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

Paul Miller paulagmiller at gmail.com
Fri Nov 23 07:43:07 EST 2018


Hi Dileep

Just with reference to the ReSPECT Template to let you know I will be
working with the development team on implementing this in some applications
in the New Year. It may be as we do that that we need to change the
template, but hopefully it is 'good enough' for first of type examples
currently.

The ReSPECT template is very UK specific, I think, but there may be lessons
to be learned or elements of the template that could be usefully used in
other contexts.

Please get in touch with me if you decide to use any of it or have any
comments/queries.

Best wishes

Paul

Dr Paul Miller
Glenburn Medical Practice
Fairway Avenue
Paisley
PA2 8DX
Tel: 0141 884 7788
http://www.glenburnsurgery.scot.nhs.uk/

SCIMP Clinical Lead
Tel: 07711 346 928
http://www.scimp.scot.nhs.uk/
Twitter @SCIMP_GP


On Fri, 23 Nov 2018 at 10:19, Ian McNicoll <ian at freshehr.com> wrote:

> 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
> truth.
>
> So, for instance, this national (Scotland) project
>
>
> https://www.mobihealthnews.com/content/former-skyscanner-cto-joins-nhs-scotland-build-national-digital-platform-%E2%80%98world-first%E2%80%99
>
> 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).
>
>  http://ckm.apperta.org/ckm/#showProject=1051.61.31
>
> This is a UK-wide project.
>
> There is also some older modelling work at
>
> http://ckm.apperta.org/ckm/#showProject=1051.61.4
>
> but some of this has been superceded by new requirements.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
> https://www.code24.nl/ 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
>
> Ian
>
> Dr Ian McNicoll
> mobile +44 (0)775 209 7859
> office +44 (0)1536 414994
> skype: ianmcnicoll
> email: ian at freshehr.com
> twitter: @ianmcnicoll
>
>
> Co-Chair, openEHR Foundation ian.mcnicoll at openehr.org
> 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 healthelife.in> 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
>> http://ckm.apperta.org/ckm/retrieveResources?list=true.
>>
>> 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: healthelife.in  e: dileep at healthelife.in
>>
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