Major update to openEHR Task Planning (workflow) draft specification

Thomas Beale thomas.beale at openehr.org
Thu Jun 1 10:54:03 EDT 2017


On 01/06/2017 02:57, Tony Shannon wrote:
> Looks good Tom, certainly comprehensive.
> Like the fractal nature aspect :o)
>
> Not sure how to judge it without challenging with a clinical scenario 
> at a reference implementation.
> Is there a related OS implementation in the works?
>

We'll need to do a bit more design work, but I think parts could be 
implemented soon, in an experimental version.

I should point out that this design is heavily influenced by a) 
experiences from various openEHR implementers, b) my involvement in the 
Intermountain Healthcare Activity project and c) a lot of literature 
research. At Intermountain we have a working system (it's based on their 
own form of archetypes, and a different reference model, so not directly 
re-usable for us) and we have gained experiences already with clinical 
users on:

  * radiology reporting and workflow
  * stroke management, based on the IHC acute stroke guideline
    <https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0ahUKEwi257L58JzUAhUHqFQKHcEzBM4QFggzMAA&url=https%3A%2F%2Fintermountainhealthcare.org%2Fext%2FDcmnt%3Fncid%3D520500199&usg=AFQjCNGni-t0KZX9MzXAwQG3NBzdvxTvhA&sig2=Y7iU0ggf5-0ZfetDONs6ag>,
    which is comprehensive
  * various nursing procedures featuring sequence-of-steps

It would be great to get your help and that of other clinicians to test 
out the new spec with NICE guidelines e.g. I'd like to have a go at 
(parts of?) sepsis, and stroke is always a good one as well.

But even the simplest use cases need to be tested to make sure we have 
got the model right - things such as in-patient routine drug admin, 
R-CHOP chemotherapy protocol and so on.

I think the simplest way to initially test, given we don't have software 
yet, is to build some archetypes. So for example, a typical R-CHOP Task 
List can be built as a set of archetypes.

So I think the steps from here are:

  * a bit more design work and validation
  * republish a 'good enough' draft to test and implement from
  * build some archetypes and templates for some well-known case to show
    how this is done
      o when we add the model to the existing RM BMM, any BMM-consuming
        tool will be able to build Task Planning archetypes, which at
        least includes ADL Workbench, LinkEHR and I think the new Marand
        ADL-designer.

If you or any other clinical person wants to propose clinical scenarios 
we should concentrate on, please do so. I'm working on the idea that we 
will start with:

  * multi-day / multi-drug chemo plan
  * in-patient scheduled drug admin plan
  * elements of a stroke guideline (IHC or NICE)

Then we will need to iterate like that for a while; when the archetyped 
Task Plans look solid enough, I think software building can begin in 
earnest.

- thomas


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