Eric Browne wrote:
>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."
>
yes, I would say this is an important idea for people to understand as a
general principle...
>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.
>
yes, for the sake of simplicity, I did not get into the protocol (what
we call the "how" of the observation - position, cuff, instrument etc.)
but our archetypes model exactly these things.
>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?
>
I have to admit that I don't yet have a special term for this - usually
I jsut say something like "data conforming to archetype xxx" or so.
Actually, I don't think "archetype instance" is such a bad term. Maybe
"archetype exemplar". I'll have to think on it. Suggestions welcome...
- thomas beale
