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Approach
The Northern Territory approach to the creation of an electronic Pregnancy Health Record is to use clinically-agreed archetypes as the basis for an Antenatal software development.
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Content for each of these archetypes have drawn heavily from existing resources such as the NT Pregnancy Health Record, the Queensland Antenatal Health Record, the national HandHeld antenatal National Hand Held Maternity record and international resources. Sometimes the content alignment with the existing resources is easily recognisable; sometimes it may appear a little different. This is because in all situations the data needs to be represented so that it can be re-used in many different potential activities and scenarios, including safe and sensible clinical decision support.
1. Identify clinical concepts
The existing resources have been analysed and the discrete clinical concepts that contribute to the whole document have been identified - see the images below.
For example: 24 concepts have been identified within the current NT Antenatal Record. Each clinical concept is needs to be represented as a separate archetype, and each of these
2. Map clinical concepts to archtypes
Each of the clinical concepts were mapped to existing archetypes within the NEHTA Clinical Knowledge Manager (CKM), or the need identified for creation of a new archetype.
Some of the existing archetypes meet the requirements for the NT Pregnancy Record already; others needed modification or enhancement to meet the requirements.
The newly created archetypes have been uploaded to an online tool, known as the Clinical Knowledge Manager ( CKM), which is hosted by NEHTA, and the ones requiring modification have been updated.
Within the CKM each archetype will then undergo review rounds by a range of clinicians, terminologists, software engineers, informaticians and other interested experts. The purpose of each review round will be to fine-tune each archetype so that it meets the requirements for each stakeholder group.
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Review rounds will continue until consensus has been achieved – surprisingly, in experience to date, the inclusive nature of the maximal data set has enabled consensus on the structure of the archetypes. If consensus is not achieved, then it will need a resolution process will allow for publication of the agreed parts of the model, allowing for further research and discussion and potential future revision of the archetype.
Analysis
The archetypes identified for this Pregnancy Health record are:
Clinical Concept | Comment | Corresponding archetype concept name | Status |
|---|---|---|---|
Antenatal Plan | An overarching plan for the patient's antenatal care | <EVALUATION.antenatal_plan> | |
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<strong>Step 3:</strong> CKM Review
Within CKM each archetype will undergo review rounds by a range of clinicians, terminologists, software engineers, informaticians and other interested experts. The purpose of each review round will be to fine-tune each archetype so that it meets the requirements for each stakeholder group.
CKM Videos:
<ul>
<li><a href="http://www.youtube.com/watch?v=2fb11902NQ4" target="_blank">CKM Introduction</a></li>
<li><a href="http://www.youtube.com/watch?v=Uy-LfrG5U7Y" target="_blank">CKM Archetype Reviews</a><span style="background-color: yellow;">
</span></li>
</ul>
Decision Support
Possible functions:
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