I need some help/explanation/advice on how to attach multiple
terminologies to the same entry. If I understand the concept
correctly it seems that there are two manners to do so. Let me
explain first what I would like to do:
In the Dutch archetype for 'medication' I'm trying to make, I would
like to attach several terminologies to the same medicine. In the
Netherlands we use the G-standard which comprises of many sub
terminologies. For instance there is a different code for generic and
for 'named' drugs, which seem to be specific for the Netherlands.
Furthermore each drug combination (drug, dose, delivery form and
producer) has an unique code. To make it even more complex, this code
was first specific for the Netherlands (RVG code) alone and then
harmonized for the EU (EU code). Older drugs only have a RVG code.
Then this medicine can also be related to the ATC code...... To make
a long story short, I would like to be able to attach all these
terminologies to the same medicine.
First I figured that I put al those items in one 'medicine' (sub)
three. So Medicine name/dose/delivery form, GPK, HPK, EU, RVG, ATC.
The latter would then have constraints for that specific (sub)
terminology.
But now I just found out that it possible to create multiple ... (I
don't know how to call this. I've found it for example in the
archetype evaluation-injury, under the entry 'factor'. It has a
symbol which resembles a switch). To me it seems that I can use this
to attach several terminologies to the same item as well. In the
'interface' option' all these 'terminologies' are then displayed as
tabs.
My question is: how can I best solve this issue. Can I use both
methods or is one of them to prefer over the other and why?
Furthermore can somebody explain to me how I can create the switch
type function. I known it exists since it's present in some
archetypes but haven't found out how to create one via the Ocean
archetype editor (latest version).
I need some help/explanation/advice on how to attach multiple terminologies to the same entry. If I understand the concept correctly it seems that there are two manners to do so. Let me explain first what I would like to do:
In the Dutch archetype for ‘medication’ I’m trying to make, I would like to attach several terminologies to the same medicine. In the Netherlands we use the G-standard which comprises of many sub terminologies. For instance there is a different code for generic and for ‘named’ drugs, which seem to be specific for the Netherlands. Furthermore each drug combination (drug, dose, delivery form and producer) has an unique code. To make it even more complex, this code was first specific for the Netherlands (RVG code) alone and then harmonized for the EU (EU code). Older drugs only have a RVG code. Then this medicine can also be related to the ATC code… To make a long story short, I would like to be able to attach all these terminologies to the same medicine.
First I figured that I put al those items in one ‘medicine’ (sub) three. So Medicine name/dose/delivery form, GPK, HPK, EU, RVG, ATC. The latter would then have constraints for that specific (sub)terminology.
But now I just found out that it possible to create multiple … (I don’t know how to call this. I’ve found it for example in the archetype evaluation-injury, under the entry ‘factor’. It has a symbol which resembles a switch). To me it seems that I can use this to attach several terminologies to the same item as well. In the ‘interface’ option’ all these ‘terminologies’ are then displayed as tabs.
My question is: how can I best solve this issue. Can I use both methods or is one of them to prefer over the other and why?
Furthermore can somebody explain to me how I can create the switch type function. I known it exists since it’s present in some archetypes but haven’t found out how to create one via the Ocean archetype editor (latest version).
The DV_TEXT in the current medication list allows ‘mappings’ to as many terminologies as you like - ie you can attach the codes (and give a reason for the mapping) to the medication. If one code returns the string you want displayed, then you can substitute a DV_CODED_TEXT and set the defining code to this value - this is what you should do with the main coding used in the Netherlands for coding medications.
At present we do not constrain mappings in the archetype - have not got that far - but it would be possible if people wanted to do this.
This sounds a bit like you might be mixing levels of what a
medication IS. The per-brand, RVG, and EU codes refer to a
branded and marketed drug as bought in a pharmacy. ATC codes
refer to classes and acting substances (and a few
combinations thereof). Although it is more work it may be
necessary to make archetypes for "active substances" which
then get aggregated into "generic" and "branded" drugs
archetypes. A "prescribed medication" may need to be yet
another higher level as there can also be custom-made
formulations. This isn't thought out well I admit. I just
want to point you in a direction that you might need to take
into account.
The correct Ontological method for solving this problem is to have an
organizing concept for the drug independent of its formulation. In the
NDF-RT that would be the Preparations (e.g. Atenolol Preparation) which
can have different strengths and formulations (groups of inactive
ingredients as children of the more general concept).
Warm regards,
Peter
Peter L. Elkin, MD
Professor of Medicine
Mayo Clinic College of Medicine
(507) 284-1551
Fax: (507) 284-5370
I am interested to know how did you proceed on this. Did you use the “Generic name” node of the archetype “openEHR-EHR-ITEM_TREE.medication.v1” for the drug substances or ATC code?
Sorry for the late response. For some reason I’ve overlooked this mail till today.
Unfortunately I haven’t come much further. Here in the Netherlands several parties are interested and want to be involved (TNO and the KNMP (society of pharmacist who is responsible for the G-standard) but since we haven’t a viable use/ bussiness case and/or sufficient money we’re still waiting for better times.
Hopefully we’ll start a project after the summer involving a personal medication record and in that case we’ll continue working on the medication AT.