Archetypes are constraints on an UML model.
Archetypes define what can be documented about a topic.
Templates are Archetypes.
Archetypes are not Templates
because Templates are the aggregated archetypes, collected and further constrained to suit a specific business context.
In order to reduce possibilities for confusion we need to become more clear what we mean.
Semantic interoperability and confusing meanings of things do not go well together.
Types of Archetypes
Templates:
Archetypes suiting the needs of a specific business case/context, constraining parts of the EN13606 or OpenEHR Reference Model, the Folder class, the Composition class and Section Class, plus, in addition, constrain included Entry Archetypes that are parts of the Sections.
Entry Archetypes:
Archetypes that in general collect what can be documented in general about a health concept using Cluster Proto-Archetypes and Element Proto-Archetypes.
There are: Demographic, Observation, Evaluation, Instruction and Action Entry Archetypes.
[Question: What type is a Patient Mandate Archetype?]
Cluster Proto-Archetype:
Archetypes that in general collect/unite two or more elementary archetypes
Elementary Proto-Archetype:
Archetype that defines one aspect of an Entry Archetype
Re-Use
Re-use will take place at the Template Level (ieTypes of documents in other documents, types of sections in other sections, etc) All these reflect business needs
Re-use will take place at the Template Level by using Entry Archetypes. Reflecting interoperability needs
Re-use will take place within the Entry Archetype by means of generic Proto-Archetypes. Reflecting interoperability needs.
Gerard
– –
Gerard Freriks, MD
Huigsloterdijk 378
2158 LR Buitenkaag
The Netherlands
I would agree with most, of not all of your definitions.
I can forsee use for templating being done on single archetypes to define local or professional constraints e.g minimum datasets or ‘good-practice’ guides.
I would regard a patient mandate archetype as an Evaluation but we may have a different idea of what constitutes a patient mandate. Can you give a specific example - ? something like ‘Does not wish to be resuscitated in event of cardiac arrest?’
Now I realize there are at least two mandates.
And perhaps three (after a discussion with my daughter)
a- Patient Information Mandate: Who has what access, change rights to the record or any piece of it
b- Author Information Mandate: idem, but then by the author
c- Patient Health Mandate: Who has the right to do what with my body and soul.
a and b are twins.
c is a different species.
Of course it is not only what but also when, where and perhaps why.
Gerard
– –
Gerard Freriks, MD
Huigsloterdijk 378
2158 LR Buitenkaag
The Netherlands
I’ve got a question about Author Information Mandate. (an issue brought up under ‘Archetype production: Types of Archetypes’ by Gerard Freriks.)
What is determined about the access control of information documented by the physician that s/he wants to keep obscured from the patient?
I believe that the whole care process is characterised by a the subtle ‘game’ between physician and patient, where the physician has its private thoughts and goals (which he wants to document) but doesn’t want the patient to know, or only partly. For instance, a GP might be quite sure the patient has cancer but doesn’t want to alarm the patient right away so orders blood tests. (There surely are medically more correct examples.) Others are i.e. whether the physician believes the patient or not, or when the physician has got extra information conveyed by a relative that the patient mustn’t know about. It is harmful to the care process and the physician-patient relation if the patient has access to all of this.
Is there a way, in the RM for instance, that everything that is under EVALUATION is kept hidden from the patient? I think this should be so. There should be –according to my opinion – two separate parts in the EHR: a shared part (open to, and access controlled by the patient) and a private part containing the physicians evaluations and comments. This latter part should only be made visible to the patient under certain (legal) circumstances, where the patient can order to delete certain info.
My question: has this been taken care of right now? If so: how?
I posted this message to the clinical mailing list, but think this should be on the technical mailing list. Apologies if I’m not correct (and please a further explanation about what is meant by ‘technical’ )
I’ve got a question about Author Information Mandate. (an issue also brought up under ‘Archetype production: Types of Archetypes’ by Gerard Freriks.)
What is determined about the access control of information documented by the physician that s/he wants to keep obscured from the patient?
I believe that the whole care process is characterised by a the subtle ‘game’ between physician and patient, where the physician has its private thoughts and goals (which he wants to document) but doesn’t want the patient to know, or only partly. For instance, a GP might be quite sure the patient has cancer but doesn’t want to alarm the patient right away so orders blood tests. (There surely are medically more correct examples.) Others are i.e. whether the physician believes the patient or not, or when the physician has got extra information conveyed by a relative that the patient mustn’t know about. It is harmful to the care process and the physician-patient relation if the patient has access to all of this.
Is there a way, in the RM for instance, that everything that is under EVALUATION is kept hidden from the patient? I think this should be so. There should be –according to my opinion – two separate parts in the EHR: a shared part (open to, and access controlled by the patient) and a private part containing the physicians evaluations and comments. This latter part should only be made visible to the patient under certain (legal) circumstances, where the patient can order to delete certain info.
My question: has this been taken care of right now? If so: how?
In een bericht met de datum 14-12-2007 20:44:14 West-Europa (standaardtijd), schrijft gfrer@luna.nl:
Hi,
Thanks.
Now I realize there are at least two mandates.
And perhaps three (after a discussion with my daughter)
a- Patient Information Mandate: Who has what access, change rights to the record or any piece of it
b- Author Information Mandate: idem, but then by the author
c- Patient Health Mandate: Who has the right to do what with my body and soul.
a and b are twins.
c is a different species.
Of course it is not only what but also when, where and perhaps why.
Gerard
Case c is definitely public health and safety of the public in relationship to individuals with severe mental disorders.
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
)