Let's try an example, please let me know if it is wrong:yep, that's pretty good.
Act - write progress note Entity - a physician called Andrew Ho. Role - physician Participation - "physician" (role) can "write progress note" (act) Act_relationship - after "write progress note" (act) can "sign progress note" (act) Role_link - all psychiatrists (role) are physicians (role).
[based on reference at http://workflow.healthbase.info/monographs/RIM_rationale.html]
well spotted. THat's what it usually means - in general, any "observation" is the Act "make an Observation" or "made an Observation"... the odd thing about this is that only sometimes are you interested in the act (if it is in the future - you are) and other times (in the past) you are interested in the result - the information, and how the act was done is of less interest. Anyway, Act is about equivalent to Entry in CEN revised/ openEHR...Its purpose is as an abstract model from which to build specific message
models - HL7 believes everything can be expressed as a specialisation
(i.e. a constrained form) of the RIM - i.e. they see all clinical
information as an Act.
Does this mean, for example, "Write a progress note" = "A progress note"?
yep - that's a good example as well. Of course we should note that on the COmposition you find all the commit audit details, and on the Entry (you are using the vanilla ENV 13606model above) you have other context details, e..g subject of entry, provider of information, other participants, protocol, etc.- the EHR Extract is a package of Compositions extracted from the EHR.
CEN ENV 13606 specifies this; openEHR also specifies one. Eventually
these might become one, or the openEHR one a clean superset of the other.
A Psychiatric Record (folder) - a Progress note (composition) - treatment plan (headed section) - delusion (item) - [haloperidol 5mg (item) PO qHS (item) prescribed today] (cluster) - "haloperidol prescribed" for "delusion" (link) - show all items in the Progress Note (view)
[reference: http://www.chime.ucl.ac.uk/work-areas/ehrs/EHCR-SupA/13606v1_8/sld017.htm]
In the RIM there are also audit data - all the relevant times and demographic entities - however - on a per Act basis.
One big difference is that you have to build al information structures out of Acts with the RIM, whereas in openEHR & CEN you use the ENtry as the root node of any logical act, and the interior nodes (imagine for example the 20 - 30 nodes of a microbiology result) are all expressed as cluster/element nodes - much simpler, since these have almost no attributes - just name, value and a couple of archetype-related things).
I don't have the API on me, but a reference to look at is omg.org - the COAS standard. Dave Forslund would be able to supply a URL. The openEHR one will borrow from this, but will have archetypes in the interface as well, meaning that both for data creation and data retrieval, you mention which archetypes to use; in querying it is via archetype paths. So you will be able to write things like:- and EHR API is a query and modification interface to the EHR, enabling
applications and other services to access a given EHR server.
I am not sure what this could look like. Could you provide a simple example?
my_list_of_comp_ids := retrieve (pat_id, type="composition", time_window = yesterday - 2 weeks ago, path_pattern = some_archetype_path)
Not saying this is the exact syntax, but you get the idea.
- thomas
