So after some experimentation and further thinks on the valuable responses given above, we are settling on a design. The approach is to create sections that allow (only) one problem EVALUATION and one or more ‘goal’ sections that allow one goal EVALUATION. This way there is a strict link between the goal and the problem defined by the composition(template). I think this approach makes sense and it seems to work well for building the application page.
This approach does make it a bit more difficult to view the goal for a problem outside of the context of the care plan. E.g. if you look back in the EHR notes where the problem is described (probably in a report composition) you want to easily ‘click through’ to see related goals. So we are planning to model an element to the goal archetype the contains a DV EHR URI referring to the problem. And automatically let the application fill this element based on the problem in the section above the goal entry.
I’ll share my archetypes when they are in a state that matches the descriptions above.
Any thoughts on:
- specialising the clinical indication dv text ELEMENT into instead of adding a separate dv ehr uri ELEMENT?
- in this approach the problems are recorded in the care plan composition. This implies the diagnosis is made at the moment of recording the care plan. While in reality the diagnosis is made in a different context. This is acceptable for now but expresses one of the motivations for: Cross-reference, citations and a solution for managed lists
- we want to be able to record a progress report relating to the goal and/or problem. Should they be individual report composition instances, grouped in an episode FOLDER, with a link between the FOLDER and the goal?