# Patient notifications

**URL:** <https://discourse.openehr.org/t/patient-notifications/15687>\
**Category:** Technical (archive)\
**Created:** [25 November 2002 07:39 UTC](https://discourse.openehr.org/t/patient-notifications/15687 "2002-11-25T07:39:08Z")\
**Posts on this page:** 5\
**Page:** 1

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**Author:** ![Sam](https://discourse.openehr.org/letter_avatar_proxy/v4/letter/s/5f9b8f/32.png) [@Sam](https://discourse.openehr.org/u/Sam)\
**Post date:** [25 November 2002 07:39 UTC](https://discourse.openehr.org/t/patient-notifications/15687/1 "2002-11-25T07:39:08Z")

</div>

Dear All

I have been developing the idea of part of the record that the patient can  
write in - I have (Gates style) called it My Folder (eh?) and have two  
subfolders in it at present - consent statements (as these will be written  
by the patient) and appointments and notifications.

It is clear that the patient needs to write and interact with these. I have  
thought recently that we may be best to develop a transaction for each of  
the patient notifications - which will have all the details in it - rather  
than process notifications into a collected transaction (like a calendar) -  
this means that the application will need to process these.

I have thought that we could have an archive folder for when the patient has  
done whatever was required - or declined to do so. This would mean perhaps  
an archive folder and an entry for the outcome of the notification.

What do you think?

Sam

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<div class="post-metadata">

**Author:** ![Jim\_Warren](https://discourse.openehr.org/letter_avatar_proxy/v4/letter/j/d2c977/32.png) [@Jim\_Warren](https://discourse.openehr.org/u/Jim_Warren)\
**Post date:** [26 November 2002 06:49 UTC](https://discourse.openehr.org/t/patient-notifications/15687/2 "2002-11-26T06:49:34Z")

</div>

Dear Sam,

I think it's wonderful to take OpenEHR in that direction -- not sure what I  
think of "My Folder" as a name per se :-\

It potentially creates a bit of complication for the app in that it'd need to  
interface with the doctor/practice appointment book, but as a record concept it  
seems great. Consent... well, as long as online consent has status.

There are of course lots of other folder possibilities:

1. My Goals. Patient goals in their own terms with ongoing patient (and  
provider) assessment of attainment. Probably fit in exercise regimens here.

2. My Medications. A place for the patient to enter OTC and alternative  
medications. GEHR handles the fact that this info derives from the patient.  
The GP app could provide the ability to review-and-confirm the patient's  
entries.

3. My Learning. A set of on-line learning links apropos to this patient,  
preferrably including online quizzes and log of results.

[Perhaps all of the above, including the appointments, goes under My Plan.]

4. My Observations. Home blood glucose, BP, etc. log -- OK, I'm getting  
carried away.

I like the overall direction a lot.

Jim

A/Prof Jim Warren  
Director, Advanced Computing Research Centre  
University of South Australia  
Mawson Lakes SA 5095 AUSTRALIA  
+61 8 8302 3446  
warren@cs.unisa.edu.au

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**Author:** ![thomas.beale](https://discourse.openehr.org/user_avatar/discourse.openehr.org/thomas.beale/32/35_2.png) [@thomas.beale](https://discourse.openehr.org/u/thomas.beale)\
**Post date:** [26 November 2002 07:37 UTC](https://discourse.openehr.org/t/patient-notifications/15687/3 "2002-11-26T07:37:53Z")

</div>

And FOLDERs are nestable and archetypable, so you can do just what you say Jim, and I can do something completely different in my EHR (although, if we both have the same archetype source, we might end up being the same....)

- thomas beale

Jim Warren wrote:

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<div class="post-metadata">

**Author:** ![Sam](https://discourse.openehr.org/letter_avatar_proxy/v4/letter/s/5f9b8f/32.png) [@Sam](https://discourse.openehr.org/u/Sam)\
**Post date:** [26 November 2002 21:09 UTC](https://discourse.openehr.org/t/patient-notifications/15687/4 "2002-11-26T21:09:49Z")

</div>

Aniket

Of course I know about CPGs - just the acronym eluded me!

