Can someone give me a hint about how I should do following, which kind
of entries are most suitable for this?
There is a software-requirement, I work with, which says that a patient
should do sport, exercises.
And to encourage the patient, there must be some kind of decision
support, which checks, the exercises the patient has done, and this
evalution must be stored for a later look-back how the patient is doing.
So, there must be an archetype which is able to decribe the exercise to
do, and there must be an archetype for evaluation-results.
I only need some hints to look at, so I am not foolish misusing some
concepts.
I looked at the entry-classes, evaluation, activity, instruction, and so
on. But I am not sure which one to use, because in the documentation,
the seem to target other purposes.
A quick response - it really depends on the level of detail that needs
to be monitored.
You might start with an INSTRUCTION if you needed to describe the
exercise regimen in detail, though there is not an appropriate
archetype for that in CKM at the moment, unless the exercise needs a
formal referral.
You could express the goal/target via the EVALUATION.goal archetype.
Do you need to monitor just the attendance at exercise classes, in
which an ACTION archetype might be sufficient, or is more detailed
monitoring e.g exercise tolerance testing required in which case you
might also need an OBSERVATION archetype.
Basically the requirements need to be much better elaborated before
any sort of definitive answer can be given but I suspect that other
then 'Goal' some new and perhaps very local archetypes may need to be
created.
Ian
Dr Ian McNicoll
office +44 (0)1536 414 994
fax +44 (0)1536 516317
mobile +44 (0)775 209 7859
skype ianmcnicoll
ian.mcnicoll@oceaninformatics.com
Clinical Modelling Consultant, Ocean Informatics, UK
Director/Clinical Knowledge Editor openEHR Foundation www.openehr.org/knowledge
Honorary Senior Research Associate, CHIME, UCL
SCIMP Working Group, NHS Scotland
BCS Primary Health Care www.phcsg.org
This sounds like an action plan for the patient i.e. to do exercise and the monitoring of such an action plan.
Yes it would be interesting to see if there is any archetype for an action plan or care plan for the patient. Let’s see if anyone knows whether one exists.
There are some care plan archetypes in local systems and the Swedes
are developing some examples for national use.
However, these archetypes are really just controllers for the care
plan process and a careplan /action plan is actually a whole document
with a mixture of all kinds of entries relating to needs assessment,
actions to be taken, subsidiary instructions, results of follow-up
etc.
Ian
Dr Ian McNicoll
office +44 (0)1536 414 994
fax +44 (0)1536 516317
mobile +44 (0)775 209 7859
skype ianmcnicoll
ian.mcnicoll@oceaninformatics.com
Clinical Modelling Consultant, Ocean Informatics, UK
Director/Clinical Knowledge Editor openEHR Foundation www.openehr.org/knowledge
Honorary Senior Research Associate, CHIME, UCL
SCIMP Working Group, NHS Scotland
BCS Primary Health Care www.phcsg.org
Thanks for this … true … yes the care plan is a document consisting of various entries … is there a way of identifying instructions, actions and results for which patients have a responsibility for delivery? … I guess in the case of Bert’s question.
A quick database search revealed that the Arquetype: Level of exertion to be
useful as you will need to register the patients “level of fitness” pre and
post training.
Also you have the related clinical observations: blood pressure, heart rate,
ECG recording
It would be useful to create a Borg perception of exercise (subjective) as
it correlates well with level of exertion.
I can be bold and try to make an Arquetype for: VO2max Testing which is my
expertise.
I didn’t find any “exercise prescription” Arquetype. ( I´d like to see that
too).
I´ll help patch the pieces together if you want.
Be well
Domingo Liotta
1. Just use the existing HealthCare Service Request but directed to
the patient themselves, essentially regarding the patient as 'service
provider', ties subsequent activities into formal workflow.
2. Create a specific "Instruction to patient" archetype
Ian
Dr Ian McNicoll
office +44 (0)1536 414 994
fax +44 (0)1536 516317
mobile +44 (0)775 209 7859
skype ianmcnicoll
ian.mcnicoll@oceaninformatics.com
Clinical Modelling Consultant, Ocean Informatics, UK
Director/Clinical Knowledge Editor openEHR Foundation www.openehr.org/knowledge
Honorary Senior Research Associate, CHIME, UCL
SCIMP Working Group, NHS Scotland
BCS Primary Health Care www.phcsg.org
Your suggestions are very appropriate if a very detailed level of
exercise surveillance is expected but I am not certain from Bert's
description if this is actually needed.
