Link between goals and other clinical concepts

Thomas Beale thomas.beale at oceaninformatics.com
Sat Jun 21 05:43:24 EDT 2014


On 20/06/2014 19:51, pablo pazos wrote:
> Hi Thomas, is that status similar to the mood idea of HL7 v3 / CDA in 
> Acts?
>
> About the values, I see "actual" and "target" as something useful, but 
> what's "planned" for? It seems to overlap a little with the concept of 
> INSTRUCTION to be something to do in the future.

that's true - and the existence of Observation / Evaluation / 
Instruction / Action deals with the coarse grained intentionality & 
epistemic status. However, at some point a somewhat more precise notion 
of epistemic status will be needed. E.g. to distinguish between the 
following for procedures:

  * done
  * not done
  * scheduled
  * strongly recommended
  * recommended
  * etc

The HL7v3 mood code started out as an attempt to deal with the type of 
intentionality (and full marks to the designers for recognising the 
problem here, and trying to use Speech-act theory, which was a 
reasonable starting point), but it subsequently got confused with all 
kinds of other things like 'promises', 'appointment requests' and so on. 
The lesson here is that you can't deal with epistemic status (level of 
knowledge that a statement makes about the real world), linguistic 
mode/mood (intentionality), currency (and old BP is probably not going 
to be true today), and so on, in one coded data point.

- thomas

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