CPGs are very interesting from an EHR point of view. The issue here is the  
generic CPG and the specific - how we allow specialisation to the particular  
patient, how we merge a number of them sensibly, how we allow updates of  
CPGs to influence future care.

Our learning in this area has a long way to go but we can start. The openEHR  
entry called an instruction allows specific 'guidelines' to be entered into  
the record - monitoring or notifications, therapies etc. This is relatively  
straight forward - the issues start to arise when a generic guideline is  
altered - what does this mean to someone who is adhering to the previous  
guideline?

We can go with defaults - 2 years in Australia for a PAP test recall. So if  
the Care Plan of a patient has a notification for a pap recall, and the  
period is set to default, then the notification period can change with the  
guideline. Not so bad - fixed recall periods will not be altered. There  
might be some people however who need a 2 year one based on the evidence -  
clinicians could learn to fix the period of anyone with any abnormality -  
that seems solvable.

Then we get into the issue of a complex CPG such as immunisation - there are  
many rules, temporal and sequencing, age at immunisation etc. Changing the  
default guideline becomes very interesting and really requires a little  
decision support engine to be available specifically for the purpose.

What do you think?

Cheers, Sam

---

<div class="post-metadata">

**Author:** ![system](https://discourse.openehr.org/uploads/default/original/2X/f/f0a1dedb20c42747bddcafd6c7df9db5f34f003c.svg) [@system](https://discourse.openehr.org/u/system)\
**Post date:** [27 November 2002 09:16 UTC](https://discourse.openehr.org/t/patient-notifications/15687/5 "2002-11-27T09:16:26Z")

</div>

Hi,

Information relating to a patient cinsits of possibly the following classes:  
- Invariant Personal information like name, data of birth, gender, parents  
- Variant Personal information: adresses, telphone numbers, maried, etc  
- Financial/administrative personal information: insurance, etc  
- acces control related information  
- logistics related information: notifications, appointments, etc  
- private health related information as entered by the patient. Personal  
information.  
- health related information as entered by a healthcare provider. Personal  
information.  
- sharable health related information

