Archetypes have a very important requirement: to be targetted
to an informatoin model which acts as a "base ontology". In openEHR we
use the openEHR reference model fr this purpose. This is what allows you
to write an archetype for somehting like "Apgar result", which needs to
use concepts like OBSERVATION (with properties data, state and
protocol), HISTORY (with properties events, origin), EVENT (property
data), and varous data structure types, like TREE, LIST, TABLE and SINGLE.
EN 13606 is not designed directly to support archetyping; it is designed
as a lowest-common denominator EHR data interoperability model, with
support for transmitting archetyped information.
This is not the same as providing sufficient ontological definitoins to
support the building or use of archetypes. If you were to use EN13606
literally for archetypes, you could only use ENTRY, CLUSTER and ELEMENT;
you will see that trying to define most clinical concepts with such a
weak ontology will be annoying difficult, error-prone, and ultimately
will not engage clinical professionals.
So openEHR currently offers at least part of a base ontology for
building archetypes, with concepts of sufficient strength to make
higher-level clinical concepts easily expressible. In the near future,
we intend to propose the creation of an agreed "base level ontology"
reference model, expressed in UML, for use by everybody for buiulding
archetypes. We will include the core of the openEHR reference model for
this (from COMPOSITION down); but we want other organisations to think
about what they need to see in this. There are other reference models
such as the Danish G-EPJ which have clean concepts which may need to be
in this base ontology; also ENV 13940 (continuity of care) models need
to be analysed for possible contributions. We will propose this base
ontology at the next CEN working group meeting. I believe people will
agree in principle.
A data mapping is also being defined between openEHR (and later, the
common base ontology) and EN13606. This wll enable 13606 to fulfull its
purpose, which is to move data faithfully between EHR sites, including
data which has been archetyped in those sites.
But please don’t try to directly archteype 13606 information structures
– you will be going down he wrong route!
– thomas beale (Posted in email@example.com discussion list)