But if we want to avoid double results in querying, we need some sort of 'is_derived' or 'is_copy' marker (and a link to original content) on the copy. At least that's where I got to the last time I thought about it.
Yes – I think we need some kind of marked. We have been thinking about adding this to the link. Some kind of “link to self”. Then to avoid duplicates you MUST include that in every AQL. This is why we ended up with the proposal of a Composition category which solely of re-used (copies) data. The same pattern could be applied on several levels (ENTRY, CLUSTER). I.e. a Blood Pressure with an attribute ‘is_copy’ should by default be excluded from AQL queries. Something like that? Vennlig hilsen Bjørn Næss Produktansvarlig DIPS ASA Mobil +47 93 43 29 10<tel:+47%2093%2043%2029%2010> Fra: openEHR-technical [mailto:openehr-technical-boun...@lists.openehr.org] På vegne av Thomas Beale Sendt: søndag 3. april 2016 15.31 Til: openehr-technical@lists.openehr.org Emne: Re: Usage of Compositoin.Category these examples from Ian illustrate exactly why we never figured this out before - because of the possible mixture of original content, referenced content, and sometimes copied content e.g. in a discharge summary. The problem is that 'derived' content can occur at a lower granularity than Composition. Unless... we impose a discipline that says otherwise. For example, if there is only original content and references (links, DvEhrUris) then everything is easy. As far as I can see, the problem is if content is copied inline from e.g. a lab result or Dx list into the discharge summary. For a physician, this is pretty natural, and it's easy to see how a nice UI can enable it. But if we want to avoid double results in querying, we need some sort of 'is_derived' or 'is_copy' marker (and a link to original content) on the copy. At least that's where I got to the last time I thought about it. - thomas On 12/03/2016 07:40, Ian McNicoll wrote: Hi Ivar, I'm not sure the situation is quite as clear-cut, in that I donlt think there is necessarilly a simple distinction between primary data which should normally be query-accessible and in-line vs. secondary data which is normally query-inaccessible and referenced. A few scenarios 1. Vital signs event - easy!! Primary, in-line and accessible 2. Diagnosis event. Primary, in-line but depending on whether a secondary problem list is maintained, you may not want to use these original diagnoses events for decision support. 3. Problem summary. Secondary and definitely need to be query-accessible, but may be in-line or referenced depending on implementation. 4. Discharge summary. Mostly secondary but may introduce new primary content and again, whether the content is in-lie or referenced is to some extent an implementation decision. DIPS have decided to use referencing, others do not. 5. End of Life Summary. The critical aspects of this document are primary e.g Resuscitation wishes but other aspects are secondary (though and may be in-line or referenced. I think the points raised are valid but we may need to tease out several axes here. Ian Dr Ian McNicoll mobile +44 (0)775 209 7859 office +44 (0)1536 414994 skype: ianmcnicoll email: i...@freshehr.com<mailto:i...@freshehr.com> twitter: @ianmcnicoll Co-Chair, openEHR Foundation ian.mcnic...@openehr.org<mailto:ian.mcnic...@openehr.org> Director, freshEHR Clinical Informatics Ltd. Director, HANDIHealth CIC Hon. Senior Research Associate, CHIME, UCL On 11 March 2016 at 09:39, Ivar Yrke <i...@dips.no><mailto:i...@dips.no> wrote: Hi An interesting discussion that touches the very concept of structured information, in my opinion. I wonder if the suggested solution looks at the problem from the best angle. So here is my angle: As a person with some SQL experience I would expect an AQL to return ONLY primary content unless told otherwise. Any content that lives in a Composition as a link I would not expect to see in that Composition as an entry. Resolving links is a task for the level "above" (rendering on a screen etc.). I can see that there possibly are needs for an AQL that resolves links, but I would rather see this as the special case, much like joining in foreign keys in SQL is an explicit decision (the SQL analogy have some obvious flaws!) Why is this important? Because showing linked information in compositions where they were not originally recorded creates doubt about the origin of the information (source of truth). The duplication that Bjørn wants to solve is a symptom of un unhealthy structure that undermines an essential aspect of structured information. If a summary composition, like a discharge letter, only links information from other composition, there should be no duplication. So there should not be any need for later special handling. There should be no problem to solve (well, there would be the need for the optional resolving, but this would be a feature rather than a problem). AQL should relate only to the data and how they are recorded, not to how they are used. With regards, Ivar Yrke Senior systemutvikler DIPS ASA Telephone +47 75 59 24 06 Mobil +47 90 78 89 33 -----Original Message----- From: openEHR-technical [mailto:openehr-technical-boun...