Hi Ian,
In an other e-mail I have explained how 'problems' like: 'ECG Diagnosis' and
'Tobacco use' can be modeled.
[Have a look at the url and download this e-mail as PDF including some pictures
that were to big
https://www.yousendit.com/download/QlVqK0d0WkJ3TGhMWE1UQw ]
Modeling archetypes on
Sent: Thursday, 21 June 2012 9:09 PM
To: Stefan Sauermann
Cc: For openEHR clinical discussions
Subject: Re: An ACTION or INSTRUCTION referencing an AGENT, is it possible?
Stefan,
I agree.
For me the EHR contains data and information that is placed there because of an
author/healthcare provider.
In my
Ian,
Thanks.
'ECG diagnosis': You mean an interpretation of the ECG like:'atrium
fibrillation' or 'pattern conforms to infarction in the left lower cardiac
artery'?
In 'my book' the first is an Observation provided by a an Action that defined
the device/service that produced it.
In 'my book' t
Hi Gerard
I don't have a problem with the definitions. I am interested in how you
would apply these to the ECG diagnosis and tobacco use examples I gave
before. I am sure we can always apply better definitions but I have found
that this does not necessary resolve these sort of issues. The more
abs
In my 'book' any document without a person responsible and accountable is
something I will not trust.
In Australia you might organise around it and use a QA process to make somebody
else accountable. (the organisation?)
This is not what I would advocate, personally.
When something else places da
In reality each observation is performed following an explicit or implicit
protocol.
That what is taught and trained in Medical School.
Actions execute those implicit or explicit protocols. Unless they are unplanned
(e.g. Lightning, other 'Acts of God', car accidents, etc.)
Observations store in
Dear colleagues,
What is wrong with the definitions we use in the EN13606 Association?
Paraphrasing:
Observation: is about phenomena generated by states in the patient system and
that are observed using the faculties of any human (seeing, smelling, etc)
Evaluation: is about Inferences about any
Stefan,
I agree.
For me the EHR contains data and information that is placed there because of an
author/healthcare provider.
In my 'book' all data and information must be there because of the execution of
an act by a human. There is a strong legal requirement that always a human can
be held a
Hi Everyone,
I would go even furhter. In many observation procedures effort is made
to reduce the effect of human interference to a level where the fact
that, as Gerard says, what's documented always goes through a human mind
is insignificant. My interpretation of the openEHR
OBSERVATION-EVALUATIO
Hello!
Just a few cents, as Gerard wrote:
> Everything documented in an EHR is based on human interpretation.
A raw, non-validated, blood glucose value is not based on human
interpretation. It comes out of a machine.
It is a requirement for EHRs to support the clinical validation process.
I ther
Everything documented in an EHR is based on human interpretation.
Therefor human interpretation is not a discriminator when we want to define the
specialisations of an Entry.
And neither is the fact whether something is located in time.
An neither is the fact whether it applies to the patient as a
Hi Gerard,
The last time I look at your alternative definitions, they seemed
pretty close to the original openEHR ones.
EVALUATION:
class in the Target Reference Model
that can be used for the documentation about an inferred process in
the patient system using observations, expertise and knowledg
t; --
>> Kind regards,
>> Ing. Pablo Pazos Guti?rrez
>> LinkedIn: http://uy.linkedin.com/in/pablopazosgutierrez
>> Blog: http://informatica-medica.blogspot.com/
>> Twitter: http://twitter.com/ppazos
>>
>>> From: jussara.macedo at gmail.com
>>
>>> S
Hi Gustavo,
There are situations where it is helpful to use ACTIONS to record the
process of an OBSERVATION (or group of Observations) e.g to monitor
the progress of a lab test order or a request to perform regular Vital
Signs monitoring, This will become much more common as we move towards
care p
Hi, you all
It's so exciting to be part of this excepcional moment of our community,
showing that, despite our different points of views, we're enlarging our
knowledge. But, as Thomas Beale once pointed out that blackberry users were
unusual email responders, same apllies to iPhone ones, interf
This became a very rich and interesting conversation, it is being very good
to be learning so much with you all.
> So EVALUATIONS are NOT limited to opinions or assessments, although that
> is a common misunderstanding.
>
I have to disagree, the paper "An Ontology-based Model of Clinical
Inform
Hi Pablo,
> Yes, all ENTRY subtypes can include data about devices because ENTRY has a
> "protocol" attribute.
