Hi Sam, thanks for the answer... I'm having several hours of bad sleeping, trying to understand this :D
Hi Pablo, The design principles are that the Instruction should remain unaltered by people basing actions on this instructions ? as the action and instructions could be disconnected at any moment. For example, the instruction (medication order) should not be changed by anyone just to give a medication etc. Sounds very reasonable. But I think that sometimes administrative entries could also change the state of an Instruction, like when scheduling a procedure. I asked Heather on that issue (http://omowizard.wordpress.com/2011/07/11/anatomy-of-an-procedure-action-archetype/) and her answer seems reasonable too: generaly scheduling tasks are done on external administrative systems (LIS, RIS, ...) and them a message is sent to the EHR to tell the Instruction had been scheduled. But: how is that change of the Instruction state recorded on the EHR?Receiving a message from an external system could trigger the creation of an ACTION?Is that the way you have implemented that? So the state of the instruction is carried in the record of the action (if appropriate). Is that recorded on ACTION.instruction_details.wf_details? We have decided to name the pathway steps and attach a machine readable state to that step. This makes it much easier for clinicians to model and to see what is going on. You will see an archetype ACTION in the openEHR repository and the careflow_steps are archetyped to provide a name and the current state matches an openEHR code for state. This means that a careflow step being carried out will set the state to a particular machine state. I think I saw that on the ehr_im.pdf as an example for "UK GP medicaton order workflow". As I understand it, this can be done by constraining the "ACTION.ism_transition" attribute, with the Archetype Editor, for all the ACTIONS that will be used to execute ACTIVITIES of the medication order INSTRUCTION. If that's right (?), maybe there's a bug on the specs, because ISM_TRANSITION inherits from PATHABLE, and to be archetyped I think it should inherit from LOCATABLE (see ehr_im.pdf page 53). For the workflow definition, do you use the INSTRUCTION.wf_definition? I can't find an example on how to express a workflow there (maybe something like this could help http://doc.openerp.com/v6.0/developer/3_9_Workflow_Business_Process/index.html). In our openEHR repository we maintain an instruction index ? that is a pointer to all instructions and all actions that relate to that instruction ? and the current state of the instruction. Ok, so at an instance level, we should have all INSTRUCTION instances, the current state of each instruction, and all the ACTIONs executed for each INSTRUCTION/ACTIVITY.That is a great implementation consideration, I'll add that on the openEHR spanish course docs. :D Thanks a lot! Cheers,Pablo. -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.openehr.org/mailman/private/openehr-technical_lists.openehr.org/attachments/20111208/d5cbedfd/attachment.html>
