Archetypes for consent, end-of-life planning and advance decision to refuse treatment

Ian McNicoll ian at
Fri Nov 23 05:17:46 EST 2018

Hi Dileep,

My apologies for the slow reply.

These are good questions! The issue of 'source of truth' is still 'in
development' in the UK. Typically there is a paper document which is the
formal source of truth with electronic copies held at different
institutions with varied attempts /approaches to synchronising or
developing an electronic source of truth.  So a messy space but the forward
direction in many places is to have a patient orientated single source of

So, for instance, this national (Scotland) project

is going to use the new Respect End of life care form as the first app to
be built on the digital platform (based on openEHR).

This is a UK-wide project.

There is also some older modelling work at

but some of this has been superceded by new requirements.

 2. The rules around engagement and authority change continually but
clearly these kind of decisions need to be very clearly documented and
reflected in archetypes/templates - you will see how that is handled in the
Respect example.

3. Mental Health - feshEHR has done a little bit of work in this space for
some English trusts and there is a plan to do some more. You might also
want to contact Martin van den Meer at Code24 in the Netherlands as they have extensive experience with mental health
care plans.

There are no plans to move the UK end of life care archetypes and templates
to the international CKM. Most of these are quite specific to UK practice /
legislation but they can be freely downloaded and used/adapted from the
Apperta UK CKM


Dr Ian McNicoll
mobile +44 (0)775 209 7859
office +44 (0)1536 414994
skype: ianmcnicoll
email: ian at
twitter: @ianmcnicoll

Co-Chair, openEHR Foundation ian.mcnicoll at
Director, freshEHR Clinical Informatics Ltd.
Director, HANDIHealth CIC
Hon. Senior Research Associate, CHIME, UCL

On Mon, 12 Nov 2018 at 14:03, Dileep V S <dileep at> wrote:

> Dear Ian,
> We are in discussions with a state government in India for the use of our
> EHR.Network platform for implementing a public Mental Health Management
> System(MHMS) in line with the Indian National mental healthcare act
> 2017(MHA).
> Some of the requirements of this system are registration of advance
> directives, consent and designated persons. As the MHA defines mental
> healthcare as a right, these directives hold a very critical role in care
> related decisions.
> While exploring options and trying to understand how others have gone
> ahead with such requirements, we came across some archetypes that (I think)
> you had posted in the following link
> Can you give some background on how these were used and if you believe
> that they are still relevant? Is there any plans to port these to the
> OpenEHR CKM for more wider use?
> My specific questions are
>    1. Were these meant to be used as the source of ultimate truth or just
>    for information at point of care?
>    2. In our case there is a formal registration process with submission
>    and approval by people in authority. Was this envisaged when creating the
>    above archetypes?
>    3. Are you aware of any previous OpenEHR implementations for Mental
>    health care?
> Thanks in advance
> regards
> Dileep V S
> *Founder*
> HealtheLife Ventures LLP
> m: +91 9632888113
> a: 106, Innovation Centre, IIIT, Electronics City, Bangalore 560100
> w:  e: dileep at
> _______________________________________________
> openEHR-clinical mailing list
> openEHR-clinical at
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <>

More information about the openEHR-clinical mailing list