Matias Thanks for the email - and sorry to be so slow getting back to you. Our current work in this area relates to instructions as a generic class in the reference model.
The links between individual instructions can modelled in a number of ways: 1. The start condition for one instruction might be the start of another (paralell) or the completion of another (chained) 2. A set of instructions might have overlapping start and finish - that is they have no relationship other than the fact that they occur at the same time. 3. A section - perhaps called 'Regime' could contain linked medications. 4. A link could be used. >> >> We are currently working on an oncology project in which medication >> regimens are used. I would appreciate some guidance on the preferred >> way to model regimens using openEHR. Here is an example of a regimen >> I am modeling: >> >> Regimen Name: CAF >> Step 1: Cyclophosphamide 100 mg/m2/day po days 1-14 >> Step 2: Doxorubicin 30 mg/m2/day iv days 1 and 8 >> Step 3: 5FU 500 mg/m2/day iv on days 1 and 8 repeat q 4 weeks >> >> As I see it, there are two possible models: >> >> 1. One INSTRUCTION with an ITEM_TABLE data structure that has each >> step in a different column. The way we are modelling instruction would mean that this must be two separate instructions - as the frequency of the action specified is held in the timing part of the instruction and must apply to the complete action. A regime could be displayed in this manner. >> OR >> >> 2. Three INSTRUCTIONs with LINKs between them (i.e. a "concurrent >> medication order"). This would be very similar to the "chained >> medication order" described in the EHR Information Model (Figure 27). >> However in this case, the LINKs' meaning would be "concurrent actions" >> rather than "next action". Any instruction with the same timing is concurrent by definition - the question is - do we need to know that they are linked in a way that is more than concurrent timing. I think not, apart from the ability to link these as you describe - have the same indication and be organised as a regime or course or other grouping as required. >> >> Does anyone have a preference or another way to model this? >> >> Thanks, >> >> Matias >> Cheers, Sam - If you have any questions about using this list, please send a message to d.lloyd at openehr.org
