RE: Archetype modelling pattern for Physical examination findings

[Heather Leslie]

Hi everyone,

3 weeks ago I asked for feedback about the physical examination patterns, below.

We've had one clinician comment on the page but not a lot of other feedback.

If I don't hear anything further then I will assume agreement in principle and 
I will start building the models based on the recommended pattern so we can 
test it further.

Thanks

Heather

From: openEHR-implementers  On 
Behalf Of Heather Leslie
Sent: Thursday, 7 March 2019 3:33 PM
To: For openEHR technical discussions ; 
For openEHR implementation discussions 
; For openEHR clinical discussions 

Subject: Archetype modelling pattern for Physical examination findings

Hi everyone,

The CKM editors have been gradually refining our views on how to model Physical 
examination findings for many years now. There have been many hours wasted 
exploring options that have had dead ends. We'd like to prevent others having 
the same experience by sharing and publishing an agreed pattern and we feel 
that we have one ready for broader consumption.

We clearly needed to find a solution that works from a modelling point of view 
ensuring that the clinically diverse requirements are catered for, as well as 
the needs of implementers for querying etc.

I have developed a page on the wiki to try to explain our proposal and provide 
some examples - 
https://openehr.atlassian.net/wiki/spaces/healthmod/pages/380993560/Proposal+-+Physical+examination+findings+pattern

Comments welcome, probably best if you add them to the wiki page, please.

Regards

Heather

Dr Heather Leslie
MB BS, FRACGP, FACHI, GAICD
M +61 418 966 670
Skype: heatherleslie
Twitter: @atomicainfo, @clinicalmodels & @omowizard
www.atomicainformatics.com
[cid:image001.jpg@01D4E8B0.83956080]

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Re: Archetype modelling pattern for Physical examination findings

[GF]

Dear colleagues,

I looked at the page url provided and have difficulty to inspect the figures 
because of a low resolution.

I agree that a more patterned way is necessary in order to have EHR systems 
that have access to more uniformly defined data needed for processing.
This requirement I call: Interpretability.

When all kinds of Observations need to be expressed in a uniform way we need 
ideally:
1- We need uniform patterns for each possible observation and all the various 
ways in which observations are expressed
2- We need to cater for ways to express the metadata of Observations that are 
part of a meaningful list
3- We need to cater for ways to express the metadata of the observation, itself
4- We need to cater for ways to express the metadata around the data subject
5- We need to cater for ways to express the metadata of the treatment process 
of the topic
6- We need to cater for ways to express the metadata of the clinical process
7- We need to cater for ways to express the metadata of the documentation 
process
8- We need to cater for ways to express the metadata of all the contextual 
information

ad1: e.g. quantitative-, semi-quantitative-, qualitative observations expressed 
using: numbers, text, codes, and many units of measurement, 
ad2: e.g. Blood pressure, Lab panels, … 
ad3: e.g. seeing, hearing, touching, smelling, tasting, …
ad4: e.g. body position, before, during or after exercise, etc.
ad5: e.g. reason for encounter, data collection/observation, history, 
examination, evaluation, planning, ordering, execution
ad6: e.g. intake, investigation, treatment, referral, 
ad7: e.g. de novo recording of a fact, re-use of previously, recorded facts, 
clinical data, administrative data, preliminary data/unprocessed data, data 
admitted to the record
ad8: e.g. localisations in time and space in absolute and relative terms

In my way of thinking I start with the documentation process in the ENTRY with 
two CLUSTERS. One for the context data and one for the Panel.  The Panel 
consists of a CLUSTER for each Panel component and one for the context of all. 
And then per Panel component two CLUSTERS: one for data and one for its context.

Gerard   Freriks
+31 620 34 70 88
‭+31 182 22 59 46‬
  gf...@luna.nl

Kattensingel  20
2801 CA Gouda
the Netherlands

> On 7 Mar 2019, at 05:33, Heather Leslie 
>  wrote:
> 
> Hi everyone,
>  
> The CKM editors have been gradually refining our views on how to model 
> Physical examination findings for many years now. There have been many hours 
> wasted exploring options that have had dead ends. We’d like to prevent others 
> having the same experience by sharing and publishing an agreed pattern and we 
> feel that we have one ready for broader consumption.
>  
> We clearly needed to find a solution that works from a modelling point of 
> view ensuring that the clinically diverse requirements are catered for, as 
> well as the needs of implementers for querying etc.
>  
> I have developed a page on the wiki to try to explain our proposal and 
> provide some examples - 
> https://openehr.atlassian.net/wiki/spaces/healthmod/pages/380993560/Proposal+-+Physical+examination+findings+pattern
>  
> 
>  
> Comments welcome, probably best if you add them to the wiki page, please.
>  
> Regards
>  
> Heather
>  
> Dr Heather Leslie
> MB BS, FRACGP, FACHI, GAICD
> M +61 418 966 670
> Skype: heatherleslie
> Twitter: @atomicainfo, @clinicalmodels & @omowizard
> www.atomicainformatics.com 
> 
>  
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> openehr-clini...@lists.openehr.org 
> http://lists.openehr.org/mailman/listinfo/openehr-clinical_lists.openehr.org 
> 
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RE: Archetype modelling pattern for Physical examination findings

[Bert Verhees]

Very important, I see as major advantage that gives predictability for 
archetypepaths which is necessary for wild carding AQL queries on unknown 
archetypes or groups of archetypes on different observations. In the field of 
observations this is part of a major step forwards. Researchers and software 
developers, also, but not only in AI, will profit from this. 

The growth towards pattern was already visible during last several years, and I 
am glad that the desire to have this, and architecture howto do it,  has become 
available for the public. I hope modelers will use this, even in moments when 
without pattern seems more effective on a single archetype, they still will 
choose for the greater good of patterned information. 

Congratulations for the CKM team for this major step forwards. 
Bert

Sent from my Xperia™ by Sony smartphone

 Heather Leslie wrote 

>Hi everyone,
>
>The CKM editors have been gradually refining our views on how to model 
>Physical examination findings for many years now. There have been many hours 
>wasted exploring options that have had dead ends. We'd like to prevent others 
>having the same experience by sharing and publishing an agreed pattern and we 
>feel that we have one ready for broader consumption.
>
>We clearly needed to find a solution that works from a modelling point of view 
>ensuring that the clinically diverse requirements are catered for, as well as 
>the needs of implementers for querying etc.
>
>I have developed a page on the wiki to try to explain our proposal and provide 
>some examples - 
>https://openehr.atlassian.net/wiki/spaces/healthmod/pages/380993560/Proposal+-+Physical+examination+findings+pattern
>
>Comments welcome, probably best if you add them to the wiki page, please.
>
>Regards
>
>Heather
>
>Dr Heather Leslie
>MB BS, FRACGP, FACHI, GAICD
>M +61 418 966 670
>Skype: heatherleslie
>Twitter: @atomicainfo, @clinicalmodels & @omowizard
>www.atomicainformatics.com
>[cid:image001.jpg@01D4D4EB.68E10F10]
>
>
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