Archetypes for "Body fluid or substance" and "Bodily output"

> Hi Silje,
>
>
>
> It may be that the descriptions need to be improved a *little* (or a lot!).
>
>
>
> As Hugh suggests, the cluster archetype for fluid has been designed for
> re-use in multiple situations – which will be commonly in nursing fluid
> output charts etc, but potentially other places as well, eg describing the
> base of a weeping wound, hence modelling the quantity attributes within the
> cluster itself.
>
>
>
> The intent of the OBSERVATION.bodily_output, as I understand it, is to
> support the recording of fluid loss within a nursing chart context and in
> practice the CLUSTER.fluid archetype is intended to be nested within this
> ENTRY every single time. We hope that the tooling will one day enable
> embedding of clusters where the intent is for them to be present in a slot
> 100% of the time, but that is not yet possible. In the meantime the metadata
> should definitely be enhanced to explain this further.
>
>
>
> Ian modelled these specifically for recent use in a nursing system
> implementation. He reconfigured the CLUSTER significantly and we discussed
> it ‘robustly’ for some time to get them to this point. However as Hugh also
> suggested, that doesn’t mean they won’t be significantly improved with
> broader clinical input. Until there is a content review round for these
> archetypes, please record any comments in the discussion section of CKM:
>
> ·         OBS.bodily_output:
> http://www.openehr.org/knowledge/OKM.html#showArchetype_1013.1.695_COMMENTS
>
> ·         CLUSTER.fluid:
> http://www.openehr.org/knowledge/OKM.html#showArchetype_1013.1.23_COMMENTS
>
>
>
> I hope that clarifies the intent and anticipated use… Ian (as author) will
> hopefully be able to comment when he returns from holiday.
>
>
>
> Regards
>
>
>
> Heather
>
>
>
> From: openehr-clinical-bounces@...
> [mailto:openehr-clinical-bounces@...] On Behalf Of Hugh Leslie
> Sent: Thursday, 6 October 2011 10:50 AM
> To: For openEHR clinical discussions
> Subject: Re: Archetypes for "Body fluid or substance" and "Bodily output"
>
>
>
> Hi Silje
>
> You'll notice that both the 'body fluid or substance' archetype and the
> 'bodily output' archetype reference (nest) the 'body fluid or substance'
> archetype.  i.e. the 'body fluid or substance' archetype is self referential
> and can cascade.  This is about re-use of the content in different places
> where it makes sense i.e. the 'body fluid or substance' archetype may be
> used in describing a sample as well for a pathology specimen or after the
> result of a procedure etc.  So the volume of the fluid is part of the
> description of the fluid itself and is only found in the one place.
>
> Note that both of these archetypes are still in draft and therefore may not
> be perfect.  If you are planning to use these, we would recommend that we
> get further clinical input by getting them into a review round.
>
> I wasn't directly involved in the development of either of these models so
> one of the original authors may shed more light on this.
>
> regards Hugh
>
> On 5/10/2011 11:49 PM, Bakke, Silje Ljosland wrote:
>
> Hi!
>
>
>
> We’re slowly getting into translating a small set of archetypes into
> Norwegian, and we’re a bit confused about some properties from the
> archetypes Body fluid or substance and Bodily output. Bodily output is
> described as “Recording of findings and measurement (or estimation) of
> bodily output such as fluid output and defaecation.”, and Body fluid or
> substance as “Details of the findings relating to a bodily fluid, secretion
> or substance.”.
>
>
>
> In relation to these, we’re wondering why the parameters relating to
> measured quantity are in the archetype describing the fluid itself, instead
> of the archetype describing the measurement.
>
>
>
> We would be very happy if someone would explain the rationale behind this! J
>
>
>
> --
>
> Mvh.
>
> Silje Ljosland Bakke
>
> Rådgiver/Prosjektleder Meldingsløftet
>
> FoU avdeling, Seksjon for IKT
>
> Helse Bergen HF
>
>
>
> +47 40 20 32 98
>
> silje.ljosland.bakke@...
>
>
>
> http://www.helse-bergen.no/fagfolk/samhandling/meldingsloftet/
>
>
>
>
> _______________________________________________
>
> openEHR-clinical mailing list
>
> openEHR-clinical@...
