ACTIONs, OBSERVATIONs and procedures

Ian McNicoll ian at
Wed Sep 2 06:56:17 EDT 2015

Hi David,

In theory you are correct but in many clinical records the date of the
observation acts as a sufficient proxy for activity being performed.

Where we do use actions is where we need to track the workflow of the
procedure though there is not always a direct correlation between the
procedure tracked and the observation.

As an example a blood pressure will often be taken as part of a vital signs
measurement. Ie the requested and tracked procedure is "perform vital signs
measurement' every 4 hrs".

I would use a single procedure action archetype to track the 'vital signs
process' in the same composition as the individual observations.

On Wed, 2 Sep 2015 at 10:23, David Moner <damoca at> wrote:

> Hello,
> I have just had an interesting conversation with Diego during a coffee
> break, and several doubts arose around the representation of procedures.
> At the CKM we have an ACTION archetype to represent any type of
> procedures. It is described as "A clinical activity carried out for
> screening, investigative, diagnostic, curative, therapeutic, evaluative or
> palliative purposes". So far, so good.
> Now the doubt is about what happens when the procedure is something simple
> and non-invasive that just generates an OBSERVATION. For example, a
> temperature taking. Should we always have the ACTION.Procedure instance
> generated together with the OBSERVATION.Temperature? Or do we just need to
> record the procedure "temperature taking" as part of the protocol of the
> If the answer is to have both archetype instances, then probably most
> OBSERVATIONs will allways have an ACTION linked to it. If the answer is
> that in some cases we only need to record the OBSERVATION with a protocol,
> then we are creating a division of all the universe of procedures, as
> typically defined in terminologies such as SNOMED CT.
> Thoughts?
> --
> David Moner Cano
> Grupo de Informática Biomédica - IBIME
> Instituto ITACA
> Universidad Politécnica de Valencia (UPV)
> Camino de Vera, s/n, Edificio G-8, Acceso B, 3ª planta
> Valencia – 46022 (España)
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