Good day everyone
I am trying to work out the most appropriate way to represent the progression and lifecycle of a condition/diagnosis using OpenEHR.
I’m a developer working on a team with clinicians, but I don’t have a medical background myself so please forgive my naivety. Some contrived examples I’m trying to work out how to represent are:
- A skin condition that spreads to new body sites over time.
- A cancer that changes “stage” over time and also spreads to new body sites. It may also go into remission, but may also come back.
- A single burn incident with different severities (e.g. full thickness, partial thickness) across different body sites that is evaluated on multiple occasions.
- Distinct (i.e. unrelated) occurrences of the same type of condition (e.g. flu, burns, broken bones, etc.)
The problem/diagnosis archetype seems appropriate to store any of the above for a single point in time, but it’s not clear to me how to represent the change over time.
The approaches I’ve considered so far are:
1. Amended the problem/diagnosis as needed in order to represent the current state.
The fact that the problem/diagnosis archetype has a “Date/time of resolution” implies to me that this may be the correct approach, but then how would you represent the previously evaluated states to see the progression.
2. Create a new problem/diagnosis for each progression.
But then how would you connect these all together in a way that the cancer progressions are linked together as events of the same condition, with the most recent being “current” while the rest are historical/superseded. While at the same time not inherently linking every occurrence of the flu as one long condition, particularly when these may never be marked as resolved because the patient doesn’t return when it has cleared up.
I’m aware I can distinguish between acute and chronic conditions which I think gives important clinical context to the above flu scenario, but even an acute condition may have several evaluations connected to one occurrence.
3. Look at other archetypes like "Story/History"
I haven’t come across any that seem to quite fit. Story/History for example is described as subjective information reported by the patient.
I would appreciate any insights!