The attestation knowledge getting lost except perhaps in Dipak and Sam's minds is more often occurring in clinical models.
In the ISO technical specification for detailed clinical models there is an option to include such specific information in one of the clinical fields as evidence base, instruction or interpretation. Best used it it is a clinical mind required.
Or in traceability to other standards if a specific guideline or protocol is used, or issues if it is a Modelling construct deployed in a specific way.
In your case I would complete some instruction how to handle the junior - senior clinical situation and to define how that must be expressed in ADL model in the issue field.
Of course such issue field would need to become part of ADL. Probably version 2.2?
I don't really agree with your suggested approach. The specific
requirement is to be able to formally sign or counter-sign the entire
document, possibly for reasons of medico-legal responsibility as Dipak
has described, or because specific requests or orders must have senior
sign-off. The majority of documents will have no attestations but the
potential need is universal, whilst orthogonal to the type of document
or content. This makes it entirely sensible to handle at RM level.
Attestation is quite different from the ideas of evidence, use of
guidelines etc that you seem to be talking about.
Ian
Dr Ian McNicoll
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I prefer to deal in the Reference Model with the documentation and archiving aspects.
Any Composition needs to be signed, irrespective of the content.
And that signing on occasion is by multiple persons, in different roles.
When specific parts of the data as defined by the Composition need to be signed-oof, than that is a different matter.
And signing off the Composition as artefact (Archetype) is a different matter again.
Right - signing / attesting is an RM matter for the reasons Ian & Gerard have mentioned. And Dipak has provided some typical clinical reasons for it. Note that the openEHR attestation, while attached to the whole Composition does allow indicating specific bits of the Composition - see the model . I personally think have always thought this is a bad idea, because in the human world, people attest documents or screens - things that function as a whole statement, not bits and pieces. But we put it in anyway, to fit in with 13606, and I could of course be proved wrong in the future. So the option is there. - thomas
