How to model the place of execution in the context of a medication order

Currently, I am modeling the medication order in our EHR from our proprietary data model onto openEHR.

Based on our internal requirements’ analysis, I have to fulfill the use case, where a prescriber can create a medication order and specify where the drug administration takes place. For this purpose, I need to map the “place of execution” consisting of two data elements, namely

  1. Organization or clinic (mandatory): At which site, such as a partner clinic or a different facility
  2. Station/ward (optional): Where exactly at the respective sit

To fulfill this requirement, I would personally use either one of the following two options:

  1. Use the “context” field in the respective Composition and map both data elements onto the demographic model archetypes or for my purpose newly created or specialized clusters
  2. Use the archetype “Therapeutic direction” and specialize it to conform to the requirement by adding the respective fields.

Before I start specializing clusters and archetypes I want to ask you, how you would model this requirement. Or how it should be modelled. Your help is highly appreciated.

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Hi Lucas,

Can I clarify that the place of execution is actually specified in the order, and that this is not about recording where the execution actually took place? I only ask because I’ve never come across that in medication order before. Is this a national requirement of more local or perhaps because of a particular speciality need?

Assuming that this is part of the order, I would not use Composition.context because that is really about the context of where the order took place.

I think I would create a CLUSTER archetype that could be plugged into the medication order but also into e.g Service request where , I suspect the inclusion of ‘allowed location’ might actually be more common.

I would not put it in Therapeutic direction as this is really part of the detailed structured dose-timing information - perhaps just use the ‘Additional details’ slot?

I agree that this new Cluster archetype would probably largely carry demographic archetypes but you might want to have some simple text elements also


CLUSTER: Requested activity location

  • Description
  • Organisation
  • Organisation details (slot)
  • Location( station/ward)

I’ll be interested in alternative opinion on this one!!


Hi Ian,

And thank you for your response. The place of execution (at which Organization/Clinic and Station/Ward) should be defined in the medication order. After reviewing the output of the requirements’ analysis, this information is required when chemotherapy is ordered.

When a prescriber specifies the place of execution, then the administration of the drug should be performed at that specified place. Thus, at the end, the drug administration will take place, at the place, the prescriber specified - just to make sure, we are on the same page, as I fear, I might misunderstand your question.

I like your idea, as a cluster is light-weight enough to be reused in different use cases and archetypes altogether.

Thanks Lucas,

You got my question correctly and answered perfectly!! I can see that this makes more sense in the context of chemotherapy.

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Hey Lucas,

Some thoughts and questions…

Can we be sure that the location will always be the same? I’m curious why the location needs to be specified - there might be any number of reasons why a location might need to be changed without changing the other parts of the order.

I can also see that it might be useful to record something like ‘always give in ICU in case of risk of an anaphylactic reaction’ or only dispense from a specified methadone centre. Can you provide more details?

If always the same place, no exceptions, then have you considered nesting it within the ‘Order details’ inline CLUSTER inside the INSTRUCTION.medication_order - either as an added data element or CLUSTER.organisation, depending on what level of detail you need.

Or both - see EVALUATION.death_summary for an example. Specifically ‘Place of death’ and the ‘Structured place of death’ SLOT.

If you think it needs to be another separate CLUSTER, what would the data elements be?



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Hi Heather,

Our current EHR supports the input of the place of execution (at which organization and ward as two different information elements, and probably stored in more data elements, as street and so forth will be added). Consequently, I want to map this information onto openEHR, such that this implemented use case will be available, when having openEHR as our clinical data repository.

So far, I am listing all information and data elements, for which openEHR does not provide an innate solution, and it is growing. When I am done, I will group these elements and create the respective clusters.

For the topic I asked in this channel, I would probably create a cluster named “Requested activity location” (subject to change), where I will include all the data elements supported in our EHR. I have not decided, where exactly this cluster would be included. When I start modelling this use case in Archetype Designer, I will have a better understanding, where it best suits, as I am currently mapping the data elements in the use case onto openEHR in XMind.