The template is being built in the form of a Report, which sort of matches the real world, in as much as someone does the assessment which is then made available as a report.
I have 2 challenges currently :
How to group the concepts of Biometrics, Physiological variables e.g. Vital Signs and Investigation Results e.g. labs, radiology. These all feel as though they should be grouped somehow as part of the assessment but there is a conflict (in my head) between the archetypes for investigations_results and exam findings. Is NIBP an investigation or an exam finding ? I appreciate that the line between these concepts is a bit blurred.
How to model the typical systematic enquiry when taking a history relevant for peri-op care, e.g. how to record the presence of angina, hypertension, heart failure, murmurs and group them under “Cardiovascular”.
I’m not sure if you are asking about the groupings in the ui or in the models. Non invasive blood pressure could appear wherever it makes most sense for you. You can also use section archetypes to group items in the composition but I would never want to imply meaning by the parent grouping. A blood pressure is a blood pressure whether you consider this locally to be best grouped under examination or investigation. Headings are useful but in openehr the querying is designed to be able to ignore the section archetypes.
Is a tricky question as it partly depends on who is asking the question, why and what ought to happen if someone picks up a new diagnosis. Should this be added formally as a diagnosis to the patients record.
The pure but more complex approach is to handle this with a set of problem diagnosis archetypes to capture positive responses and exclusion archetypes to handle the negatives. This has the benefit of the data being collected in more reusable and codsble way but is more annoying to hook up to the ui.
The quick and dirty alternative is to create a local archetype with a set of booleans that just ask angina yes no. Easy to fit the ui but essentially throw away.
I haven’t done thuis yet in practice. But for question 2 I have considered doing both templates. A typical questionare yes/no and the more complex way. Were in the background the questionare would propegate the more clean template. It hasbenefits:
easy to create both a write and read user interface
the complex template you can easy create lists of included and excluded decaeses.
In our case the more complex way fits better for interoperable web service
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I didn’t know about section archetypes, but now that you mention it, I see that’s what I’ve actually used - openEHR-EHR-SECTION.investigations_results_rcp.v1
I was thinking about grouping in the model - essentially what I’ve done is to rename the section archetype “Biometrics, Vital Signs and Investigation Results”.
From what you say, it sounds as though that’s an acceptable way to organise/categorise the archetypes within that section.
On point 2, I’ll try the problem diagnosis archetypes approach initially and see how I get on.
Yes. Just rename to whatever works for you. We would never search on the section only on the entry archetypes underneath so the way that you group or name that group does not affect the querying of the data.
Just taking a peek and it looks great, by the way. Looks like Ian and others have you covered from a design pattern POV.
There are a couple of points, not sure if it is important to you.
In the international CKM there is an updated version of EVAL.housing_summary and CLUSTER.housing_record. These have been published in recent months and the ones you have in the template are from 12 months ago. I have no idea if this is a deliberate governance decision by the Apperta CKM admin or just an oversight. Anyway, just in case it is of interest. See the Social context project here: https://ckm.openehr.org/ckm/#showProject=1013.30.39
Also you seem to have some mixed versions of exclusion in the template, some set to zero occurrence anyway but in any case the international CKM archetypes are mirrored in Apperta CKM as Exclusion – global and Exclusion-specific. The template has an old version of Exclusion of procedure, albeit set to zero occurrence.