> I believe (correct me if I'm wrong) the "protocol" attribute of an
> OBSERVATION can record the device and other information about the execution
> itself, but this should be directly r
> ________________
> From: gbacelar at gmail.com
> Date: Sun, 17 Jun 2012 10:03:15 +0100
> Subject: Re: An ACTION or INSTRUCTION referencing an AGENT, is it possible?
> To: openehr-clinical at lists.openehr.org
>
>
> Hi Pablo,
> I'm an ophthalmol
Hi Diego,
I think we have found that the idea of protocol (method, metadata etc)
applies to virtually every clinical data collection. I think Evaluation
is the catch all for the reason you have identified.
The history of this is:
Care Entry - data + protocol
Requirement to deal with serial ob
Because it happens that the generic entry class (which exists in
openEHR) is only useful for a) what we call Evaluations b) what we call
Admininstrative Entries (AdminEntry) and c) legacy data a la 13606. It's
no use for Observations, Actions or Orders, which comprise the majority
of clinical
gt;
> --
> Kind regards,
> Ing. Pablo Pazos Guti?rrez
> LinkedIn: http://uy.linkedin.com/in/pablopazosgutierrez
> Blog: http://informatica-medica.blogspot.com/
> Twitter: http://twitter.com/ppazos
>
>> From: jussara.macedo at gmail.com
>
>> Subject: Re: An ACT
Hi Diego,
I think the point is that for most of the models there is a pretty
clear distinction between what is an Observation and what is an
Evaluation, and in the majority of cases the 'ontological'
classification matches up with the structural class. There are a few
grey areas where the congruen
So if that is the case, why don't stick with a generic Entry and use
the ontology described on your paper (T. Beale et al. / An
Ontology-based Model of Clinical Information) to clearly describe
(bind) the root node of an archetype?
If you use classes and an ontology with meaning you have the poten
The definition of ENTRY specialisations are essential when data is to be
interpreted and processed by clinical Decision Support Systems.
The semantic meaning must be clear for 100%.
Gerard Freriks
+31 620347088
gfrer at luna.nl
On 19 Jun 2012, at 17:34, pablo pazos wrote:
> Hi Gustavo,
>
>
All that is documented by an author is subjective and evaluated by the author.
So we need to have a better discriminator.
ERS proposed to have as discriminator the relation with, the effect on, the
patient system.
In short:
Observation: the documentation by the author of a state in the Patient Sy
If we continue to use the word 'Evaluation' in all its possible senses
in English, this comment is undoubtedly true. But its meaning in openEHR
is narrower than that - it is a 'clinical opinion about the subject
based on previously collected evidence'. So although a doctor manually
'observing
On Archetypes and Ontologies...
Ian often says: 'it doesn't really matter in the end, what matters is
whether you know how to query'. From a practical perspective, this is
correct, and it is what we should be focussed on, not being
over-theoretical about the ontological side of things.
So the
ACTION or INSTRUCTION referencing an AGENT, is it
> possible?
>
> Hi All
>
> The idea of a device as an agent is interesting and at some point
> devices will have features of agents. The use of a re-useable cluster
> is clearly the solution - regardless of which part of openEHR
>
>
>
> Heather
>
>
>
> From: openehr-clinical-bounces at lists.openehr.org
> [mailto:openehr-clinical-bounces at lists.openehr.org] On Behalf Of Gustavo
> Bacelar
> Sent: Monday, 18 June 2012 8:14 AM
> To: For openEHR clinical discussions
>
>
> Subject: Re:
Date: Sun, 17 Jun 2012 23:13:42 +0100
Subject: Re: An ACTION or INSTRUCTION referencing an AGENT, is it possible?
To: openehr-clinical at lists.openehr.org
Hello everyone,I agree with Jussara. I think it depends on the nature of the
entry.
A summary is not necessarily an opinion. If a summary is about p
Hi Sam,
Date: Mon, 18 Jun 2012 06:17:13 +0930
From: sam.he...@oceaninformatics.com
To: openehr-clinical at lists.openehr.org
Subject: Re: An ACTION or INSTRUCTION referencing an AGENT, is it possible?
Hi All
The idea of a device as an agent is interesting and at
ds,
Ing. Pablo Pazos Guti?rrez
LinkedIn: http://uy.linkedin.com/in/pablopazosgutierrez
Blog: http://informatica-medica.blogspot.com/
Twitter: http://twitter.com/ppazos
> From: jussara.macedo at gmail.com
> Subject: Re: An ACTION or INSTRUCTION referencing an AGENT, is it possible?