I have an example of a pulmonary function test archetype which
includes V02max. It might be interesting for you to have a look at it
and see if we can it fit enough for review on CKM.
Ian
Dr Ian McNicoll
office +44 (0)1536 414 994
fax +44 (0)1536 516317
mobile +44 (0)775 209 7859
skype ianmcnicoll
ian.mcnicoll@oceaninformatics.com
Clinical Modelling Consultant, Ocean Informatics, UK
Director/Clinical Knowledge Editor openEHR Foundation www.openehr.org/knowledge
Honorary Senior Research Associate, CHIME, UCL
SCIMP Working Group, NHS Scotland
BCS Primary Health Care www.phcsg.org
Of course!! I can review it.
I do VO2max in a cardiac (rehabilitation) service but the techic is the
same. Send me the arquetype by email please. I didnt find it searching CKM
Thank you all for your suggestions, it is very helpful.
At this moment, the level of surveillance will not be very detailed.
The project is to encourage people with certain serious diseases to do
exercises.
It seems that treatment works better if they do, and the chance for
surviving a serious disease is also higher.
They will be monitored by there smart-phone.
It is just that they do exercises, that is all, it is not very important
what they do, that also depends on the person.
But, in other projects, it may well be possible that a more detailed
surveillance is required, for example for monitoring people which had a
heart-failure.
I have already written some archetypes before, and now I have
inspiration to find my way to write these too.
> From: Bert Verhees bert.verhees@rosa.nl > Subject: evaluate sport activity > To: openehr-clinical@openehr.org > Date: Wednesday, 21 December, 2011, 11:39 > > Hi all, > > Can someone give me a hint about how I should do following, which kind > of entries are most suitable for this? > > There is a software-requirement, I work with, which says that a patient > should do sport, exercises. > And to encourage the patient, there must be some kind of decision > support, which checks, the exercises the patient has done, and this > evalution must be stored for a later look-back how the patient is doing. > > So, there must be an archetype which is able to decribe the exercise to > do, and there must be an archetype for evaluation-results. > > I only need some hints to look at, so I am not foolish misusing some > concepts. > > I looked at the entry-classes, evaluation, activity, instruction, and so > on. But I am not sure which one to use, because in the documentation, > the seem to target other purposes. > > Can someone give me a hint? > > Thanks > Bert Verhees > _______________________________________________ > openEHR-clinical mailing list > openEHR-clinical@openehr.org > http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-clinical
> From: Bert Verhees bert.verhees@rosa.nl > Subject: evaluate sport activity > To: openehr-clinical@openehr.org > Date: Wednesday, 21 December, 2011, 11:39 > > Hi all, > > Can someone give me a hint about how I should do following, which kind > of entries are most suitable for this? > > There is a software-requirement, I work with, which says that a patient > should do sport, exercises. > And to encourage the patient, there must be some kind of decision > support, which checks, the exercises the patient has done, and this > evalution must be stored for a later look-back how the patient is doing. > > So, there must be an archetype which is able to decribe the exercise to > do, and there must be an archetype for evaluation-results. > > I only need some hints to look at, so I am not foolish misusing some > concepts. > > I looked at the entry-classes, evaluation, activity, instruction, and so > on. But I am not sure which one to use, because in the documentation, > the seem to target other purposes. > > Can someone give me a hint? > > Thanks > Bert Verhees > _______________________________________________ > openEHR-clinical mailing list > openEHR-clinical@openehr.org > http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-clinical
Hi Bert, I had a similar requirement on a project recently.
There were recommendations or indications of doing exercise, recorded by a doctor, this is recorded using an INSTRUCTION. The structure is very basic: a free text explaining the indication/recommendation, and a numeric value to evaluate results (that’s another requirement). The idea is to have something like:
Walk for X minutes, Y days a week, for Z weeks.
Run X km a week.
Then a follow-up proccess done by a nurse, an adminsitrative clerk or done by the patient itself, record the accomplishments: X minutes, X kilometers, etc. This is recorded into an ACTION.
Later, the analysis process compares the INSTRUCTION with all the ACTIONS registered for that instruction to calculate a % of accomplishment of the indication, that helps to see if the patient is improving.
Thanks for your input. I decided to try out a very first schematic Arquetype based on your sugestions.
Ill send it to the group for review. Sorry its my first one
