Re: Medinfo 2010.. Re: clinically useful set of archetypes for a connect
Thanks Tim, Heather, As Heather points out, there is already a basis on which we can build, we have already done some detailed work in the NHS addressing some of these common clinical documentation requirements in the past. What we have not had are the vendors who are able to directly leverage the related archetypes...hence the push behind the Opereffa development and now the Medinfo connectathon to open this out.. As you both suggest the key is to agree the scope and the wiki is a place we can sketch out a few simple patient journeys in pragmatic detail (not too much, not too little) which we can then compare against the archetypes that are available/draft/developing, before then making available to those over to those who want to take part. I'm happy to take a lead on sketching out some very simple, generic but clinically recognisable patient journeys on the wiki, hoping others will critique/add comments/add detail and am happy to try to steer them to a reasonable level of detail.. I'll stick with the SOAP and Summary approach, in a vague cradle to grave fashion, as an outline framework to begin. I'll also draw a line in the sand to say lets try to complete these few patient journeys by end September to allow good time for the related archetype development work to be done by Dec 1. (Times might shift a bit but might as well start with some timescales..) Heres the placemarker for where the stories can start from.. http://www.openehr.org/wiki/display/resources/Connect-a-thon+Details Any issues/comments on that approach please let me know. Thanks, Tony Dr. Tony Shannon Consultant in Emergency Medicine, Leeds Teaching Hospitals Clinical Lead, Clinical Content Service, NHS Connecting for Health Chair, Clinical Review Board, openEHR Foundation +44.789.988 5068 tony.shannon@nhs.net Heather Leslie wrote:
Hi Tony, Tim, Sorry for the delay in response - have been travelling. Foundation work for the archetypes that would support a general SOAP and summary have been developed and re-used in previous work, starting with the 2007 NHS project. The best of these, ie those that we considered about 70-80% right have already been uploaded to CKM; some published, some under review, some still as draft. There remain other archetypes that were developed but still need some more work before being ready for CKM upload. It is likely that the more generic the proposed scenarios, the component archetypes comprise published archetypes from CKM; the more specific the proposed scenario, we may have to settle for a hybrid of published and draft archetypes. If we want to develop the specific scenarios as outlined by Tim, this will take additional archetype development work to create new domain specific archetypes. So we definitely don't need to start from scratch, but we do need to consider whether we only want to use agreed archetypes or are happy to use a mixture for this project. In fact by the time Medinfo rolls around they could all conceivably be agreed - will our demonstrator systems be able to absorb the archetypes as they evolve from draft to agreed? First lets agree on scope, then we can identify existing archetypes that can be re-used, and those that need to be created from scratch. Regards Heather On 30/08/2009 4:51 AM, Tony Shannon wrote:Thanks Tim, Thats useful. Some other feedback from clinical colleagues would be useful on this. Certainly the high level use cases you posted , ie Newborn and then 65yo with Chronic Diseases should be useful. The detailed candidate content posted up about these 2 I'm not so concerned about directly replicating.. if we can tackle the archetypes needed to do SOAP and Summary noting these can form the basis of the material needed to support both journeys. The top 10 Emergency Archetype work Heather is currently over seeing will begin that. Not sure what timetable is realistic for broadening out CKM input to cover the other material needed for SOAP, but Im sure it will be months rather than weeks. It may be that a few of us produce a candidate subset of archetypes that can handle both SOAP and Summary for the Connectathon purposes ahead of any ARB/CRB checks, given the time pressures you were suggesting earlier. Dec 1 gives us about 12 weeks I guess. My sense is there must be value in agreeing a small set of very basic set of archetypes over the next weeks for these purposes if that helps move forward the Connectathon.. Others may have a view on that? #Heather do you want to comment on this thanks.. Perhaps other can comment on the date time and technical issues for the connectathon. I've updated the wiki as we will be aiming to use Opereffa within the Connectathon, Serefs time will likely be constrained but thankfully he is certainly willing to try... Regards, Tony Tim Cook wrote:Hi Tony, I have added two potential use cases http://www.openehr.org/wiki/display/resources/Connect-a-thon+Details now I need clinicians to tell the