Since 2015, the ism_transition /reason element has been available in the RM for specifying the “reasons for this careflow step having been taken”. In parallel, because it hasn’t been exposed in tools so we didn’t know about it, modellers have been diligently adding “Reason” data elements to ACTION ar…

So I’ve had three likes and one +1, but no response from tooling implementers. What do you think @sebastian.garde and @borut.fabjan ? :smile:

We can add this to the RM tab, e.g. [Action RM attributes] The text I have used is a mixture of reason texts in current archetypes and the specs. If you want to extend or change the text to make this clearer to clinical modellers please let me know. Once agreed, we can add this to CKM immediate…

That’s helpful right now but this will probably have to be constrainable in archetypes e.g with a codedList. It is the reason associated with a particular careflow_step - that means that to properly represent in AD or CKM, it has to appear as partof the constraint for a Careflow_step. Very roughly …

[image] ian.mcnicoll: constrainable in archetypes e.g with a codedList. We have actually enabled the upload of such archetypes soon after that field was added to the spec, so you should be fine to upload this to CKM. However, we are not visualising it at the moment. This could be added witho…

The archetypes I had a look at today (with the explicit reason element) don’t code the reason at the moment though. Sure but that’s because it is not supported in archetype tooling right now!! So if we get it supported in AD, it will work fine in CKM.

We also need to check if this attribute is supported in CDRs. It ought to be but you never know.

Yep sure - I’m not sure it will be redundant, though. There may well be use-cases for Reason to associate with the whole ACTION plus the overhead of converting/updating. It might usefully be renamed at some point.

[image] ian.mcnicoll: I’m not sure it will be redundant, though I think the current element will probably be redundant, as its semantics are exactly the same as the RM element. Of course if there’s a need for a “reason” element for the whole archetype we can add that whenever the requirement …

ACTION 'reason' exposed in tools?

Implementation Tools

sebastian.garde (Sebastian Garde) 17 January 2025 09:13 9

What I meant is this explicit “Reason” element in Description.
My understanding was that this is the element that will be obsolete once the careflow_step has a (fully supported) reason? It surely is supported by AD to use a Coded Text there?

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COMPOSITION.category multiple options Clinical archetype	14	353	17 August 2023
ELEMENT.null_reason proposal Technical (archive)	7	2	25 January 2017
ISM Transition : definition of allowed transitions Technical (archive)	4	1	5 March 2015
Linking INSTRUCTION / ACTION archetypes in a workflow Clinical archetype , template	13	159	11 November 2025
How to define transitions in the ISM Clinical (archive)	27	11	27 August 2018
Original text in ADL? ADL	7	1048	15 November 2023
DV_CODED_TEXT with open/extensible set of codes (value set) ADL archetype , terminology , modelling-patterns , template , adl	29	1557	3 April 2020
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ACTION 'reason' exposed in tools?

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