[Archetypefinder] Archetypes as mindmaps, German archetypes

Clinical (archive)
1

Dear all,

There is a new version of the Archetypefinder available at http://www.archetypes.com.au where you can easily find the latest openEHR archetypes.

Most noticable changes:

  • we have included a browsable mindmap for each of the archetypes now (see e.g. http://www.archetypes.com.au/archetypefinder/mindmaps/mindmap.html?openEHR-EHR-OBSERVATION.blood_pressure.v1.mm for the Blood pressure mindmap). Murat Goek from the University of Goettingen, Germany did the hard work on this one during his internship here with us.
    Feedback we got so far is that mindmaps bring archetypes closer to clinicians and makes it easier to organise and discuss the content necessary for an archetype. We would be really interested in your view on this!
  • we reference all the latest openEHR archetypes in all languages the archetype is available. This includes the approx. 50 archetypes that have recently been translated into German by Jasmin Buck, University of Heidelberg, Germany and myself. You can easily find them when you select Language=German in the Country tab. (There will be Spanish archetypes too soon I am being told!).
  • In the advanced search, you can search for additional meta-data now like ‘other contributors’
    As always, please let me know any comments you may have.

Cheers
Sebastian

Dr Sebastian Garde
Dr. sc. hum., Dipl.-Inform. Med, FACHI

Faculty of Business and Informatics, Central Queensland University
Austin Centre for Applied Clinical Informatics, Austin Health
Heidelberg Vic 3084, Australia

s.garde@cqu.edu.au
Ph: +61 (0)3 9496 4040
Fax: +61 (0)3 9496 4224

Skype: gardeseb
http://healthinformatics.cqu.edu.au
http://www.acaci.org.au

Visit the new open access electronic Journal of Health Informatics (eJHI): http://ejhi.net

2

Hi

Re Mindmap use.
I use mindmanager V7 for many projects and find it an excellent way of getting lots of information on one page in a visual format.
The hyperlinking is also useful to expand maps and map parts and link to further information which may be web pages or documents.
It’s a very good way to gather information together and allows for easy prompting for greater details without the pain of going back and forth in the traditional text document.
?
Russell Banks
Head of IM&T/Telecomms
Sheffield Children’s NHS Foundation Trust
UK

From: | “Sebastian Garde” s.garde@cqu.edu.au |

Dear all,

There is a new version of the Archetypefinder available at http://www.archetypes.com.au where you can easily find the latest openEHR archetypes.

Most noticable changes:

  • we have included a browsable mindmap for each of the archetypes now (see e.g. http://www.archetypes.com.au/archetypefinder/mindmaps/mindmap.html?openEHR-EHR-OBSERVATION.blood_pressure.v1.mm for the Blood pressure mindmap). Murat Goek from the University of Goettingen, Germany did the hard work on this one during his internship here with us.
    Feedback we got so far is that mindmaps bring archetypes closer to clinicians and makes it easier to organise and discuss the content necessary for an archetype. We would be really interested in your view on this!
  • we reference all the latest openEHR archetypes in all languages the archetype is available. This includes the approx. 50 archetypes that have recently been translated into German by Jasmin Buck, University of Heidelberg, Germany and myself. You can easily find them when you select Language=German in the Country tab. (There will be Spanish archetypes too soon I am being told!).
  • In the advanced search, you can search for additional meta-data now like ‘other contributors’
    As always, please let me know any comments you may have.

Cheers
Sebastian

Dr Sebastian Garde
Dr. sc. hum., Dipl.-Inform. Med, FACHI

Faculty of Business and Informatics, Central Queensland University
Austin Centre for Applied Clinical Informatics, Austin Health
Heidelberg Vic 3084, Australia

s.garde@cqu.edu.au
Ph: +61 (0)3 9496 4040
Fax: +61 (0)3 9496 4224

Skype: gardeseb
http://healthinformatics.cqu.edu.au
http://www.acaci.org.au

Visit the new open access electronic Journal of Health Informatics (eJHI): http://ejhi.net

3

Dear Sebastian and others,

I have always been very impressed with the ‘mindmap’ representation of Archetypes so I would like to say thanks for the recent work. One thing challenges me with multilingual archetypes is to extend my MST archetypes so as to include all 11 officially released translations (English, French, Italian, German, Portuguese, Spanish, Russian, Hungarian, Czech, Turkish and Japanese) within the ontology section! As there are many MST archetypes, I recommend starting with existing MST_Colon archetype first.