rest of us is this a doable situation. Can we do these two with the 15-20 archetypes that were discussed below? If not, what needs to change? I also need feedback on the other items on that page. Also, please start making commitments to participate. http://www.openehr.org/wiki/display/resources/Connect-a-thon +Participants If we do not have systems signed up and committed to participate then we are wasting our time in planning the event. Cheers, Tim On Fri, 2009-08-21 at 10:22 +0100, Tony Shannon wrote:Thanks Tim, In reply.. I am a believer in keeping things simple where possible. My sense is that we can demostrate an impressive solution if we offer support around a single/few patient journey(s) and a limited set of archetypes. Let me play devils advocate and suggest all we need to address for the majority of this is just 2 overlapping groups of archetypes. 1) The Emergency Summary set (Top10) that Heather has been polling for 2) The SOAP note set Note that these have significant overlap. That journey could begin in any/many ways.. eg 1) Newborn .. with a SOAP note*MailScanner has detected a possible fraud attempt from "74.125.77.132" claiming to be* *MailScanner warning: numerical links are often malicious:* http://74.125.77.132/search?q=cache:YO6tdfa2xXgJ:faculty.washington.edu/alexbert/MEDEX/Spring/MCHNewBornsoapnote.doc+soap+note+newborns&cd=5&hl=en&ct=clnk&gl=ukHome with a Summary note 2) To the Primary Care doc.. with a new SOAP note At end of visit.. an updated Summary 3) To the ED/other Unit.. where we access the Summary Then we add a new SOAP note Then we update the Summary 4)..into old age.. When a Long Term condition requires more SOAP notes and updates to the Summary and so on and so on.. OK a very simplistic example, but I hope it illustrates a point. If some think that its too broad then we could use a subset of that journey..again only needing with SOAP and Summary. The top 10 Summary drive has already begin the process of now starting to explore 15/20 key archetypes, all of which selected can and will provide the basis for the SOAP note too. One point your question does raise is whether we are aiming for archetypes that have more breadth or depth, or a mix in between. I would be looking for the Medinfo demo set to provide *just enough* (and no more than that) detail to get the demo across. I would not expect us to have finalised the definitive archetypes for Summary/SOAP by then. There will be never be "final" versions of any of these anwway..always works in progress. Hope these ideas help.. Tony Tim Cook wrote:On Mon, 2009-08-17 at 17:46 +0100, Tony Shannon wrote:Thanks Tim & co for moving on this. Tim You kindly offered to help organise this, please let me know if I can help in any way.Tony, I think that you will be key in leading the charge to be sure that we have the correct archetypes in place. Maybe even if they haven't all passed review by then???? We at least need to have a MedInfo2010 Set defined. Probably no later than 1 December. So we have the list prior to everyone going on the holiday break. This will provide time for the various application developers to do template building and testing. Maybe enough time for CKM/ARB certification as well? But of course this means that we also need to define the number of use cases and number of patients we will be demoing. Comments please........ --Tim-- Dr. Tony Shannon Consultant in Emergency Medicine, Leeds Teaching Hospitals Clinical Lead, Clinical Content Service, NHS Connecting for Health Chair, Clinical Review Board, openEHR Foundation +44.789.988 5068 tony.shannon@nhs.net ******************************************************************************************************************** This message may contain confidential information. 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Thank you for your co-operation. NHSmail is the secure email and directory service available for all NHS staff in England and Scotland NHSmail is approved for exchanging patient data and other sensitive information with NHSmail and GSI recipients NHSmail provides an email address for your career in the NHS and can be accessed anywhere For more information and to find out how you can switch, visit www.connectingforhealth.nhs.uk/nhsmail ******************************************************************************************************************** _______________________________________________ openEHR-implementers mailing list openEHR-implementers@openehr.org http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-implementers __________ Information from ESET NOD32 Antivirus, version of virus signature database 4386 (20090901) __________ The message was checked by ESET NOD32 Antivirus. http://www.eset.com-- *Dr Heather Leslie* MBBS FRACGP FACHI Director of Clinical Modelling *Ocean Informatics <http://www.oceaninformatics.com/>* Phone (Aust) +61 (0)418 966 670 Skype - heatherleslie Twitter - @omowizard
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