>
> http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-clinical
>
>
>
> --
>
> ________________________________________________
> Dr Hugh Leslie MBBS, Dip. Obs. RACOG, FRACGP, FACHI
> Chief Medical Officer
> Ocean Informatics Pty Ltd
> M: +61 404 033 767   E: hugh.leslie@...  W:
> www.oceaninformatics.com
>
> _______________________________________________
> openEHR-clinical mailing list
> openEHR-clinical@...
> http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-clinical
>

> Hi Silje,
>
> Good to hear from you. Heather and Hugh are pretty well spot on with
> their replies. I had to do a fair bit of re-thinking of the existing
> archetypes to make them work across a range of contexts in a
> paediatric hospital. Bodily output/fluid output turns out to be quite
> tricky to model because of some overlapping requirements.
>
> 1. Record fluid output quantities within the context of a fluid chart,
> possibly with some description or other comment on the fluid.
> 2. Record details of fluids e.g wound exudate, sweat, urine outside
> the context of a fluid chart, but possible requiring the quantity to
> be recorded.
> 3. In some (but not all) circumstances the quantities recorded in (2)
> will be included or copied to (1).
> 4. Faeces is a little tricky since it can be both solid and fluid
>
> Working from the existing CKM archetypes as Heather and Hugh have
> described I now have
>
>
> openEHR-EHR-OBSERVATION.fluid_output.v1
> specialised to
>
> openEHR-EHR-OBSERVATION.fluid_output-urine.v1
> openEHR-EHR-OBSERVATION.fluid_output-faeces.v1
> openEHR-EHR-OBSERVATION.fluid_output-vomiting.v1
>
> and
>
> openEHR-EHR-CLUSTER.bodily_substance.v1
> specialised to
>
> openEHR-EHR-CLUSTER.bodily_substance-faeces.v1
> openEHR-EHR-CLUSTER.bodily_substance-sputum.v1
> openEHR-EHR-CLUSTER.bodily_substance-sweat.v1
> openEHR-EHR-CLUSTER.bodily_substance-urine.v1
> openEHR-EHR-CLUSTER.bodily_substance-vomit.v1
>
>
> the idea being that these cluster archetypes can be used in the non
> Fluid_output context e.g. details of sputum in an aspirate. Heather
> and I are scheduled to spend a little time kicking these into shape
> for CKM, then get them up for review, when they will supercede the
> CLUSTER.fluid.v1 archetype. They are very close to this archetype in
> content and structure.
>
> Similarly the OBSERVATION.fluid_output.v1 archetypes are pretty close
> to the current bodily_output series.
>
> I can easily send these new archetypes over to you (or anyone else)
> who is interested but bear in mind that ANY draft archetypes are
> subject to change and therefore my mess up your translations. I would
> certainly be very interested to know if/how they meet your local
> requirements. They are working well in the hospital application to
> date but we are only now implementing the Fluid charting so some
> changes may ensue.
>
> Regards,
>
> Ian
>
> Dr Ian McNicoll
> office +44 (0)1536 414 994
> fax +44 (0)1536 516317
> mobile +44 (0)775 209 7859
> skype ianmcnicoll
> ian.mcnicoll@...
>
> Clinical Modelling Consultant, Ocean Informatics, UK
> openEHR Clinical Knowledge Editor www.openehr.org/knowledge
> Honorary Senior Research Associate, CHIME, UCL
> BCS Primary Health Care  www.phcsg.org
>
>
>
>
> On 6 October 2011 07:06, Heather Leslie
> <heather.leslie@...> wrote:
>> Hi Silje,
>>
>>
>>
>> It may be that the descriptions need to be improved a *little* (or a lot!).
>>
>>
>>
>> As Hugh suggests, the cluster archetype for fluid has been designed for
>> re-use in multiple situations – which will be commonly in nursing fluid
>> output charts etc, but potentially other places as well, eg describing the
>> base of a weeping wound, hence modelling the quantity attributes within the
>> cluster itself.
>>
>>
>>
>> The intent of the OBSERVATION.bodily_output, as I understand it, is to
>> support the recording of fluid loss within a nursing chart context and in
>> practice the CLUSTER.fluid archetype is intended to be nested within this
>> ENTRY every single time. We hope that the tooling will one day enable
>> embedding of clusters where the intent is for them to be present in a slot
>> 100% of the time, but that is not yet possible. In the meantime the metadata
>> should definitely be enhanced to explain this further.
