Re: Major update to openEHR Task Planning (workflow) draft specification

[Pablo Pazos]

Hi Thomas, is there any way to see a diff of the changes? Going through the
full document again to detect changes is difficult. Thanks!

On Wed, Jun 7, 2017 at 3:31 PM, Thomas Beale 
wrote:

>
>
> On 07/06/2017 19:03, Thomas Beale wrote:
>
>
> A new version is now up, with substantial rework on the runtime classes,
> also other new sections elsewhere in the document.
>
> - thomas
>
>
> with link
> 
> ...
>
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Re: Major update to openEHR Task Planning (workflow) draft specification

[Thomas Beale]

On 07/06/2017 19:03, Thomas Beale wrote:



A new version is now up, with substantial rework on the runtime 
classes, also other new sections elsewhere in the document.


- thomas



with link 
...
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Re: Major update to openEHR Task Planning (workflow) draft specification

[Thomas Beale]

A new version is now up, with substantial rework on the runtime classes, 
also other new sections elsewhere in the document.


- thomas


--
Thomas Beale
Principal, Ars Semantica 
Consultant, ABD Team, Intermountain Healthcare 

Management Board, Specifications Program Lead, openEHR Foundation 

Chartered IT Professional Fellow, BCS, British Computer Society 

Health IT blog  | Culture blog 

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Re: Major update to openEHR Task Planning (workflow) draft specification

[Thomas Beale]

Hi Pablo,

thanks for the comments.


On 04/06/2017 03:28, Pablo Pazos wrote:

Hi all, here is my first review:

Section 2

a. Try to link the concept of task / task list with worklist item / 
worklist commonly used in imaginology flows and DICOM terminology.


I've added a new section 
 
which (briefly) describes the relationship to things like BPMN. Here it 
is noted that the Task Planning spec is designed to primarily address 
the question of patients as 'cases' rather than passive objects, such as 
tissue samples, images, or even the patient-as-imaging-subject, which is 
the patient in a passive role. We could potentially try to cover 
scenarios from imaging as well, but we probably need to work out which 
ones. Do you have specifics in mind?




b. Rephrase "A list of planned tasksneed not all relate to a single order"

c. Requirements are too generic on the first 3 paragraphs of 2.1., 
would be better to use the first section to show samples of concrete 
requirements, then abstract them to show the family of requirements 
that will be handled by this spec. I think it goes to a solution too 
quick without specifying the requirements nor the scope :)


*Ideas for use cases:*

1. physiotherapy rehab sessions (recurrent therapeutic procedure, with 
end)

2. dialysis sessions (recurrent therapeutic procedure, might be chronic)
3. diet + physical activity plan for overweight treatment (recurrent 
tasks, patient feedback, care team evaluation and plan adjustments = 
plan can change over time, will end when the patient reaches a healthy 
status)
4. medication (consider both acute and chronic, associated with a 
symptom, condition or problem)

5. surgery planning (one time event)
6. patient care plan related to goals (goals can be established over 
vitals or lab results/analytes, tasks are defined for the patient to 
fulfill; tracking, evaluation and correction to the plan is a common 
flow; ends when the patient reaches healthy values)


this is a good list; I've incorporated it into the top of the 
requirements section.




*Basic requirements*: (based on my experience, this might not be 
complete in any case, and some items might be out of the spec scope 
but I wish these can be taken into account)


1. task definition: what should be done, by whom, in which context, to 
whom, when, with what priority, where, etc.
2. commit defined tasks: share the task in the EHR, will be on planned 
status
3. communicate planned tasks: planned tasks are sent to the 
correspondent fulfillment systems, departments, units or specific 
people (actors)
4. task execution status tracking: the execution of tasks should be 
tracked, and each status change be recorded and committed to the EHR 
so other parties can look at it (query)
5. communicate task executions / status change: specific actors should 
receive information about status change on specific tasks (e.g. tasks 
they follow, tasks they defined/planned, tasks related to EHRs in 
which they participate)
6. all associated information (care + administrative) generated from 
the task execution should be available in the EHR


Agree with these, but I think they are taken care of already so far. I 
may add in a section that makes it a bit clearer how the Task plan 
should connect to the EHR.





d. "framwork", "|OBSRVATION"| typos


fixed, thanks.




Section 3.

a. "One difficulty with posting a full plan is that in some cases, the 
order is effectively open-ended, i.e. it has no intended completion". 
I think this is used as argument to differentiate INSTRUCTION/ACTIVITY 
from TASK, but I don't see the problem of creating a new 
INSTRUCTION/ACTIVITY. A complete plan for a chronic case would not be 
on one INSTRUCTION, would be a set of INSTRUCTIONs in the EHR of the 
patient.


actually, this is true regardless of whether there is an order or not. 
I've reworded somewhat. A complete plan for any non-trivial condition 
would almost certainly involve more than one Instruction. But 
Instructions only represent orders, not planned tasks.




b. One problem we have with the current INSTRUCTION/ACTIVITY and 
ACTION spec is that it is stated that the archetype for 
ACTIVITY.description should be equal to the ACTION.description, and 
that only applies to medication. This is on an email from last year 
(we talked about that on other thread).


yes, I think we will need to look at that again, and possibly revise it.





Section 5, 6, 7. review of modela

a. Let me check if I got it right:

blue: definition
orange: execution tracking / status



I've now fixed the colours in the instance diagrams to match those in 
the class diagrams.




b. I don't see much difference between TASK_LIST and TASK_GROUP. 
Looking at the hierarchy & composite pattern, is like what we have on 
ITEM_TREE and CLUSTER, knowing that the tree is basically the same as 
the cluster

Re: openEHR-technical Digest, Vol 64, Issue 6

[Karsten Hilbert]

On Mon, Jun 05, 2017 at 05:54:49PM +0100, Thomas Beale wrote:

> With 'true' questionnaires, the questions can be nearly anything. For
> example, my local GP clinical has a first time patient questionnaire
> containing the question 'have you ever had heart trouble?'. It's pretty
> clear that many different answers are possible for the same physical facts
> (in my case, occasional arrhythmia with ventricular ectopics whose onset is
> caused by stress, caffeine etc; do I answer 'yes'? - maybe, since I had this
> diagnosed by the NHS, or maybe 'no', if I think they are only talking about
> heart attacks etc).

And, in fact, the GP may not actually be interested that much
in whether you actually really had any (clinical) *heart*
trouble. After all, quite a few people will list their
esophageal burns or intercostal nerve irritations (which
is NOT a problem !).

What a GP may be after is likely your internal model of your
state of health...

Large swathes of Primary Care have needs way different from
the more restricted areas of health management.

Regards,
Karsten
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