and Excel as you are now. What we need is equivalent openEHR
archetype for each of your Care Statement RMIMs and in your mapping
spreadsheet a couple of columns for the openEHR archetype mappings. Once we
get the process right we can then develop the tools to support it.
BTW, a member of my development team (who was a obstetrician) is going
through the process of developing a pregnancy clinical scenario (mega
storyboard) and mapping the data element and sample data into archetypes. I
wonder of you would be interested in working with her or at least sharing
your experiences and current process?
Regards
Heath
Heath Frankel
Product Development Manager
Ocean Informatics
Ground Floor, 64 Hindmarsh Square
Adelaide, SA, 5000
Australia
ph: +61 (0)8 8223 3075
fax: +61 (0)8 8223 2570
mb: +61 (0)412 030 741
email: mailto:heath.frankel at oceaninformatics.biz
heath.frankel at oceaninformatics.biz
_
From: openehr-technical-boun...@openehr.org
[mailto:openehr-technical-bounces at openehr.org] On Behalf Of
Williamtfgoossen at cs.com
Sent: Tuesday, 19 September 2006 7:01 AM
To: openehr-technical at openehr.org
Subject: Antw: Re: Antw: Re: Antw: Re: EHRcom/openEHR the new exciting
paradigm
In een bericht met de datum 18-9-2006 10:45:04 West-Europa (zomertijd),
schrijft Thomas.Beale at OceanInformatics.biz:
There are guideline and
workflow languages (not provided by HL7 or openEHR), and the beginnings
of models for choreography coming from WfMC and other places.
I have looked into the WfMC materials, and the basic process flow
descriptions are currently met with the HL7 v3 Care Plan. (This is not a
point if HL7 can do, it is the point that it is possible to define the
clinical process using a standard, I think it is transferable to OpenEHR
archetype as well).
The key here is the use of the following mood codes:
definition will tell you wat according to best practice or evidence base
should be done for a patient with problem x. (including monitoring of
observations, tests, meds etc).
The OpenEHR template specification that links archetypes could perhaps do
similar things.
intent mood helps the clinician to carry over from guideline into the care
plan what is necessary for individual patient P.
Thus the set of data required can be determined, and it can be justified why
items are not carried from guideline to plan. (E.g. you do not female things
for a male patient).
Then if some professional wants to order a observation this can be done with
request. e.g. the doctor askes the nurse to measure the blood pressure 4
times a day.
In the Goal mood, the expected value can be set, e.g. the expected value of
BP in a week should best be 130/90.
the observatoin is carried out say 7 days 4 times a day leading to 7 x 4 =
28 observations in event mood.
The statement collecter allows to trend this.
The comparison of goal versus the event(s) trends, or the last value of day
7 allows to determine if the goal is met (conclusion being then the 29th
observation).
The derivation method allows to specify also workflow rules like:
do BP measurements until 4 x 130/90 or similar as a criterion for the do X
until Y workflow standard.
I am not telling this is best handled in HL7 v3, I just want to say that a]
it is possible to express clinical meaningful workflows, that at EHR level
are pretty handy for a nurse to pop up on the worklist every 6 hours, and
that it is possible to exchange the semantics of such a workflow / careplan
via a message.
Yes, this is interesting stuff and needs a lot of work.
William
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