> Aniket
> 
> Of course I know about CPGs - just the acronym eluded me!
> 
> CPGs are very interesting from an EHR point of view. The issue here is the  
> generic CPG and the specific - how we allow specialisation to the particular  
> patient, how we merge a number of them sensibly, how we allow updates of  
> CPGs to influence future care.
> 
> Our learning in this area has a long way to go but we can start. The openEHR  
> entry called an instruction allows specific 'guidelines' to be entered into  
> the record - monitoring or notifications, therapies etc. This is relatively  
> straight forward - the issues start to arise when a generic guideline is  
> altered - what does this mean to someone who is adhering to the previous  
> guideline?
> 
> We can go with defaults - 2 years in Australia for a PAP test recall. So if  
> the Care Plan of a patient has a notification for a pap recall, and the  
> period is set to default, then the notification period can change with the  
> guideline. Not so bad - fixed recall periods will not be altered. There  
> might be some people however who need a 2 year one based on the evidence -  
> clinicians could learn to fix the period of anyone with any abnormality -  
> that seems solvable.
> 
> Then we get into the issue of a complex CPG such as immunisation - there are  
> many rules, temporal and sequencing, age at immunisation etc. Changing the  
> default guideline becomes very interesting and really requires a little  
> decision support engine to be available specifically for the purpose.
> 
> What do you think?
> 
> Cheers, Sam  
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_  
> Dr Sam Heard  
> The Good Electronic Health Record  
> Ocean Informatics, openEHR  
> 105 Rapid Creek Rd  
> Rapid Creek NT 0810  
> Ph: +61 417 838 808  
> sam.heard@bigpond.com  
> www.gehr.org  
> www.openEHR.org  
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
> 
> > From: aniket Joshi [mailto:anya\_joshi@yahoo.com]  
> > Sent: Wednesday, 27 November 2002 3:02 AM  
> > To: Sam Heard  
> > Subject: RE: Patient notifications
> > 
> > Clinical practice guidelines.  
> > These can be incorporated in GEHR and thus we can have  
> > a much more specific application development.  
> > We can have mappings which will lead to particular set  
> > of tests as per the CPGs.  
> > This will ease the implementation of CPGs in clinical  
> > practice.  
> > Dr Aniket Joshi
> > 
> > > Aniket
> > > 
> > > I am not aware of CPG ??
> > > 
> > > Sam  
> > > \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_  
> > > Dr Sam Heard  
> > > The Good Electronic Health Record  
> > > Ocean Informatics, openEHR  
> > > 105 Rapid Creek Rd  
> > > Rapid Creek NT 0810  
> > > Ph: +61 417 838 808  
> > > sam.heard@bigpond.com  
> > > www.gehr.org  
> > > www.openEHR.org  
> > > \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
> > > 
> > > > From: aniket Joshi [mailto:anya\_joshi@yahoo.com]  
> > > > Sent: Monday, 25 November 2002 6:02 PM  
> > > > To: Sam Heard  
> > > > Subject: Re: Patient notifications
> > > > 
> > > > In our scenarios majority of the population is  
> > > > illeterate,so interaction with the computers is
> > > 
> > > out of
> > > 
> > > > question.We can record their videos and keep them
> > > 
> > > in
> > > 
> > > > the folders.  
> > > > Other non-medical communication which come from
> > > 
> > > the
> > > 
> > > > HCPs can definitely be kept in the folder.  
> > > > For the medical record of each appt a Hyperlink
> > > 
> > > can be
> > > 
> > > > given so that we can have a vertical record.  
> > > > Have gone through the CPGs and their application
> > > 
> > > in
> > > 
> > > > GEHR?  
> > > > DR ANIKET JOSHi
> > > > 
> > > > > Dear All
> > > > > 
> > > > > I have been developing the idea of part of the  
> > > > > record that the patient can  
> > > > > write in - I have (Gates style) called it My
> > > 
> > > Folder
> > > 
> > > > > (eh?) and have two  
> > > > > subfolders in it at present - consent statements
> > > 
> > > (as
> > > 
> > > > > these will be written  
> > > > > by the patient) and appointments and
> > > 
> > > notifications.
> > > 
> > > > > It is clear that the patient needs to write and  
> > > > > interact with these. I have  
> > > > > thought recently that we may be best to develop
> > > 
> > > a
> > > 
> > > > > transaction for each of  
> > > > > the patient notifications - which will have all
> > > 
> > > the
> > > 
> > > > > details in it - rather  
> > > > > than process notifications into a collected  
> > > > > transaction (like a calendar) -  
> > > > > this means that the application will need to
> > > 
> > > process
> > > 
> > > > > these.
> > > > > 
> > > > > I have thought that we could have an archive
> > > 
> > > folder
> > > 
> > > > > for when the patient has  
> > > > > done whatever was required - or declined to do
> > > 
> > > so.
> > > 
> > > > > This would mean perhaps  
> > > > > an archive folder and an entry for the outcome
> > > 
> > > of
> > > 
> > > > > the notification.
> > > > > 
> > > > > What do you think?
> > > > > 
> > > > > Sam  
> > > > > \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_  
> > > > > Dr Sam Heard  
> > > > > The Good Electronic Health Record  
> > > > > Ocean Informatics, openEHR  
> > > > > 105 Rapid Creek Rd  
> > > > > Rapid Creek NT 0810  
> > > > > Ph: +61 417 838 808  
> > > > > sam.heard@bigpond.com  
> > > > > www.gehr.org  
> > > > > www.openEHR.org  
> > > > > \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
> > > > > 
> > > > > -  
> > > > > If you have any questions about using this list,  
> > > > > please send a message to d.lloyd@openehr.org
> > > > 
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