SV: Alive vs Dead

Vebjørn Arntzen varntzen at ous-hf.no
Tue Jan 5 07:51:13 EST 2016


Hi all

Remember that the Subject of Care could not be born yet, though I guess that in most practices information about the unborn child is documented in the mother's EHR. In case of procedures or samples in utero, some systems can create a health record for the foetus itself, and as a result of this, can be registred as deceased before "it left the uterus" ( = birth?). This will be valid e.g. if there are twins and one dies before birth, or a child need transfusion before birth.


Regards
Vebjørn

Fra: openEHR-clinical [mailto:openehr-clinical-bounces at lists.openehr.org] På vegne av Heath Frankel
Sendt: 5. januar 2016 11:21
Til: For openEHR clinical discussions
Emne: RE: Alive vs Dead

Yep, they are certainly clinical and different to the original concepts you suggested (or at least the ones I interpreted that you were suggesting).

I think Shinji's concept of death as event is aligned with the data concepts you now mention.
Regards

Heath

_____________________________
From: Heather Leslie <heather.leslie at oceaninformatics.com<mailto:heather.leslie at oceaninformatics.com>>
Sent: Tuesday, January 5, 2016 6:55 PM
Subject: RE: Alive vs Dead
To: For openEHR clinical discussions <openehr-clinical at lists.openehr.org<mailto:openehr-clinical at lists.openehr.org>>



Thanks Heath - death date, source of notification, location, certificate number in that archetype - demographic indeed.

Clinicians record that the patient is not breathing, no pulse and conclusion that they are declared dead in the patient's health record. Plus the cause of death including contributing clinical factors. There is crossover between demographics and clinical.

H

From: openEHR-clinical [mailto:openehr-clinical-bounces at lists.openehr.org] On Behalf Of Heath Frankel
Sent: Tuesday, 5 January 2016 7:04 PM
To: For openEHR clinical discussions <openehr-clinical at lists.openehr.org<mailto:openehr-clinical at lists.openehr.org>>
Subject: RE: Alive vs Dead

Heather,
See ITEM_TREE.person_details.v1 in CKM.

In this case I see no difference between the administrative death data and its use in the clinical context unlike the usual gender vs sex use case.

We don't want two places to maintain and represent this. FHIR, CDA and HL7 V2 only have one means to do this.

Regards

Heath

_____________________________
From: Heather Leslie <heather.leslie at oceaninformatics.com<mailto:heather.leslie at oceaninformatics.com>>
Sent: Tuesday, January 5, 2016 6:17 pm
Subject: RE: Alive vs Dead
To: For openEHR clinical discussions <openehr-clinical at lists.openehr.org<mailto:openehr-clinical at lists.openehr.org>>


Hi Heath,

There are many things in the demographic archetypes that we seem to sometimes need in a clinical context. And this seems to be one.

I couldn't find it in any demographic archetype on CKM - do you have one?

Regards

Heather

From: openEHR-clinical [mailto:openehr-clinical-bounces at lists.openehr.org] On Behalf Of Heath Frankel
Sent: Tuesday, 5 January 2016 6:37 PM
To: For openEHR clinical discussions <openehr-clinical at lists.openehr.org<mailto:openehr-clinical at lists.openehr.org>>
Subject: RE: Alive vs Dead

Heather,
The fact that a person is deceased is already represented in demographic archetypes.
Regards

Heath


On Mon, Jan 4, 2016 at 11:20 PM -0800, "Heather Leslie" <heather.leslie at oceaninformatics.com<mailto:heather.leslie at oceaninformatics.com>> wrote:
Just talking it through further with Hugh.

The notion of a patient being alive is only possible while they are in the room with you. As soon as they walk out the door they could drop dead.

So this adds a further complication. From a pure modelling point of view:

*         the only reliable status is to record if a patient is dead, maybe alongside date of death, cause of death etc - ie the archetype of death that contains clinically relevant data!

*         for querying  -  if the patient is not recorded as being known as dead or deceased, then we assume either the patient is still alive or that their status is unknown.

I suspect that the reality is that many current systems do have an alive vs dead  status of some sort - would anyone like to confirm or deny?

Cheers

Heather

From: openEHR-clinical [mailto:openehr-clinical-bounces at lists.openehr.org] On Behalf Of Heather Leslie
Sent: Tuesday, 5 January 2016 5:44 PM
To: For openEHR clinical discussions <openehr-clinical at lists.openehr.org<mailto:openehr-clinical at lists.openehr.org>>
Subject: Alive vs Dead

Hi everyone,

Seeking some advice please.

In the context of a data registry or research database to record if a person is alive or dead. Maybe there might be an alternative value of 'unsure' or 'indeterminate' as well, I guess.

I'm wondering if there is any naming convention for this data element - I've come across 'Alive status' and 'Vital status' by googling and researching all the places I can think of. Surprisingly there seems very little available on the topic. SNOMED CT has alive and dead within the 'General clinical state finding (finding)' hierarchy, although 'deceased' is part of the 'Finding related to general body function (finding)' hierarchy.

'Living status' was proposed on a forum, but seems a bit weird if they are dead.

To add to the confusion, the requirements I am modelling uses the name 'Status' (which needs some sort of archetype context) and the values are 'Alive' and 'Deceased' which cross the SNOMED CT hierarchies!

We could just be very pragmatic and label the data element 'Alive vs Dead?'

Curious problem - I thought there would be more on the internets :).

Any wisdom you can share would be most appreciated.

And then I guess we need to think of related data elements that might be grouped with this status.

Regards

Heather

Dr Heather Leslie MBBS FRACGP FACHI
Consulting Lead, Ocean Informatics<http://www.oceaninformatics.com/>
Clinical Programme Lead, openEHR Foundation<http://www.openehr.org/>
p: +61 418 966 670<tel:+61%20418%20966%20670>   skype: heatherleslie   twitter: @omowizard




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