Of course I will need support from people who speak those languages as I am not familiar with them all. It is a lot of work but not that I have finished my Ph.D. studies I have more time and will to support openEHR community.

So what do you (all) think? I guess it would be a good benchmark/test archetype to test in numerous implementations.

Best regards,

Koray Atalag, MD, Ph.D.

Sebastian Garde wrote:

4

Dear Koray,

First: congratulations on finishing your PhD!!

It would be fantastic to have such an archetype.

I'd probably favour a smaller and more general archetype for this (like
the blood pressure one), but I am happy to go with the MST one too and
we may be able to do both of them anyway.

I think it is important to pick an archetype that has been through the
mill a bit and is fairly stable (so that later changes in 11 languages
are limited), the MST colon archetype seems to fulfil this as far as I
can tell as a non-clinician?

I'd offer to do the German translation of it, if a German speaking
doctor (Thilo maybe??) agrees to help for the parts where in-depth
medical knowledge is required.

You could add Farsi as the 12th language...Shahla?

Regards

Sebastian

5

Dear Koray Atalag

If you don’t mind, Could I help your MST archetype extension in translation?
I think it will be good for Korean language to be added.

With Best Regards

Seung Jong Yu MD, MS

seungjong.yu@gmail.com

Research Doctor
Medical Information Center Lab.
Seoul National University Hospital
28 Yongon-dong, Chongno-gu
Seoul 110-799, Korea
+82-2-2072-1978

2007/9/10, Koray Atalag <atalagk@yahoo.com>:

6

@Koray: congrats from me as well, only had a quick look and will
defenitely give it a better read once I find time

Regarding translation: I am happy to help whereever I can. Sebastian
and I should be able to tackle the German translation.

Keep up the good work!

7

Hi,

If it is one or a few archetypes I can probably ask some of the physicians
our group collaborate with to help me translate them into Swedish if it is
interesting to someone. (I should probably not try to do in on my own
because I am an engineer.)

  Greetings,
  Mikael

8

Sebastian,
The new archetype representation is great!
At the moment we are starting the selection of the archetypes we will
use to represent a clinical encounter in a hospital. this will be a
generic internal medicine encounter after that we will translate or
create other compositions as needed. As soon as I have them translated
I'd like to share them with the OpenEhr community.
I hope by the end of this year we will have a big basket of Portuguese
archetypes!
Again, congratulations! great work!
Beatriz

9

Seung Jong Yu wrote:

Dear Koray Atalag

If you don't mind, Could I help your MST archetype extension in
translation?
I think it will be good for Korean language to be added.

With Best Regards

Seung Jong Yu MD, MS

seungjong.yu@gmail.com <mailto:seungjong.yu@gmail.com>

Research Doctor
Medical Information Center Lab.
Seoul National University Hospital
28 Yongon-dong, Chongno-gu
Seoul 110-799, Korea
+82-2-2072-1978

2007/9/10, Koray Atalag <atalagk@yahoo.com <mailto:atalagk@yahoo.com>>:

    Dear Sebastian and others,

    I have always been very impressed with the 'mindmap'
    representation of Archetypes so I would like to say thanks for the
    recent work. One thing challenges me with multilingual archetypes
    is to extend my MST archetypes so as to include all 11 officially
    released translations (English, French, Italian, German,
    Portuguese, Spanish, Russian, Hungarian, Czech, Turkish and
    Japanese) within the ontology section! As there are many MST
    archetypes, I recommend starting with existing MST_Colon archetype
    first.

    Of course I will need support from people who speak those
    languages as I am not familiar with them all. It is a lot of work
    but not that I have finished my Ph.D. studies I have more time and
    will to support openEHR community.

    So what do you (all) think? I guess it would be a good
    benchmark/test archetype to test in numerous implementations.

    Best regards,

    Koray Atalag, MD, Ph.D.

    Sebastian Garde wrote:

    Dear all,
     
    There is a new version of the Archetypefinder available at
    http://www.archetypes.com.au where you can easily find the latest
    openEHR archetypes.
     
