I think this statememt of Thomas Beale's is crucial to the understanding..

"But note: EHR systems are not passing around definitions of BP, they are
passing around actual BP measurements, which is why archetypes correspond
to this interoperability requirement, not underlying ontologies."

When health event information is stored in an EHR, there needs to be
metadata about a particular concept, not merely the fact that an instance
of a concept has occured. I.e. the metadata qualifies the instance.
For blood pressure to be recorded, it is common practice to record
whether the patient is sitting or standing at the time of measurement.
Other metadata that might qualifier the measurement are such things
as the instrument used to take the measurement. For a diagnosis of colon
cancer, the severity might be recorded using the Dukes Classification.

If my understanding is correct, archetypes give a way to define the
set of metadata to be associated with a concept, that when applied
to an individual instance, capture the nature of the instance
sufficiently for it to be understood and communicated clearly and
unambiguously by the community of users in the domain.

The fundamental elements of ontologies are usually simple - facts,
concepts, term definitions. Knowledge is represented by the meaning
attached to the definitions, together with the relationship between the
terms. The fundamental elements of EHR transactions are complex -
instances of archetypes.

In order to more clearly discuss these concepts, it would be nice if
someone could come up with a name for "instance of archetype" (perhaps
something like "archeobject", or "EHRfactlet" or "EHRlet"), to cover the
elements of an EHR transaction (diagnostic procedure, diagnosis,
therapeutic procedure, adverse health events etc. ).
Perhaps Thomas et al already have?

eric browne
---------------------------------------------------------------
[EMAIL PROTECTED]           http://www.healthbase.info
---------------------------------------------------------------


Reply via email to