I have always considered that the way of using a persistent list (for example, the problem list) is: First, an event composition is registered, with all its context information. For example, using the Encounter archetype. Then, a persistent list is created/updated, either automatically or curated …

[image] damoca: Is this approach conceptually correct? Does the scope of the Problem list archetype (or of any persistent list in general) cover this use case? The conceptual problem with this approach is that it obscures (or maybe even loses completely) the fact of recognising the problem at…

[image] thomas.beale: The result over time will be a very large problem list for most patients, of which the top 3% are live problems, and the other 97% is dead stuff from the past. That’s a great argument :smile:

Hi David - beware, you are going ‘deep’ here!! Your headline question ‘can a persistent list be considered the source of truth’ - absolutely. We have many persistent compositions in One London that we maintain as a source of truth. However the ‘problem list’ is actually potentially the most diffic…

I would like to explain more of the mentioned use case and the questions that come to us in the process of trying to chose the correct way to model. Is it correct to use the same archetype in two Templates in the same information system? In a Template with persistent composition spirit and in a Tem…

[image] david.alonso: another project models the diagnosis record […] This generates […] a Template for the list of the patient’s diagnoses throughout their life. Here we are talking of different scopes. There is a difference between modeling a problem and modeling a problem list, and that’…

Hi David, Thanks for the detailed response. The simple answer to your question is that there are choices in the scenario you have outlined. In a GP system we helped develop, we discussed the options is some detail. THe options range from Just record each diagnosis in each encounter and use quer…

[image] damoca: The fact of having a diagnosis could (should?) be documented per se, independently of being later incorporated to a summary list. I agree, because a useful summary list need to be curated, it is not just a direct copy of what was originally recorded as a problem in the encount…

This is work I did looking at how the Contsys Health Thread / Issue ideas might work in openEHR [image] GitHub - openehr-clinical/shn-contsys: Resources for the EU SemanticHealthNet... Resources for the EU SemanticHealthNet Contsys project - openehr-clinical/shn-contsys …

Definitely, we cannot forget about Contsys during the modeling processes, at least to talk in the same terms.

I haven’t looked at the latest version, but in previous versions the CONTSYS concepts were not really archetypable. More abstract concepts than data models. However we have done some work on a Health thread archetype - see this thread for the discussion late last year.

Can a persistent list be considered the source of truth?

Clinical

ian.mcnicoll (Ian McNicoll) 22 May 2024 10:49 9

This is work I did looking at how the Contsys Health Thread / Issue ideas might work in openEHR

I’m really not sure if we need new Health Thread/ Hrealth Issuearchetype or whether the existing problem-diagnosis archetype could be extended slightly (more in line with the FHIR Condition approach)

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Can a persistent list be considered the source of truth?

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