Fsurgical_preassessment>

The template is being built in the form of a Report, which sort of matches the 
real world, in as much as someone does the assessment which is then made 
available as a report.

I have 2 challenges currently :

1. How to group the concepts of Biometrics, Physiological variables e.g. Vital 
Signs and Investigation Results e.g. labs, radiology. These all feel as though 
they should be grouped somehow as part of the assessment but there is a 
conflict (in my head) between the archetypes for investigations_results and 
exam findings. Is NIBP an investigation or an exam finding ? I appreciate that 
the line between these concepts is a bit blurred.

2. How to model the typical systematic enquiry when taking a history relevant 
for peri-op care, e.g. how to record the presence of angina, hypertension, 
heart failure, murmurs and group them under "Cardiovascular".

Any thoughts ?

Cheers

Grant

--

Dr J Grant Forrest
Webmaster, SCATA
www.scata.org.uk<https://clicktime.symantec.com/372DHTSt7Bw3EvKBk2Xiixx6H2?u=http%3A%2F%2Fwww.scata.org.uk>

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