an archetype for a home-based device composition

Clinical (archive)
1

The openehr spec details how COMPOSITION's can occur
without any event_context for the case of home
monitoring devices etc. I am in a situation where I will be
constructing compositions along these lines, but now I
need an archetype that corresponds to such a
composition.

Has any standard approach to this been considered in
the NHS work? It's essentially a pretty empty archetype
- so I'm sure I could knock one up - but would defer to
those with more experience in this area if someone
already has a plan for a standard archetype along
these lines.

Andrew

2

Hi Andrew,

I don't think we've used the COMPOSITION archetype at all in our NHS work to
date - but, I wouldn't claim that this was a well-thought-through position.
(As we were in a very big hurry to create archetypes and templates to meet
an application design deadline, we tended to re-use existing patterns as
much as possible - the lack of openEHR composition examples was probably the
main reason we didn't use it in our last rush of archetypes design.) I
expect that we'll revisit the potential use of this in future, however, as
we prepare to develop a national (alongside the current project-specific)
set of archetypes.

Based on my rather superficial understanding of COMPOSITION archetypes, I'd
be interested in clarifying their use within an environment that also uses
COMPOSITION templates.

Best regards,
Laura

3

Hi Andrew

If there is any sort of timing context to the data that you will be adding then you need to use the event state and use the context - so if your data will relate to a period of exercise you can say what that period was, where it occurred etc.

Don’t build one archetype for the composition - no matter how convenient is seems as it will then be not so useful. You then need to decide if you want to organise it with any sections (section specific). Then you need to observation data which records the monitoring. The provider can be the machine if that is useful.

Cheers, Sam

Andrew Patterson wrote:

4

Small correction, the UK NHS is using the generic report and encounter archetypes, Sam

Laura Sato (NHS CFH) wrote:

5

We are using the composisitions in HL7 format (13606-5 implementation version) based on the organiser class in HL7.

We have individual items / simple scoring systems that are grouped together with use of an organiser, where the organiser gets a unique code.

e.g. a code for vital signs, where the underlying data items are temperature, blood pressure, breathing rate, pulse rate.

this structure with organisers we have used a lot for home care / community care / nursing home, especially for the acceptance to care messaging. E.g. for mobility, for risks, for daily living, for living conditions, household, expectations of the future, social situation, medical care, generic assessment, feeding, etc.

Unfortunately it is all in Dutch.

William Goossen

In een bericht met de datum 18-7-2007 17:29:21 West-Europa (zomertijd), schrijft laura.sato@nhs.net:

From: openehr-clinical-bounces@openehr.org
[mailto:openehr-clinical-bounces@openehr.org] On Behalf Of Andrew Patterson
Sent: 18 July 2007 16:16
To: For openEHR clinical discussions
Subject: an archetype for a home-based device composition

The openehr spec details how COMPOSITION’s can occur without any
event_context for the case of home monitoring devices etc. I am in a
situation where I will be constructing compositions along these lines, but
now I need an archetype that corresponds to such a composition.

Has any standard approach to this been considered in the NHS work? It’s
essentially a pretty empty archetype

  • so I’m sure I could knock one up - but would defer to those with more
    experience in this area if someone already has a plan for a standard
    archetype along these lines.

Andrew

openEHR-clinical mailing list
openEHR-clinical@openehr.org
http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-clinical

Sincerely yours,

dr. William TF Goossen
director
Results 4 Care b.v.
De Stinse 15
3823 VM Amersfoort
email: Results4Care@cs.com
phone + 31654614458
fax +3133 2570169
Dutch Chamber of Commerce number: 32121206

6

Williamtfgoossen@cs.com wrote:

We are using the composisitions in HL7 format (13606-5 implementation
version) based on the organiser class in HL7.

We have individual items / simple scoring systems that are grouped
together with use of an organiser, where the organiser gets a unique
code.

e.g. a code for vital signs, where the underlying data items are
temperature, blood pressure, breathing rate, pulse rate.

this structure with organisers we have used a lot for home care /
community care / nursing home, especially for the acceptance to care
messaging. E.g. for mobility, for risks, for daily living, for living
conditions, household, expectations of the future, social situation,
medical care, generic assessment, feeding, etc.

Unfortunately it is all in Dutch.

if this was in archetype form, translations could be accommodated
seamlessly. I am serious!

- thomas beale

7

Don't build one archetype for the composition - no matter how convenient is
seems as it will then be not so useful. You then need to decide if you want
to organise it with any sections (section specific). Then you need to
observation data which records the monitoring. The provider can be the
machine if that is useful.

Yes - I don't want to build a specific archetype for this particular home
monitoring data - I understand the high level archetypes
for composition need to be as generic as possible.

My point is that none of the currently
existing _generic_ composition archetypes
would seem to be appropriate for holding data submitted by a patient
produced by a home monitoring device.

discharge - for release from hospital
encounter - implies some interaction with health provider
history - persistent store of health data
plan - suitable for plan of care
prescription - medication related
problem_list - persistent store of problems
report - has inbuilt requirements for requesting clinician etc

I'm asking what archetype would be used for holding a composition
of patient submitted home recorded data (and if as I suspect,
none of them is suitable, should we write one?).

Andrew

8

In een bericht met de datum 19-7-2007 11:39:54 West-Europa (zomertijd), schrijft thomas.beale@OceanInformatics.biz:

I know, we will be going to work on that :slight_smile:

Unfortunately it is all in Dutch.

if this was in archetype form, translations could be accommodated
seamlessly. I am serious!

  • thomas beale

Sincerely yours,

dr. William TF Goossen
director
Results 4 Care b.v.
De Stinse 15
3823 VM Amersfoort
email: Results4Care@cs.com
phone + 31654614458
fax +3133 2570169
Dutch Chamber of Commerce number: 32121206

9

Thanks, Sam. As soon as I wrote it, I thought I might have been a bit hasty in my wording, given the mix of current NHS draft archetypes from different sources… (The short answer to the original question is the same, however - no particular insight from the NHS on home-based device compositions!)

Laura

p.s. Another small correction - the UK has more than one NHS… :wink:

10

We are using the composisitions in HL7 format (13606-5 implementation version) based on the organiser class in HL7.

We have individual items / simple scoring systems that are grouped together with use of an organiser, where the organiser gets a unique code.

e.g. a code for vital signs, where the underlying data items are temperature, blood pressure, breathing rate, pulse rate.

this structure with organisers we have used a lot for home care / community care / nursing home, especially for the acceptance to care messaging. E.g. for mobility, for risks, for daily living, for living conditions, household, expectations of the future, social situation, medical care, generic assessment, feeding, etc.

Unfortunately it is all in Dutch.

Are these in some ‘public’ place? If possible I would like to see them and Dutch is no problem:-)

Cheers,

Stef

11

Andrew,
The Report composition is used for laboratry reports where there is a
request made resulting the report hence it has context about the request and
report such as request ID, report ID, requesting provider etc.

If there is a request for the monitoring observations then you could use the
report composition but I doubt this is the case.

We are currently working on a notification composition which is used for
unsolicted reporting such as notifyable diseases etc. It has an identifer
in the other context, not sure what else off the top of my head. This may
be applicable for your use?

Sam, thoughts?

Heath

From: openehr-clinical-bounces@openehr.org [mailto:openehr-clinical-
bounces@openehr.org] On Behalf Of Andrew Patterson
Sent: Thursday, 19 July 2007 7:07 PM
To: For openEHR clinical discussions
Subject: Re: an archetype for a home-based device composition

> Don't build one archetype for the composition - no matter how

convenient is

> seems as it will then be not so useful. You then need to decide if you

want