>>
>>
>>
>> Ian modelled these specifically for recent use in a nursing system
>> implementation. He reconfigured the CLUSTER significantly and we discussed
>> it ‘robustly’ for some time to get them to this point. However as Hugh also
>> suggested, that doesn’t mean they won’t be significantly improved with
>> broader clinical input. Until there is a content review round for these
>> archetypes, please record any comments in the discussion section of CKM:
>>
>> ·         OBS.bodily_output:
>> http://www.openehr.org/knowledge/OKM.html#showArchetype_1013.1.695_COMMENTS
>>
>> ·         CLUSTER.fluid:
>> http://www.openehr.org/knowledge/OKM.html#showArchetype_1013.1.23_COMMENTS
>>
>>
>>
>> I hope that clarifies the intent and anticipated use… Ian (as author) will
>> hopefully be able to comment when he returns from holiday.
>>
>>
>>
>> Regards
>>
>>
>>
>> Heather
>>
>>
>>
>> From: openehr-clinical-bounces@...
>> [mailto:openehr-clinical-bounces@...] On Behalf Of Hugh Leslie
>> Sent: Thursday, 6 October 2011 10:50 AM
>> To: For openEHR clinical discussions
>> Subject: Re: Archetypes for "Body fluid or substance" and "Bodily output"
>>
>>
>>
>> Hi Silje
>>
>> You'll notice that both the 'body fluid or substance' archetype and the
>> 'bodily output' archetype reference (nest) the 'body fluid or substance'
>> archetype.  i.e. the 'body fluid or substance' archetype is self referential
>> and can cascade.  This is about re-use of the content in different places
>> where it makes sense i.e. the 'body fluid or substance' archetype may be
>> used in describing a sample as well for a pathology specimen or after the
>> result of a procedure etc.  So the volume of the fluid is part of the
>> description of the fluid itself and is only found in the one place.
>>
>> Note that both of these archetypes are still in draft and therefore may not
>> be perfect.  If you are planning to use these, we would recommend that we
>> get further clinical input by getting them into a review round.
>>
>> I wasn't directly involved in the development of either of these models so
>> one of the original authors may shed more light on this.
>>
>> regards Hugh
>>
>> On 5/10/2011 11:49 PM, Bakke, Silje Ljosland wrote:
>>
>> Hi!
>>
>>
>>
>> We’re slowly getting into translating a small set of archetypes into
>> Norwegian, and we’re a bit confused about some properties from the
>> archetypes Body fluid or substance and Bodily output. Bodily output is
>> described as “Recording of findings and measurement (or estimation) of
>> bodily output such as fluid output and defaecation.”, and Body fluid or
>> substance as “Details of the findings relating to a bodily fluid, secretion
>> or substance.”.
>>
>>
>>
>> In relation to these, we’re wondering why the parameters relating to
>> measured quantity are in the archetype describing the fluid itself, instead
>> of the archetype describing the measurement.
>>
>>
>>
>> We would be very happy if someone would explain the rationale behind this! J
>>
>>
>>
>> --
>>
>> Mvh.
>>
>> Silje Ljosland Bakke
>>
>> Rådgiver/Prosjektleder Meldingsløftet
>>
>> FoU avdeling, Seksjon for IKT
>>
>> Helse Bergen HF
>>
>>
>>
>> +47 40 20 32 98
>>
>> silje.ljosland.bakke@...
>>
>>
>>
>> http://www.helse-bergen.no/fagfolk/samhandling/meldingsloftet/
>>
>>
>>
>>
>> _______________________________________________
>>
>> openEHR-clinical mailing list
>>
>> openEHR-clinical@...
>>
>> http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-clinical
>>
>>
>>
>> --
>>
>> ________________________________________________
>> Dr Hugh Leslie MBBS, Dip. Obs. RACOG, FRACGP, FACHI
>> Chief Medical Officer
>> Ocean Informatics Pty Ltd
>> M: +61 404 033 767   E: hugh.leslie@...  W:
>> www.oceaninformatics.com
>>
>> _______________________________________________
>> openEHR-clinical mailing list
>> openEHR-clinical@...
>> http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-clinical
>>
>