Link between goals and other clinical concepts

Heather Leslie heather.leslie at oceaninformatics.com
Fri Jun 20 01:32:58 EDT 2014


Hi Pablo,

Comments inline

Heather

From: openEHR-clinical [mailto:openehr-clinical-bounces at lists.openehr.org] On Behalf Of pablo pazos
Sent: Friday, 20 June 2014 10:09 AM
To: openEHR Clinical
Subject: RE: Link between goals and other clinical concepts

Hi Heather!

Yes, I was evaluating the goal archetype. Great, now I get what the "Target archetype node" is for.

About that I have a question, what's the role of the "Target measurement"? My understanding was that's the value set for the goal (e.g. target body weight),
[HVL:] Agreed. Perhaps we should refine the name/description to make that clearer.

not the measurement to be evaluated against the goal (e.g. current body weight).
If that value is the measurement, where should the value for the goal be set? Or the idea is not to set a value like quantity but set a text in "Target".

My question was focused on the relationship between the value set for the target goal and the archetype used to record the measurements to be compared with the value of the goal. Because the goal and the measurements should comply the same constraints (magnitude, units, etc)
[HVL:] Understood . That is what I was referring to with my comment "correlation with magnitude and unit constraints would be nice to have, but is not currently easy to achieve." We would currently do that manually in the template. Alternatively we could specialise the goal archetype for each measurement, but that has lots of overheads as well.

If we were to look at changing the modelling patterns to allow for a common CLUSTER to be used within both the measurement OBSERVATION and the EVALUATION.goal then we could achieve what you asked for. In the current ADL 1.4 world that would be an enormous modelling overhead as then no measurement model is standalone and ready to go but needs to be combined with others in order to be used in every modelling scenario.

It is not clear that the requirements for goal justify the changed modelling pattern scenario. The value and clarity of the standalone OBSERVATIONs is huge.

Also, what about when you have a goal for the BP and you need to specify a value for systolic and diastolic? Should I create two instances of the goal? (One for systolic and one for diastolic).
[HVL:] Depends on what you are trying to achieve. You could do it the way you describe, and then reaching each goal can be assessed independently. Or if you want to reduce the BP as a whole, you could set a goal of 'Reduce BP' and have two targets, one for Systolic and the other for Diastolic

Thanks!



--
Kind regards,
Eng. Pablo Pazos Gutiérrez
http://cabolabs.com<http://cabolabs.com/es/home>
________________________________
From: heather.leslie at oceaninformatics.com<mailto:heather.leslie at oceaninformatics.com>
To: openehr-clinical at lists.openehr.org<mailto:openehr-clinical at lists.openehr.org>
Subject: RE: Link between goals and other clinical concepts
Date: Wed, 18 Jun 2014 03:13:09 +0000
Hi Pablo,

Is it safe to assume that you've seen the current archetype for Goal? It is here: http://www.openehr.org/ckm/#showArchetype_1013.1.124

In it we have a data element that specifically identifies the archetype and path of the specific node that should be used to capture the actual measurement, eg the weight or height or systolic blood pressure.

This combination of the EVALUATION.goal archetype with various target OBSERVATIONs for recording the actual data is being used in implementations in Australia as part of a personalised care plan, as Hugh has indicated. The correlation with magnitude and unit constraints would be nice to have, but is not currently easy to achieve.

Regards

Heather

From: openEHR-clinical [mailto:openehr-clinical-bounces at lists.openehr.org] On Behalf Of pablo pazos
Sent: Saturday, 14 June 2014 5:21 AM
To: openEHR Clinical
Subject: Link between goals and other clinical concepts

Hi, if I want to establish a goal for body weight, I think there's a need of linking the goal concept with the body weight concept, but the body weight archetype is for measuring the weight not to specify a goal for it.

I understand the difference between a goal (what you want to achieve, fixed value) and the measures (to control your progress and compare with the goal, variable value through time).

Also, I think the target measurement from the goal archetype will depend on the specific concept I'm creating a goal for (body weight), I mean the magnitude and units constraints should be inherited someway from the concept I'm measuring (body weight) into the goal archetype.

Does anyone has an idea of how will be a good way of modeling a goal related to another concept like weight or BP?

Thanks!

--
Kind regards,
Eng. Pablo Pazos Gutiérrez
http://cabolabs.com<http://cabolabs.com/es/home>

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