@lists.openehr.org] On Behalf Of Bjørn Næss Sent: 10. mars 2016 20:33 To: For openEHR technical discussions <openehr-technical@lists.openehr.org><mailto:openehr-technical@lists.openehr.org> Subject: SV: Usage of Compositoin.Category Hi Ian Great response. The most important thing for me is to precisely define the semantic meaning of the content in a composition. In this specific use-case the content of the composition is always a copy of the primary source. This means that the Discharge letter only bring one new thing into the EHR - that is the fact that there is an approved discharge letter. But the entries in the composition is link and copies of entries in other primary sources. The requirements to the system is quite small: * Content of "report" documents MUST not be in the resultset when doing normal AQL queries. * It MUST be possible to query for "report" compositions with specific content. The solution to this problem is simple and I can give an example with an AQL query. Below is a standard query for body weight. Look at the WHERE condition. Here I am looking for all body weights which are NOT part of a report composition. This WHERE condition will be the default filter on all queries. If the client would like to query for all body weights in report document, then just change from NOT EQUALS 434 to EQUALS 434. SELECT o/data[at0002]/events[at0003]/data[at0001]/items[at0004]/value/magnitude FROM COMPOSITION c CONTAINS OBSERVATION o[openEHR-EHR-OBSERVATION.body_weight.v1] WHERE c/category/defining_code/terminology_id/value = 'openehr'AND c/category/defining_code/code_string != '434' Given that we agree that there is a class of compositions which belongs to the "report" group. Then we should add such semantic into the RM to make it precise and consistent. Best regards Bjørn Næss Product owner DIPS ASA Mobil +47 93 43 29 10 -----Opprinnelig melding----- Fra: openEHR-technical [mailto:openehr-technical-boun...@lists.openehr.org] På vegne av Ian McNicoll Sendt: mandag 7. mars 2016 18.16 Til: For openEHR technical discussions <openehr-technical@lists.openehr.org><mailto:openehr-technical@lists.openehr.org> Emne: Re: Usage of Compositoin.Category Hi Björn, I finally got around to thinking a bit about this. It is an interesting problem and I think I can see the need to specify different data handling requirements but I am not sure that overloading composition.category is the best approach here. I suspect this will take a bit of teasing out (and other commit/query strategy metadata) - might it be better to put this in a cluster archetype in the Composition extension slot. That would let us play around with the requirements before pushing something definitive to the RM? So far I have 3 axes: 1. Normal commit strategy: persistence vs. event i.e do we normally overwrite an existing composition. 2. Source-of-truth i.e. Should this document be regarded as the primary source of truth for certain kinds of data or otherwise e.g Does a system look into event compositions or e.g to a Problem list for 'current problems' 3. Is this a primary document or secondary document? e.g. a Discharge letter is a secondary document derived from other primary records. Just starting the discussion :) Ian Dr Ian McNicoll mobile +44 (0)775 209 7859 office +44 (0)1536 414994 skype: ianmcnicoll email: i...@freshehr.com<mailto:i...@freshehr.com> twitter: @ianmcnicoll Co-Chair, openEHR Foundation ian.mcnic...@openehr.org<mailto:ian.mcnic...@openehr.org> Director, freshEHR Clinical Informatics Ltd. Director, HANDIHealth CIC Hon. Senior Research Associate, CHIME, UCL On 17 February 2016 at 21:59, Bjørn Næss <b...@dips.no><mailto:b...@dips.no> wrote: We are discussing the use of Composition.Category which is a DV_CODED_TEXT. There is a terminology: <group name="composition category"> <concept id="431" rubric="persistent"/> <concept id="433" rubric="event"/> </group> Is it required to use only these categories or could an application set any DV_CODED_TEXT? I think it would be ok to allow any category in this. To be concrete: The use-case is discharge summaries. These are Compositions which only (“mostly”) contains links to existing entries. We will be using links but since the Composition should be transferred to another health provider it must be serialized and validated against an template. Technically this Compostions contains a lot of entries which is “link to self”. The idea we are considering is to introduce a category for these Compositions. The content will not be part of AQL results for normal use-cases. But IF you ask explicit for these categories you will be able to query for discharge summaries which contains body weight above 120 kg. If we only add the references as links it will not be possible to add them into forms and neither use a Template to validate the content. This is the reason we are “thinking out of the box”. Any comments on this? Best regards Bjørn Næss Product Owner – Arena EHR DIPS ASA Mobil +47 93 43 29 10 _______________________________________________ openEHR-technical mailing list openEHR-technical@lists.openehr.org<mailto:openEHR-technical@lists.openehr.org> http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.open ehr.org _______________________________________________ openEHR-technical mailing list openEHR-technical@lists.openehr.org<mailto:openEHR-technical@lists.openehr.org> http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.openehr.org _______________________________________________ openEHR-technical mailing list openEHR-technical@lists.openehr.org<mailto:openEHR-technical@lists.openehr.org> http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.openehr.org _______________________________________________ openEHR-technical mailing list openEHR-technical@lists.openehr.org<mailto:openEHR-technical@lists.openehr.org> http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.openehr.org _______________________________________________ openEHR-technical mailing list openEHR-technical@lists.openehr.org<mailto:openEHR-technical@lists.openehr.org> http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.openehr.org -- [http://www.openehr.org/files/about/logoweb.png] Thomas Beale Management Board, Specifications Program Lead, openEHR Foundation<http://www.openehr.org> Chief Technology Officer, Ocean Informatics<http://www.oceaninformatics.com> Chartered IT Professional Fellow, BCS, British Computer Society<http://www.bcs.org/category/6044> Health IT blog<http://wolandscat.net/> Culture blog<http://wolandsothercat.net/>
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