How to define transitions in the ISM

Bakke, Silje Ljosland silje.ljosland.bakke at nasjonalikt.no
Wed Jun 27 03:35:55 EDT 2018


Hi Pablo!

I’ll try to answer your question about how clinical modellers solve this problem. Have a look at the ACTION.medication archetype (http://openehr.org/ckm/#showArchetype_1013.1.123). This archetype has 11 separate steps for the ACTIVE state. In each medication management context, one or more of these will be relevant, and often in a way or order that’s not possible to predict. We therefore “solve” the problem by leaving it to the business logic of the application. This may be frustrating for the implementers (I don’t know, is it?), but it makes our work manageable. Designing ACTION archetypes is complex in the first place, and I’m not sure we’d get any published if we needed to map out all possible combinations and orders of pathway steps too.

Regards,
Silje

From: openEHR-clinical <openehr-clinical-bounces at lists.openehr.org> On Behalf Of Pablo Pazos
Sent: Wednesday, June 27, 2018 3:45 AM
To: For openEHR clinical discussions <openehr-clinical at lists.openehr.org>
Subject: How to define transitions in the ISM

Hi all,

I'm testing the AE for a new workshop, and designed a simple state machine for and order so my students can use it as basic for more complex state machines.

I have: NEW (maps to ISM PLANNED), ASSIGNED (maps to ISM PLANNED), STARTED (maps to ISM ACTIVE) and FINISHED (maps to ISM COMPLETED).

What the AE is not allowing is to specify the ISM_TRANSITION.transition : DV_CODED_TEXT.

The problem is if I have two states mapped to ASSIGNED, how a software knows which one is the state to activate if the transition "initiate" is not define. Also I want to specify that from new should happen a "plan_step" transition to change the state to ASSIGNED. Seems we are missing important metadata in the archetype.

How do clinical modelers solve those problems?

Will test LinkEHR to see how they define the ISM and the valid transitions.

Thanks,
Pablo.

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Ing. Pablo Pazos Gutiérrez
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