lakewood at copper.net wrote: > > From Information Theory it is whatever I choose it to be and the act > of choosing has > no impact upon the original data; it does have an impact on the analysis. > In an object world an episode is derived (inherited) from 'available' > data objects. The derivation > is not original data. > However, should I choose to expand the 'derivation' to include > additional data the results may well > change.
we agree with this. By using Folders to delimit episodes, and a special Composition to contain any episode adminitrative data, every institution can include whatever encounters or other data they want in the episode- all you are doing is putting references (pointers) to things, into a Folder, not changing the underlying data. Someone could come along later in the same institution, and define a new kind of episode, and retrospectively create all the Folders for that kind of episode in certain EHRs. This also won't change any of the underlying data. Episode Folders could also be removed, renamed, their references added to or removed - none of this changes any of the data either. > BOTTOM-LINE > As long as the 'original data' is not changed and is made available to > all subsequent accesses, and > others can define their own 'episodes', issues are likely to be move > to the conference room. in which > the background of the episode can be thoroughly reviewed. > > A concern is that dedicating space in an EHR system to handling > episodes , their tracking and their > resolution, not to mention the privacy concerns and accesses by > insurers, may become burdensome. > It it apparent that multi potentially interacting episodes may exist > and there may be no easy > resolution to the lot of them. I think any institution has to have a firm model for what it thinks an episode is - e..g delimited by the points in time when it accepts responsibility for care of a patient to when it divests itself of reponsibility for care (by transfer of care, death, discharge/dismissal). > > Suggest a segmentation of 'episodes' so that they can be readily > identified and isolated. In particular, > episodic data should not be merged with the original data. Their > existance and location should be > sufficient. I believe the Folder-based solution will do all this. - thomas beale - If you have any questions about using this list, please send a message to d.lloyd at openehr.org
