As an observer it seems to me there has been a lot of effort to codify
encounters and make the data in them computable and recallable.Then we
create an entity called problem which has little formal connection
with this data - it is the synthesis by a sophisticated clinician of a
shorthand summary d
On Wed, Jul 03, 2019 at 05:35:07PM +0100, Thomas Beale wrote:
> well my epistemological (and non-MD) view is that thinking of a SOAP
> structure not just as the headings for a 'SOAP note', but as the headings
> for a 'problem summary' or similar, could create better quality
> problem-oriented data
On 28/06/2019 06:48, Paul Miller wrote:
I maybe don't quite understand yet the approach Thomas suggests for
SOAP persistence. In my head SOAP is a way of structuring an encounter
(not modelling a 'problem'), and various other such encounter headings
are present in other EHRs. Thus I think a
On Fri, Jun 28, 2019 at 12:07:48PM +0100, Ian McNicoll wrote:
> and one of the best papers is
> http://www.differance-engine.net/chirad/healthrecords2007/The%20Problem%20Oriented%20Medical%20Record.doc
I must agree.
Funny thing is, I don't remember reading that paper before,
BUT, GNUmed implemen
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>
> or, via email, send a message with subject or body 'help' to
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with chronic disease –
>> time and lack of funding will crush it in most clinical environments as
>> they stand at the moment.
>>
>>
>>
>> But let’s keep dreaming and planning. If we can put the building blocks
>> in place, and there are many that are ready to
e, and there are many that are ready to go within openEHR now, with
> CDS, smart UI, AI etc maybe much of this could be automated, or at least
> collated presented to a clinician for verification.
>
>
>
> Regards
>
>
>
> Heather
>
>
>
> *From:* openEHR-clinica
eather
From: openEHR-clinical On Behalf
Of richa...@iinet.net.au
Sent: Friday, 28 June 2019 10:04 AM
To: For openEHR clinical discussions
Subject: Re: Problem orientation in OpenEHR
Thanks for all the responses
I guess I see "problem" as a high level construct, decided by an expert
Thanks for all the responses
I guess I see "problem" as a high level construct, decided by an
expert clinician as a way of "coding" the client's various ongoing,
significant issues in a way that is relevant to management. It could
be a formal diagnosis like Diabetes or a less st
In a slightly roundabout way, Links from Problem-SOAP Compositiions to
Entries committed at other times is essentially the equivalent of
tagging, and indeed the UI could easily be built to make it look exactly
like tagging, by presenting a list of existing SOAP note problem names,
and the 'tag
If I wanted to solve POMR in a simple way without repetition, I'd use
Tagging
You'd tag anything relevant to the Problem with that problem's Tag, you
index by Tags too, in a background job
Then when searching by Problem you get all entries Tagged as relevant.
M
On Thu, 27 Jun 2019 at 19:32, Gunnar
I do agree pomr has an important role in primary care and I like the
proposal of Thomas to manage it in openEHR. I am not sure why pomr never
took on in hospitals. Larry Weeds idea was not restricted to primary care.
Gunnar Klein, GP an professor of health informatics
Den tors 27 juni 2019 19:14T
Just reflecting on what a SOAP note has traditionally been (in my non-MD
understanding), the original idea was to use the 4/5 headings to capture
things to do with a specific problem in a clean way during consultations
and further 'clinical thinking'. We don't need to discuss this now; SOAP
is
I'm not ready to give up on POMR just yet. It is a lot of work and
difficult to maintain, as Ian points out, but as a locum GP, when I work in
practices that use problem orientation it is MUCH easier and safer to treat
people you don't know. Practices that just dump everything into the record
witho
A few of my thoughts abd advice:
1- have a look at the CEN/ISO standard defining the concepts related to
Continuity of Care.
2- For may years Dutch GP’s use the SOEP method of documenting the provision of
health and care. (SOEP=Subjective, Objective, Evaluation, Plan)
3- For many years we collec
gt;
>
>
>
>
>
> - Original Message -
> From:
> "For openEHR clinical discussions"
>
> To:
> "For openEHR clinical discussions"
> Cc:
>
> Sent:
> Wed, 26 Jun 2019 15:25:02 +0100
> Subject:
> Re: Problem orientati
Hello all
I am a lurker von this list - don't have the expertise of most of you
blokes
(BTW I play music with Sam Heard regularly)
However I thought I should comment on this issue
As I understand it one of the major advantages of a properly designed
d
On 26/06/2019 11:07, Thomas Beale wrote:
As yet, the machinery to do this mostly exists, but there is little in
the way of standardised patterns or usage of it to achieve any kind of
standardised 'problem' document (NB: not the same as 'problem list' -
which is one level up, and is a managed
Thanks all that’s really helpful.
I do think it is a requirement though agree needs to be a balance between
manual curation and automation which may not be possible at present, or
even desirable?!?!
I’ll check out the SOAP archetypes tomorrow.
Good to know we have the capability if not the answe
Hi Paul,
In theorical, PMOR are estructured using some resources, but the essencial
for your question is a *SOAP method* estructure used to organize your
annotation in some encounter.
The link between the problem and others records is a SOAP estructure. Where
section "A" report one or many proble
Hi Paul,
We can do it but I am increasingly of the view that although it makes some
clinicians very happy it makes many others very unhappy as proper POMR
requires huge discipline, and is hard to maintain. As others have said ...
links.. but manging those links both clinically and technically is
c
Here was an earlier effort by me based on the Contsys approach.
https://github.com/openehr-clinical/shn-contsys
Ian
Dr Ian McNicoll
mobile +44 (0)775 209 7859
office +44 (0)1536 414994
skype: ianmcnicoll
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Director, freshEHR Clinical Informatics Lt
Hi Paul,
things like Problem lists are 'interesting', and I consider them a
second order informational artefact. The short answer on how to do them
is probably something like this:
* creating an artefact to represent a specific problem such as chest
pain will mostly be done at execution t
Hi Paul!
Yes, this is part of the openEHR specification LINK class
(https://specifications.openehr.org/releases/RM/latest/docs/common.html#_link_class),
and it needs to be handled by the application. I know DIPS has started using
this in some functional areas like their hospital care plan modul
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