    Most noticable changes:

        * we have included a browsable mindmap for each of the
          archetypes now (see e.g.
          http://www.archetypes.com.au/archetypefinder/mindmaps/mindmap.html?openEHR-EHR-OBSERVATION.blood_pressure.v1.mm
          <http://www.archetypes.com.au/archetypefinder/mindmaps/mindmap.html?openEHR-EHR-OBSERVATION.blood_pressure.v1.mm&gt; for
          the Blood pressure mindmap). Murat Goek from the University
          of Goettingen, Germany did the hard work on this one during
          his internship here with us.
          Feedback we got so far is that mindmaps bring
          archetypes closer to clinicians and makes it easier
          to organise and discuss the content necessary for an
          archetype. We would be really interested in your view on this!
        * we reference all the latest openEHR archetypes in all
          languages the archetype is available. This includes the
          approx. 50 archetypes that have recently been translated
          into German by Jasmin Buck, University of Heidelberg,
          Germany and myself. You can easily find them when you
          select Language=German in the Country tab. (There will be
          Spanish archetypes too soon I am being told!).
        * In the advanced search, you can search for additional
          meta-data now like 'other contributors'

    As always, please let me know any comments you may have.
     
    Cheers
    Sebastian
     
    Dr Sebastian Garde
    /Dr. sc. hum., Dipl.-Inform. Med, FACHI/
    //
    Faculty of Business and Informatics, Central Queensland University
    Austin Centre for Applied Clinical Informatics, Austin Health
    Heidelberg Vic 3084, Australia
     
    s.garde@cqu.edu.au <mailto:s.garde@cqu.edu.au>
    Ph: +61 (0)3 9496 4040
    Fax: +61 (0)3 9496 4224
    Skype: gardeseb
    http://healthinformatics.cqu.edu.au
    <http://healthinformatics.cqu.edu.au/&gt;
    http://www.acaci.org.au/&gt;
     
    Visit the new open access *electronic Journal of Health
    Informatics* (eJHI): http://ejhi.net/&gt;
     
    ------------------------------------------------------------------------

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Dear Dr. Yu (I hope I am not wrong with the surname),

Thank you so much in your interest and offer for help with MST
Archetypes. However MST is controlled and distributed by the World
Organisation of Digestive Endoscopy - OMED (www.omed.org). This means
any translation work, which is not conducted by associated national
associations might not be officially 'valid' however possibly be useful.

For downloading all language translations of MST and introductory info
about MST refer to: http://www.omed.org/index.php/resources/re_mst/

I guess the closest work for translation to Korean could be Japanese
which is already there. In that case you might try to first examine that
(the Japanese version is unfortunately not published on the Website) and
then contact your national endoscopy association and collaborate.

BTW I just discovered now that the MindMap also works for other
archetypes published on openEHR site. It was interesting to visualize my
archetype; it definitely looks more understandable :wink:
http://www.archetypes.com.au/archetypefinder/mindmaps/mindmap.html?openEHR-EHR-OBSERVATION.mst_colon.v1.mm

In summary, related with multilingual archetypes, I agree that probably
the first ones to be completed should be common and atomic concepts like
BP, LAB, Apgar etc. but since that MST is already there in EN & TR and
that 9 officially released translations are available it would be wise
to give it a try. And please note that, while most other archetypes are
representing atomic, simple clinical concepts, MST is unique in a way
that it models a whole gastrointestinal endoscopy clinical domain.
(MST-Colon and many other archetypes by forming a Composition).

Archetypes are equally useful/enabler for modeling and separating
'highly-volatile' parts of domain knowledge contained in a health
information system. And yet, in addition to basic concepts, there may
exist many different type of clinical forms and charts for data
acquisition. So in my sense, in order to build a working clinical IS
one has to be able to model all those "information molds carved by
clinical knowledge" so as to be able to cope with complexity and
changeability. I should also point out that these principles mostly
apply to highly-specialized clinical information systems, such as
endoscopy or sub-divisions of anatomic pathology. I will reopen this
subject again for further discussion when appropriate.

Best regards,

Koray Atalag, MD, Ph.D

10

Koray Atalag wrote:

Thank you so much in your interest and offer for help with
MST Archetypes. However MST is controlled and distributed
by the World Organisation of Digestive Endoscopy - OMED
(www.omed.org). This means any translation work, which is
not conducted by associated national associations might
not be officially 'valid' however possibly be useful.

