# Toughts about archetypes and patient system

**URL:** https://discourse.openehr.org/t/toughts-about-archetypes-and-patient-system/14772
**Category:** Clinical (archive)
**Created:** [24 June 2008 07:27 UTC](https://discourse.openehr.org/t/toughts-about-archetypes-and-patient-system/14772 "2008-06-24T07:27:59Z")
**Posts on this page:** 7
**Page:** 1

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### Author: ![system](https://discourse.openehr.org/uploads/default/original/2X/f/f0a1dedb20c42747bddcafd6c7df9db5f34f003c.svg) [@system](https://discourse.openehr.org/u/system)
#### Post date: [24 June 2008 07:27 UTC](https://discourse.openehr.org/t/toughts-about-archetypes-and-patient-system/14772/1 "2008-06-24T07:27:59Z")

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Dear all,

A few thoughts I wrote down last days but now they are translated into a pictures.  
It helps me understand when to use what Archetype.

The ZIP-file with PDF’s can be downloaded via: [http://tinyurl.com/63dfg7](http://tinyurl.com/63dfg7)

1- EHR’s are about the Patient system and document the medical treatment process from the healthcare providers perspective.

2- The Patient System consists of:  
a- Inner system (chemistry, physiology, genomics, etc)  
b- Patient as a body  
c- Direct Social Patient System (family, friends, colleagues, neighbors, etc)  
d- Extended Social Patient System (society, etc)

3- In each layer of the Patient System there are processes

4- These processes give rise to states in the Patient System

5- Observations: Hearing, seeing, feeling, tasting, smelling, touching give information about the states

6- Evaluations: Using expertise and knowledge inferences are made about the processes in the Patient System

7- Instructions: are executed (as Actions) in order to get more Observations or have the intention to influence processes in the Patient System

8- Planned Actions and unplanned Actions: influence the state and/or processes in the Patient System

Gerard

– –  
Gerard Freriks, MD  
Huigsloterdijk 378  
2158 LR Buitenkaag  
The Netherlands

T: +31 252544896  
M: +31 620347088  
E: [gfrer@luna.nl](mailto:gfrer@luna.nl)

Those who would give up essential Liberty, to purchase a little temporary  
Safety, deserve neither Liberty nor Safety. Benjamin Franklin 11 Nov 1755

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### Author: ![Colin\_Sutton](https://discourse.openehr.org/user_avatar/discourse.openehr.org/colin_sutton/32/47_2.png) [@Colin\_Sutton](https://discourse.openehr.org/u/Colin_Sutton)
#### Post date: [24 June 2008 12:43 UTC](https://discourse.openehr.org/t/toughts-about-archetypes-and-patient-system/14772/2 "2008-06-24T12:43:35Z")

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It would be much easier to decide whether to use an 'Observation' or an 'Evaluation' if the word 'Evaluation' was replaced by 'Inference'.

Colin

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### Author: ![system](https://discourse.openehr.org/uploads/default/original/2X/f/f0a1dedb20c42747bddcafd6c7df9db5f34f003c.svg) [@system](https://discourse.openehr.org/u/system)
#### Post date: [24 June 2008 17:59 UTC](https://discourse.openehr.org/t/toughts-about-archetypes-and-patient-system/14772/3 "2008-06-24T17:59:42Z")

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I agree, but we can not change history.

Gerard

> It would be much easier to decide whether to use an ‘Observation’ or an ‘Evaluation’ if the word ‘Evaluation’ was replaced by ‘Inference’.
> 
> Colin

– –  
Gerard Freriks, MD  
Huigsloterdijk 378  
2158 LR Buitenkaag  
The Netherlands

T: +31 252544896  
M: +31 620347088  
E: [gfrer@luna.nl](mailto:gfrer@luna.nl)

Those who would give up essential Liberty, to purchase a little temporary  
Safety, deserve neither Liberty nor Safety. Benjamin Franklin 11 Nov 1755

---

<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: [25 June 2008 07:10 UTC](https://discourse.openehr.org/t/toughts-about-archetypes-and-patient-system/14772/4 "2008-06-25T07:10:52Z")

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Dear all,

I have added a Power Point presentation.  
Url: [http://tinyurl.com/6h2vs8](http://tinyurl.com/6h2vs8)

