# Arcetypes and care plans
**URL:** https://discourse.openehr.org/t/arcetypes-and-care-plans/15707
**Category:** Technical (archive)
**Created:** [17 January 2003 06:21 UTC](https://discourse.openehr.org/t/arcetypes-and-care-plans/15707 "2003-01-17T06:21:19Z")
**Posts on this page:** 7
**Page:** 1
### Author:  [@Oystein\_Nytro](https://discourse.openehr.org/u/Oystein_Nytro)
#### Post date: [17 January 2003 06:21 UTC](https://discourse.openehr.org/t/arcetypes-and-care-plans/15707/1 "2003-01-17T06:21:19Z")
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### Author:  [@Philippe\_AMELINE1](https://discourse.openehr.org/u/Philippe_AMELINE1)
#### Post date: [17 January 2003 09:08 UTC](https://discourse.openehr.org/t/arcetypes-and-care-plans/15707/2 "2003-01-17T09:08:32Z")
Hi,
We have been working on that topic for several years now.
The open source projet is called Odyssee and deals with such concepts as Ligne de vie (Life line) and Patient's health project manager.
A french non profit organisation has already been created in order to manage the project and raise funds ([http://cellule.odyssee.free.fr/](http://cellule.odyssee.free.fr/)). I plan to have this organisation become a member of the openEhr "ring" - we just have to create the ring 😉
Regards,
Philippe AMELINE
Nautilus
[http://www.nautilus-info.com](http://www.nautilus-info.com)
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### Author:  [@Oystein\_Nytro](https://discourse.openehr.org/u/Oystein_Nytro)
#### Post date: [21 January 2003 10:13 UTC](https://discourse.openehr.org/t/arcetypes-and-care-plans/15707/3 "2003-01-21T10:13:37Z")
Thanks for answer, I'll do some more thinking.
Meanwhile, some more questions...
- has anyone worked with medication in the context of care plans, just as a very specific example?
I have a couple of students that are working on this at the moment. Any ideas towards
archetype representation?
--- Ãystein Nytrø
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### Author:  [@thomas.beale](https://discourse.openehr.org/u/thomas.beale)
#### Post date: [23 January 2003 09:23 UTC](https://discourse.openehr.org/t/arcetypes-and-care-plans/15707/4 "2003-01-23T09:23:48Z")
Philippe AMELINE wrote:
> Hi,
>
> We have been working on that topic for several years now.
> The open source projet is called Odyssee and deals with such concepts as Ligne de vie (Life line) and Patient's health project manager.
>
> A french non profit organisation has already been created in order to manage the project and raise funds ([http://cellule.odyssee.free.fr/](http://cellule.odyssee.free.fr/)). I plan to have this organisation become a member of the openEhr "ring" - we just have to create the ring 😉
don't worry, we'll get there. I like that idea - all the other rings I know are for amusing topics, like "rare palm growers" or "theoretical evolution"...
- thomas
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### Author:  [@thomas.beale](https://discourse.openehr.org/u/thomas.beale)
#### Post date: [23 January 2003 09:27 UTC](https://discourse.openehr.org/t/arcetypes-and-care-plans/15707/5 "2003-01-23T09:27:31Z")
Øystein Nytrø wrote:
> Thanks for answer, I'll do some more thinking.
> Meanwhile, some more questions...
>
> - has anyone worked with medication in the context of care plans, just as a very specific example?
> I have a couple of students that are working on this at the moment. Any ideas towards
> archetype representation?
do you mean medications planned? I presume in the context of a care plan you mean with ongoing monitoring, possible education, and reviews. Sam Heard and I have done a certain amount of work in this area already, using the example of asthma. The medication is just oral corticosteroids, but the totality of monitoring, guideline, and other factors make it interesting. Would this be the kind of thing you woudl like to discuss?
- thomas beale
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### Author:  [@Oystein\_Nytro](https://discourse.openehr.org/u/Oystein_Nytro)
#### Post date: [23 January 2003 11:09 UTC](https://discourse.openehr.org/t/arcetypes-and-care-plans/15707/6 "2003-01-23T11:09:17Z")
I am not quite aware of the distinction between medication plans and medications planned, but anyway,
we are thinking about the "totality of monitoring, education, reviews" in addition to roles and
delegation of responsibility, with the added complexity of limiting access to the plan content according
to "need to know", i.e. unless you are in a role that has responsibility for a specific part of
a multi-problem-plan, you're not allowed to see it.
More specificly, we are starting a pilot that looks at requirements for a plan-based "record system" that supports
cooperation across roles and organizations for long-term psychiatric patients. You wouldn't want rehabilitation-
people to have access or knowledge about specifics of family history etc...
And even more: What about goals for treatments? Think "goal-driven guidelines"...
Is an archetype neutral to the underlying guideline model/semantics/"execution"...
How do we go about composition, inheritance and instantiation wrt. archetypes for plans?
Multiple plans? (After all, it is more than common to be on many medication "plans" concurrently...)
Just rambling,
--- Ãystein N.
> Ãystein Nytrø wrote:
[...]
---
### Author:  [@Sam](https://discourse.openehr.org/u/Sam)
#### Post date: [23 January 2003 21:17 UTC](https://discourse.openehr.org/t/arcetypes-and-care-plans/15707/7 "2003-01-23T21:17:02Z")
Oystein
> I am not quite aware of the distinction between medication plans
> and medications planned, but anyway,
I am not sure how it got here but there are a number of issues. First there
are recommendations from a consultant on medication, second there are
medication orders that are recorded with no administration record
(prescription based or conditional on events that have not arisen), third
there are medication orders with administration records.
> we are thinking about the "totality of monitoring, education,
> reviews" in addition to roles and
> delegation of responsibility, with the added complexity of
> limiting access to the plan content according
> to "need to know", i.e. unless you are in a role that has
> responsibility for a specific part of
> a multi-problem-plan, you're not allowed to see it.
I believe that this approach is fundamentally flawed and will need to be
separated by the record rather than the hiding bits of a care plan. Just
consider someone with HIV - who has a need to know? What can you know
without becoming aware that the person has HIV? What are the safety issues
for a person seeing part of a careplan?
> More specificly, we are starting a pilot that looks at
> requirements for a plan-based "record system" that supports
> cooperation across roles and organizations for long-term
> psychiatric patients.
This sounds interesting. The EHR will not be 'plan based' if it is a good
one as it will need to support a wide range of activities. openEHR would aim
to support such an approach but not to mean that this record could not be
used in other contexts.
> You wouldn't want rehabilitation-
> people to have access or knowledge about specifics of family
> history etc...
Don't confuse care plans with health records - they are very different
beasts.
> And even more: What about goals for treatments? Think
> "goal-driven guidelines"...
> Is an archetype neutral to the underlying guideline
> model/semantics/"execution"...
Yes - inherently - but we have a process model in openEHR - it is not so
sophisticated but I think enough for the EHR part of this.
> How do we go about composition, inheritance and instantiation
> wrt. archetypes for plans?
> Multiple plans? (After all, it is more than common to be on many
> medication "plans" concurrently...)
We would not think of a medication plan - this is probably a medication
order in our world view - one per medication - it is modelled as an
instruction. The care plan itself is a coherent document and is modelled as
a 'transaction'.
Rambling also....Sam Heard