Dear all,

In that case when your proposed arcehtypes are “locked” to a few languages
then I think we have a need to redo this kind of experiment with other
arcehtypes which not have this kind of lock. At least it is good for the
acceptans of openEHR in non-English speaking countries.

  Regards,
  Mikael

11

Dear Koray Atalag

First of all, “Yu” is my surname. You’re right ! ^^; (most korean’s name is composed of 2~3 characters and last one is surname)

I looked MST as you wrote and I thought I may be able to translate MST document into Korean but which will be beyond my scope because MST is a official document. However if possible, I can try to contact my national endoscopy association and collaborate.

And according to your email, I think you want to make endoscopic archetype using MST (MST archetype). If it is right, because one of the reasons we intend to use archetype is reusability, I think that you will consider most MST archetypes as “Entry” level for diseases & normal.

And because endoscopy is used for Observation, Diagnosis and Therapy, archetypes will be divided into “Observation entry” and “Action entry”.

However because there are various endoscopies, e.g. EGD, Colonoscopy and ERCP, I think these will be “Section”.

In summary, if you make MST archetypes(“Observation Entry” or “Action Entry” level) and these are used in "Section"s (EGD, Colonoscopy, ERCP, etc.), it will be satisfy reusability.

Lastly, I totally agree that clinical information model is made through clinical domain knowledge and I will support your efforts.

With Best Regards

Seung Jong Yu MD, MS

ggojang@gmail.com

Research Doctor
Medical Information Center Lab.
Seoul National University Hospital
28 Yongon-dong, Chongno-gu
Seoul 110-799, Korea
+82-2-2072-1978

2007/9/13, Koray Atalag <atalagk@yahoo.com>:

12

Hi Dr. Yu,

My answers are inline:

Seung Jong Yu wrote:

Dear Koray Atalag

First of all, "Yu" is my surname. You're right ! ^^; (most korean's
name is composed of 2~3 characters and last one is surname)

Good guess :wink:

I looked MST as you wrote and I thought I may be able to translate
MST document into Korean but which will be beyond my scope because MST
is a official document. However if possible, I can try to contact my
national endoscopy association and collaborate.

Yes I highly recommend that you contact the gastrointestinal endoscopy
association in your country. Keep in mind that each language translation
is performed by a panel of experts and discussed. And most terms are
highly specific for GPs or other speciality doctors to be able to
translate to the current/commonly used term. Also keep in mind that,
after all the great effort and resulting high quality terminology
system, it is underused. I guess the industry did not fully appreciated
the power of it.

And according to your email, I think you want to make endoscopic
archetype using MST (MST archetype). If it is right, because one of
the reasons we intend to use archetype is reusability, I think that
you will consider most MST archetypes as "Entry" level for diseases &
normal.

I fully agree. Yes all of the archetypes are indeed subtypes of the
ENTRY type.

And because endoscopy is used for Observation, Diagnosis and Therapy,
archetypes will be divided into "Observation entry" and "Action entry".

Yes for the Observation. However the diagnosis would be an EVALUATION
archetype. The therapy (plus diagnostic procedures) will better be
modeled by ad hoc ACTION archetypes (No INSTRUCTION type). You can check
the schematic representation of the whole MST model in my thesis
document on page 135 (You can find it under publications=>archetypes
section of openEHR Website). Just ignore the INTERVENTION and use ACTION
instead (an error).

However because there are various endoscopies, e.g. EGD, Colonoscopy
and ERCP, I think these will be "Section".
In summary, if you make MST archetypes("Observation Entry" or "Action
Entry" level) and these are used in "Section"s (EGD, Colonoscopy,
ERCP, etc.), it will be satisfy reusability.

Well, the structure of the MST model has been a hot debate during my
thesis. We discussed it many times with the experts and could not reach
a clear result. My proposal is to assemble all different archetypes
representing different parts of MST under a single COMPOSITION. This
would be useful for a report generator software (which most of the
implementations of MST are indeed this kind including mine). The
SECTIONS perhaps would form different parts of the EHR such as LAB
results, Progress Notes, Physical Exams and so on.