> Date: Su
Dear colleagues,
A SUMMARY in the terms of the definitions as defined in the EN13606 Association
document is:
an ad-hoc collection of subjectively selected facts, thoughts, and plans.
In our 'book' it is therefor a SECTION archetype where Observations,
Evaluations, Instructions and Actions are
Hi Gustavo,
I'm trying to catch on this interesting discussion.
From: gbace...@gmail.com
Date: Sun, 17 Jun 2012 20:18:03 +0100
Subject: Re: An ACTION or INSTRUCTION referencing an AGENT, is it possible?
To: openehr-clinical at lists.openehr.org
Hi Pablo,it is a common mistake to tell
If we take the viewpoint of this paper, we can imagine a continuum of
information types more finely distinguished than the OBSERVATION /
EVALUATION of today, i.e. the following:
Observation => aggregation / organisation / transformation =>
interpretation => Evaluation (synthesis)
Which of thes
Hi Thomas,
I am going to take Gustavo's side on this one. I have been heavily
influenced by a recent paper on JAMIA on Summarization, which makes it
clear, to me at least, that some degree of summarisation takes place at
every level of clinical recording,
"Summarization of clinical information: a
s
Heather
From: openehr-clinical-boun...@lists.openehr.org
[mailto:openehr-clinical-bounces at lists.openehr.org] On Behalf Of Gustavo
Bacelar
Sent: Monday, 18 June 2012 8:14 AM
To: For openEHR clinical discussions
Subject: Re: An ACTION or INSTRUCTION referencing an AGENT, is it possible?
On 17/06/2012 23:13, Gustavo Bacelar wrote:
> Hello everyone,
> I agree with Jussara. I think it depends on the nature of the entry.
>
> A summary is not necessarily an opinion. If a summary is about
> patient's data (e.g. physical activity summary, from NEHTA) so it
> should be an OBSERVATION su
On 17/06/2012 20:39, Diego Bosc? wrote:
> I would say there is not a common opinion of what an evaluation is.
> Some people agree with your definition, but others say that EVALUATION
> is just 'the generic health care record entry with protocol'
>
> I have seen plenty references to both and I am cu
Hi Diego
At the end of the day the EVALUATION is an information class. We have
created other classes over the years to cope with information
requirements that require consistent representation for computing. A lot
of the information stored in this class meets the ontological scope of
evaluativ
,
> Ing. Pablo Pazos Guti?rrez
> LinkedIn: http://uy.linkedin.com/in/pablopazosgutierrez
> Blog: http://informatica-medica.blogspot.com/
> Twitter: http://twitter.com/ppazos
>
> ----------------
> From: gbacelar at gmail.com
>
Hello everyone,
I agree with Jussara. I think it depends on the nature of the entry.
A summary is not necessarily an opinion. If a summary is about patient's
data (e.g. physical activity summary, from NEHTA) so it should be an
OBSERVATION summary. It does not include any Opinion from a healthcare
I would say there is not a common opinion of what an evaluation is.
Some people agree with your definition, but others say that EVALUATION
is just 'the generic health care record entry with protocol'
I have seen plenty references to both and I am curious which one is
the 'correct' one.
2012/6/17
Hi Pablo,
it is a common mistake to tell apart ACTION and OBSERVATION. The
Information Model document says:
"Observations are distinguished from Actions in that Actions are
interventions whereas Observations record only information relating to the
situation of the patient, not what is done to him/
Hi, guys
While observation is a sheer report of findings, without any judgement of
value by the observator, while evaluation is the interpretation of the findings
made by the interviewer, like a syndrom, a diagnosis. In psychatry is very (
or should) very easy to distinguish, mental status
Kind regards,
Ing. Pablo Pazos Guti?rrez
LinkedIn: http://uy.linkedin.com/in/pablopazosgutierrez
Blog: http://informatica-medica.blogspot.com/
Twitter: http://twitter.com/ppazos
From: gbace...@gmail.com
Date: Sun, 17 Jun 2012 10:03:15 +0100
Subject: Re: An ACTION or INSTRUCTION referencing an AGENT,
Hi Pablo,
I'm an ophthalmologist and would be gladful to help.
There are some issues about the archetype class and the nature of the test.
As it is a study test it must be considered the existence of an
intervention. If it does not include, so the most appropriate would be to
record as an OBSERVA
Hi,
I'm correcting student papers for the openEHR course in spanish.A student has
modelled oftalmologic studies for diabetic patients, with a demographic
archetype of AGENT class to model all the devices used on the test.
It could be very usefull to let record the device information in the ACTIO
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