Questionnaires and openEHR

Questionnaire data is common in the eHealth environment, really capturing workflow and ensuring information is captured that is known to be highly relevant. One problem is interoperability and extensibility of information captured in this manner.

Free text questions

The first approach is to take a very generic questionnaire with a repeatable element 'question' and an answer of any data type. This allows virtually any questionnaire to be built using a template, typing the text of the question and setting the type of answer expected. This has the advantage that any simple questionnaire can be designed at the level of a template and added to data entry. Clearly, the information will not be translated nor is it likely that it will be reliable outside the system where it was created. However, there is no doubt that such an approach is valuable for a range of documentation purposes.

Terminology based questions

 It is possible, with more design, to provide a base question and then provide the 'tail' elements from terminology. An example might be "Have you ever suffered from:" with the tail elements "Asthma", "Angina" etc. It is then possible to restrain the name of these elements to a subset of terminology from, for example, SNOMED or ICD10. This might be a specialisation of the free text questionnaire archetype which will allow queries to find all questionnaires. This approach will allow translation (using terminology translation) and will provide computable responses to queries and inferencing.

Archetype based questions

Finally, a questionnaire can be archetyped. This provides complete control of the form of the questionnaire and the results and ensures that these will always be the same. Such an approach is obviously well suited to a questionnaire that is used internationally (The WHO has some well tested check lists) or within a jurisdiction when very tight control of the data collection is required (perhaps for automatic processing).