Dear All
The first instruction (based on the openEHR instruction model proposal) is available at:
http://www.oceaninformatics.biz/archetypes
It is not complete and needs more work, but has many of the features of a medication order that are required in the health system. This is not a prescription (which is a set of medication orders) - all this information relates to a single order. It deals with the workflow and includes dispensing and administration.
The model describes the activity (details of the medication in this case, and how to administer it) and the work flow steps that might be recorded. It is worth noting that only the name of the medication is mandatory! This deals with existing systems.
Also, the idea of risk assessment has crept into the knowledge domain. The family history archetype is a specialisation of this. It is important to note that just recording that a relative had an MI is possible using the problem or problem-diagnosis archetypes, family history implies evaluation of risk.
There are also goal and target archetypes - the target archetype allows specification of a range of values for a particular patient attribute. A blood pressure goal-target will be blood pressure, systolic <140 mm[Hg], diastolic <90 mm[Hg]. It may not be clear from the target archetype that it enables such statements to be made unambiguosly (but experience will show!).
Finally, exclusions are also there - general statements like "No significant family history" or "No known allergies". Then there are specific exclusions like "No known reaction to" + "penicillin". Exclusions also deal with problems and past history.
I look forward to your comments on the list or to:
archetypes@oceaninformatics.biz
Cheers, Sam