Hi All,
The single care plan giving way to multiple views makes sense to me as well. I don't think with so many degrees of freedom in modelling with openEHR we cannot possibly reconcile the many different care plans post-hoc to create the really valuable master view for purposes Heather nicely put. Having spend entire last week in a major HIS procurement evaluation I must say this looks like the way things are already been implemented in many places around the world! I also have noted the current immaturity of using links effectively to do things just like this - maybe we need some 'design patterns' which Tom had indicated some time ago. Another point is, although I haven't been practicing Medicine for too long now, I know the links between problems vs goals vs actions do not play nicely at all times - indeed for most of the time. They can be subjective and quite error prone. Therefore I don't think 'natural order' (as in DMBS) of an EHR cannot be of POMR type - it has to follow real life: randomness and episodicity. Maybe we should look at putting a quantifier for the "likelihood" of the links - any thoughts? Cheers, -koray From: openEHR-technical [mailto:openehr-technical-boun...@lists.openehr.org] On Behalf Of Bj?rn N?ss Sent: Tuesday, 25 November 2014 8:02 p.m. To: For openEHR technical discussions Subject: Re: Problem-oriented records and querying by problem I like this approach. The master care plan is what we call Patient plan. There should be only one of this in a given EHR. This plan evolves over time as more items are addes or removed. To administer this plan you need a dashboard with functionality to filter on overdue, finished, etc. And of course you need commands like add, update, finish, etc. The plan is a master view on plan items from different systems and with contributions from all health care specialities. Depending on the users point of view it should be possible to dig into details about specific parts of the plan. I am not sure if it is possible to archetype this dashboard. I guess this is up to the application to implement this. The clinical modeller should archetype the content of different plan items. To make this work we need a basic set of INSTRUCTON/ACTIVITY/ACTION archetypes that make the outer boundaries of a care plan and care plan elements. Vennlig hilsen Bj?rn N?ss Produktansvarlig DIPS ASA Mobil +47 93 43 29 10<tel:+47%2093%2043%2029%2010> -------- Original message -------- From: Thomas Beale Date:20/11/2014 19:07 (GMT+01:00) To: openehr-technical at lists.openehr.org<mailto:openehr-technical at lists.openehr.org> Subject: Re: Problem-oriented records and querying by problem I wonder if the GP 'master care plan' is more like a 'care plan dashboard' rather than an actual care plan? With functions like 'show all overdue / suspended / etc etc'... - thomas On 20/11/2014 17:25, Heather Leslie wrote: > Hi Karsten, > > I think in practice you will see a variety of care plans depending on the > context. > > The endocrinologist will be using a diabetes care plan for their care of the > patient, and likely not having access to, nor particularly interested in, > what other specialists might be scheduling. > > The cardiologist will be using a cardiology-protocol-based care plan, > probably developed in splendid isolation from the endocrinologist activities. > > The rehab specialist will be using a purpose-built care plan for the > patient's recovery from a knee replacement. > > However it will be critical that the GP or coordinating primary care provider > develop/need a single global care plan, (which can be separated out for the > different purposes, if needed) that provides an overview of all activities > that the patient requires - what is due, overdue, planned etc. This will > ensure that the blood glucose and renal function tests required by both the > endocrinologist and cardiologist iare coordinated, if clinically appropriate > and tests/appts not repeated unnecessarily. They will have access to a > 'master' plan that will detail all reviews/goals/test/appointments for each > 'specialty' plan and have the ability to coordinate the components to suit > the best interests of the patient as a whole - a care plan for the patient, > not just one per problem. > > The patient or the parent/caregiver will also benefit with being able to > schedule appointments/tests etc. > > And we will need to be able to break down that master care plan to see which > components belong with each problem, or are shared between problems, and for > context-based sharing with other health care providers. > _______________________________________________ openEHR-technical mailing list openEHR-technical at lists.openehr.org<mailto:openEHR-technical at lists.openehr.org> http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.openehr.org __________ Information from ESET NOD32 Antivirus, version of virus signature database 10782 (20141126) __________ The message was checked by ESET NOD32 Antivirus. http://www.eset.com -------------- next part -------------- An HTML attachment was scrubbed... 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