Aniket Of course I know about CPGs - just the acronym eluded me!
CPGs are very interesting from an EHR point of view. The issue here is the generic CPG and the specific - how we allow specialisation to the particular patient, how we merge a number of them sensibly, how we allow updates of CPGs to influence future care. Our learning in this area has a long way to go but we can start. The openEHR entry called an instruction allows specific 'guidelines' to be entered into the record - monitoring or notifications, therapies etc. This is relatively straight forward - the issues start to arise when a generic guideline is altered - what does this mean to someone who is adhering to the previous guideline? We can go with defaults - 2 years in Australia for a PAP test recall. So if the Care Plan of a patient has a notification for a pap recall, and the period is set to default, then the notification period can change with the guideline. Not so bad - fixed recall periods will not be altered. There might be some people however who need a 2 year one based on the evidence - clinicians could learn to fix the period of anyone with any abnormality - that seems solvable. Then we get into the issue of a complex CPG such as immunisation - there are many rules, temporal and sequencing, age at immunisation etc. Changing the default guideline becomes very interesting and really requires a little decision support engine to be available specifically for the purpose. What do you think? Cheers, Sam ____________________________________________ Dr Sam Heard The Good Electronic Health Record Ocean Informatics, openEHR 105 Rapid Creek Rd Rapid Creek NT 0810 Ph: +61 417 838 808 sam.heard at bigpond.com www.gehr.org www.openEHR.org __________________________________________ > -----Original Message----- > From: aniket Joshi [mailto:anya_joshi at yahoo.com] > Sent: Wednesday, 27 November 2002 3:02 AM > To: Sam Heard > Subject: RE: Patient notifications > > > Clinical practice guidelines. > These can be incorporated in GEHR and thus we can have > a much more specific application development. > We can have mappings which will lead to particular set > of tests as per the CPGs. > This will ease the implementation of CPGs in clinical > practice. > Dr Aniket Joshi > --- Sam Heard <sam.heard at bigpond.com> wrote: > > Aniket > > > > I am not aware of CPG ?? > > > > Sam > > ____________________________________________ > > Dr Sam Heard > > The Good Electronic Health Record > > Ocean Informatics, openEHR > > 105 Rapid Creek Rd > > Rapid Creek NT 0810 > > Ph: +61 417 838 808 > > sam.heard at bigpond.com > > www.gehr.org > > www.openEHR.org > > __________________________________________ > > > > > > > -----Original Message----- > > > From: aniket Joshi [mailto:anya_joshi at yahoo.com] > > > Sent: Monday, 25 November 2002 6:02 PM > > > To: Sam Heard > > > Subject: Re: Patient notifications > > > > > > > > > In our scenarios majority of the population is > > > illeterate,so interaction with the computers is > > out of > > > question.We can record their videos and keep them > > in > > > the folders. > > > Other non-medical communication which come from > > the > > > HCPs can definitely be kept in the folder. > > > For the medical record of each appt a Hyperlink > > can be > > > given so that we can have a vertical record. > > > Have gone through the CPGs and their application > > in > > > GEHR? > > > DR ANIKET JOSHi > > > --- Sam Heard <sam.heard at bigpond.com> wrote: > > > > Dear All > > > > > > > > I have been developing the idea of part of the > > > > record that the patient can > > > > write in - I have (Gates style) called it My > > Folder > > > > (eh?) and have two > > > > subfolders in it at present - consent statements > > (as > > > > these will be written > > > > by the patient) and appointments and > > notifications. > > > > > > > > It is clear that the patient needs to write and > > > > interact with these. I have > > > > thought recently that we may be best to develop > > a > > > > transaction for each of > > > > the patient notifications - which will have all > > the > > > > details in it - rather > > > > than process notifications into a collected > > > > transaction (like a calendar) - > > > > this means that the application will need to > > process > > > > these. > > > > > > > > I have thought that we could have an archive > > folder > > > > for when the patient has > > > > done whatever was required - or declined to do > > so. > > > > This would mean perhaps > > > > an archive folder and an entry for the outcome > > of > > > > the notification. > > > > > > > > What do you think? > > > > > > > > Sam > > > > ____________________________________________ > > > > Dr Sam Heard > > > > The Good Electronic Health Record > > > > Ocean Informatics, openEHR > > > > 105 Rapid Creek Rd > > > > Rapid Creek NT 0810 > > > > Ph: +61 417 838 808 > > > > sam.heard at bigpond.com > > > > www.gehr.org > > > > www.openEHR.org > > > > __________________________________________ > > > > > > > > - > > > > If you have any questions about using this list, > > > > please send a message to d.lloyd at openehr.org > > > > > > > > > __________________________________________________ > > > Do you Yahoo!? > > > Yahoo! Mail Plus Powerful. Affordable. Sign up > > now. > > > http://mailplus.yahoo.com > > > > > __________________________________________________ > Do you Yahoo!? > Yahoo! Mail Plus - Powerful. Affordable. Sign up now. > http://mailplus.yahoo.com - If you have any questions about using this list, please send a message to d.lloyd at openehr.org
