How to define transitions in the ISM

Pablo Pazos pablo.pazos at cabolabs.com
Sat Jun 30 14:12:03 EDT 2018


Hi Silje,

I got the issue with complex workflows.

With the current solution you'll need to provide more metadata to the
developers so they can implement the correct workflows, like possible or
impossible transitions from one state to another, because constraints are
not in the archetype.

On the other hand, simple workflows can be completely specified in the
archetype without providing extra medadata separately from the archetype,
since both states and possible transitions can be specified there, like the
little toy state machine on my previous message. The issue is the AE
doesn't allow to express constraints for the ISM_TRANSITION.transition
(DV_CODED_TEXT) attribute (a constraint that can explicitly state a list of
valid transitions to reach that state, I think "transition" is about
inbound transitions not outbound, but that is a separate issue). I'll test
if this can be done using LinkEHR.

Also for complex flows, it would be good to provide the possible
transitions, even if the list of possibilities is big, this is just to make
the archetype contain all the metadata needed for implementation, without
the need of providing that externally to the archetype. I know this
requires more work in the archetype, but it might be less work in total,
since the problem will need to be solved as you said, in the business
logic. IMO this approach does not add more constraints to the archetype,
just more information, and made the implicit freedom of transitions
explicit.

Maybe this should be considered case by case, and modeling tools should
allow to constraint the transition, but leave that to the modeler. I think
a good approach is to constraint what can be constrained, for instance on
the medication archetype there are a lot of transitions between active
states, but maybe there are less transitions between other states, and
those can be in the archetype. This would remove a little friction at
development time.

It would be nice to know how other modelers do this and how other
implementers deal with non defined transitions in ACTION archetypes.

Best,
Pablo.

On Wed, Jun 27, 2018 at 4:35 AM, Bakke, Silje Ljosland <
silje.ljosland.bakke at nasjonalikt.no> wrote:

> 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.
>
>
> --
>
> *Ing. Pablo Pazos Gutiérrez*
> pablo.pazos at cabolabs.com
> +598 99 043 145
> skype: cabolabs
> Subscribe to our newsletter <http://eepurl.com/b_w_tj>
>
> <https://cabolabs.com/>
> http://www.cabolabs.com
> https://cloudehrserver.com
>
>
>
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>


-- 
*Ing. Pablo Pazos Gutiérrez*
pablo.pazos at cabolabs.com
+598 99 043 145
skype: cabolabs
Subscribe to our newsletter <http://eepurl.com/b_w_tj>
<https://cabolabs.com/>
http://www.cabolabs.com
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