Changes between Version 3 and Version 4 of Archtectural Overview Design of the openEHR EHR

Timestamp:

Sep 13, 2007, 5:28:18 PM (17 years ago)

Author:

KOBAYASHI, Shinji

Comment:

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Archtectural Overview Design of the openEHR EHR

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 The latter may be in the form of an existing PMI (patient master index) or other directory, or it may be in the form of an openEHR demographic repository. An openEHR demographic repository can act as a front end to an existing PMI or in its own right. Either way it performs two functions: standardisation of demographic information structures and versioning. An openEHR EHR contains references to entities in whichever demographic repository has been configured for use in the environment; the EHR can be configured to include either no demographic or some identifying data. One of the basic principles of openEHR is the complete separation of EHR and demographic information, such that an EHR taken in isolation contains little or no clue as to the identity of the patient it belongs to. The security benefits are described below. In more complete EHR systems, numerous other services (particularly security-related) would normally be deployed, as shown in FIGURE 7.
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 6.2 Top-level Information Structures
 
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 All persistent openEHR EHR, demographic and related content is found within top-level information structures. Most of these are visible in the following figures.
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 6.3 The EHR
 
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 6.4 Entries and "clinical statements"
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 Entry Subtypes
 
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 This process model is a synthesis of Lawrence Weed's "problem-oriented" method of EHR recording, and later related efforts, including the model of Rector, Nowlan & Kay [7], and the "hypothetico-deductive" model of reasoning (see e.g. [3]). However hypothesis-making and testing is not the only successful process used by clinical professionals - evidence shows that many (particularly those older and more experienced) rely on pattern recognition and direct retrieval of plans used previously with similar patients or prototype models. The investigator process model used in openEHR is compatible with both cognitive approaches, since it does not say how opinions are formed, nor imply any specific number or size of iterations to bring the process to a conclusion, nor even require all steps to be present while iterating (e.g. GPs often prescribe without making a firm diagnosis). Consequently, the openEHR Entry model does not impose a process model, it only provides the possible types of information that might occur.
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 Ontology of Entry Types
 
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 Further details on the openEHR model clinical information are given in the EHR IM document, Entry Section.
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 6.5 Managing Interventions
 
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 Coupled with the comprehensive versioning capabilities of openEHR, the Instruction/Action design allows clinical users of the record to define and manage interventions for the patient in a distributed environment.
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 6.6 Time in the EHR