With regards,

gerard

> Dear all,
> 
> A few thoughts I wrote down last days but now they are translated into a pictures.  
> It helps me understand when to use what Archetype.
> 
> The ZIP-file with PDF’s can be downloaded via: [http://tinyurl.com/63dfg7](http://tinyurl.com/63dfg7)
> 
> 1- EHR’s are about the Patient system and document the medical treatment process from the healthcare providers perspective.
> 
> 2- The Patient System consists of:  
> a- Inner system (chemistry, physiology, genomics, etc)  
> b- Patient as a body  
> c- Direct Social Patient System (family, friends, colleagues, neighbors, etc)  
> d- Extended Social Patient System (society, etc)
> 
> 3- In each layer of the Patient System there are processes
> 
> 4- These processes give rise to states in the Patient System
> 
> 5- Observations: Hearing, seeing, feeling, tasting, smelling, touching give information about the states
> 
> 6- Evaluations: Using expertise and knowledge inferences are made about the processes in the Patient System
> 
> 7- Instructions: are executed (as Actions) in order to get more Observations or have the intention to influence processes in the Patient System
> 
> 8- Planned Actions and unplanned Actions: influence the state and/or processes in the Patient System
> 
> Gerard
> 
> – –  
> Gerard Freriks, MD  
> Huigsloterdijk 378  
> 2158 LR Buitenkaag  
> The Netherlands
> 
> T: +31 252544896  
> M: +31 620347088  
> E: [gfrer@luna.nl](mailto:gfrer@luna.nl)
> 
> Those who would give up essential Liberty, to purchase a little temporary  
> Safety, deserve neither Liberty nor Safety. Benjamin Franklin 11 Nov 1755

– –  
Gerard Freriks, MD  
Huigsloterdijk 378  
2158 LR Buitenkaag  
The Netherlands

T: +31 252544896  
M: +31 620347088  
E: [gfrer@luna.nl](mailto:gfrer@luna.nl)

Those who would give up essential Liberty, to purchase a little temporary  
Safety, deserve neither Liberty nor Safety. Benjamin Franklin 11 Nov 1755

---

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### Author: ![Tim\_Cook2](https://discourse.openehr.org/letter_avatar_proxy/v4/letter/t/57b2e6/32.png) [@Tim\_Cook2](https://discourse.openehr.org/u/Tim_Cook2)
#### Post date: [25 June 2008 11:45 UTC](https://discourse.openehr.org/t/toughts-about-archetypes-and-patient-system/14772/5 "2008-06-25T11:45:28Z")

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> Dear all,
> 
> I have added a Power Point presentation.  
> Url: [http://tinyurl.com/6h2vs8](http://tinyurl.com/6h2vs8)
> 
> With regards,
> 
> gerard

Thanks for sharing this nice work.

Even if it is in that non-standard format. 😉

--Tim

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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: [2 July 2008 09:23 UTC](https://discourse.openehr.org/t/toughts-about-archetypes-and-patient-system/14772/6 "2008-07-02T09:23:40Z")

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Gerard Freriks wrote:

> I agree, but we can not change history.
> 
> Gerard
> 
> > It would be much easier to decide whether to use an 'Observation' or  
> > an 'Evaluation' if the word 'Evaluation' was replaced by 'Inference'.
> > 
> > Colin

\*we could have chosen 'opinion' as well. I suspect the debate will never  
end. Some things we do have to live with and move on....

- thomas beale

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### Author: ![system](https://discourse.openehr.org/uploads/default/original/2X/f/f0a1dedb20c42747bddcafd6c7df9db5f34f003c.svg) [@system](https://discourse.openehr.org/u/system)
#### Post date: [16 July 2008 11:28 UTC](https://discourse.openehr.org/t/toughts-about-archetypes-and-patient-system/14772/7 "2008-07-16T11:28:04Z")

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Hi Colin

The names of these classes seemed appropriate and probably still are in a general sense. The important thing is that we get the features of the classes known and understood so that they are chosen at appropriate times. We are getting better at this and we have discovered that it is not critical for edge cases.

Cheers, Sam

Cheers, Sam

Colin Sutton wrote:

> **(attachments)**
>
> ![OceanInformaticsl.JPG](https://discourse.openehr.org/images/transparent.png)