Lastly, I totally agree that clinical information model is made
through clinical domain knowledge and I will support your efforts.

Thanks for your kind remarks :slight_smile: I will remain to support and work on
MST. I believe it is a golden opportunity for HIS developers to get used
to the 'new approach' as most part of an HIS can be modeled by
archetypes and the result will be clear to be seen by all.

Koray Atalag, MD, Ph.D

13

Hello All,

I just thought I should add a couple of points…

I fully agree. Yes all of the archetypes are indeed subtypes of the
ENTRY type.


And because endoscopy is used for Observation, Diagnosis and Therapy,
archetypes will be divided into "Observation entry" and "Action entry".


Yes for the Observation. However the diagnosis would be an EVALUATION
archetype. The therapy (plus diagnostic procedures) will better be
modeled by ad hoc ACTION archetypes (No INSTRUCTION type). You can check
the schematic representation of the whole MST model in my thesis
document on page 135 (You can find it under publications=>archetypes
section of openEHR Website). Just ignore the INTERVENTION and use ACTION
instead (an error).


However because there are various endoscopies, e.g. EGD, Colonoscopy
and ERCP, I think these will be "Section".
In summary, if you make MST archetypes("Observation Entry" or "Action
Entry" level) and these are used in "Section"s (EGD, Colonoscopy,
ERCP, etc.),  it will be satisfy reusability.


Well, the structure of the MST model has been a hot debate during my
thesis. We discussed it many times with the experts and could not reach
a clear result. My proposal is to assemble all different archetypes
representing different parts of MST under a single COMPOSITION.

This is done using templates - so we can have a composition which is Colonoscopy which can be named.

Seung Jong is right - if a number of ‘oscopies’ are done at one time, then it would be appropriate to enter these within sections. This is not uncommon and has influenced our approach to different templates. One example is the obstetric ‘view’ as part of an antenatal visit - if the person raises other issues at the time it is appropriate to record these in the same encounter record. The idea of a section as an anchor for a pattern is useful in many situations that have a number of issues that may be dealt with at the same time.

 This
would be useful for a report generator software (which most of the
implementations of MST are indeed this kind including mine). The
SECTIONS perhaps would form different parts of the EHR such as LAB
results, Progress Notes, Physical Exams and so on.

Two things here - you can use Folders for hand made collections of compositions - such as those listed above. But you can also use queries to return sections or compositions which contain say an endoscopy or laboratory observation. The idea of a progress note is more related to a document in my mind - so would relate to the context of composition.

Cheers, Sam

14

Hi Sam,

Thanks for the clarification. I guess I have put too much into archetypes which would better be handled with templates. However I am sure you are aware of the fact that the documentation and tools for them freely available at openEHR or Ocean are definitely not sufficient for self-learning :wink: I hope that this will change soon…

As for the SECTIONS, after some rereading I understand your comments. That would be also useful for adding new endoscopic modalities like Endoscopic Ultrasound (EUS) and Capsule Endoscopy. The MST for the former is already published and work is being done for the latter.

Regarding where different parts of MST would fall into openEHR EHR model there may be many alternatives and I am still far from understanding them all. However let me make clear again that my primary aim with MST archetypes is modeling a clinical domain for the purpose of HIS development and then secondarily try to put parts of the data collected into an appropriate ‘EHR structure’. Clearly the type of approach taken here is just the opposite (naturally); that is first establishing a solid framework for EHR record structure and then let other (feeder) systems to adjust. My primary concern with the type of MST Archetype Model was to preserve the original structure and semantics depicted in MST. And for doing so I knew of no other way than using a COMPOSITION structure - now I do :). I am sure that much more can be achieved by using templates and I am looking forward to learning and then having a hand on experience.

Best regards,

Koray Atalag, MD, Ph.D.

Sam Heard wrote:

15

Thank you Dr Dr Atalag :slight_smile:
You are right that we have to get some more documentation done. Heather Leslie will probably be doing some of that as part of the next round of NHS work - it is becoming clearer as we go. We hope that you will see a spruced up openEHR repository soon with the opportunity to comment on different archetypes and for people to participate in authorship. This will roll out towards the end of the year.
Cheers, Sam

Koray Atalag wrote:

(attachments)

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