Re: [COAS-List] SGML Thread on Report Types

[Tim Brinson <tim@protocol.com>]

Wayne Wilson wrote:
> 
> It would seem like the lesson here (as futilely noted by one
> participant) is that the attempt to exhaustively list types has dubious
> value.  This problem space has been investigated so many times with
> similar results.  Attempts to standardize on a particular 'slice'
> through an information space only lead to frustrations and ugly
> implementations that have to find away around the arbitrary
> classifications.  There will be as many classifications as there are
> reasons for classifying.  Billing is a good reason for billing purposes
> but maybe not for the in-person patient care, nor for the public health
> investigation, und so on.

Right.  The reason I thought this was interesting for COAS is that I
figure the reports are the base Observation node.  Given that each
Observation has a QualifiedCode for the observation type it would be
used for the report type in this case.  Now, who defines the codes for
reports is another matter.  Over time there may be some standardized
ones but a lot of them will be locally defined by a hospital or maybe
even by providers.  COAS should be able to work with any of these.

Another part of the thread that was interesting was the discussion on
headings/catagories.  It sounds like a patient record may have things
like lists of alergies, history, problems, etc.  

	One question I pose to ALL of us - are these Observations?

The members of CORBAmed has asked us many times to extend COAS scope to
anything in the patient record.  At the Welches meeting we decided to do
this but I am not sure we all have a common understanding of what that
means.  

When I have asked some other knowedgeable people in this area they
indicated that alergy lists, etc. are catagories, NOT Observations. 
This was a couple hours after they indicated that Observations can be
anything in the patient record.  

I think the Alergies List in the patient record somehow links to (or
derives information from) observations that the patient has those
alergies. But, is the Alergies List itself another Observation?

Our current COAS model does not try to model a patient record.  However
I think it does model the bulk of the content that will be put in a
patient record (Observations).

Any other thoughts on this?


Tim
begin:vcard 
n:Brinson;Tim
x-mozilla-html:TRUE
org:Protocol Systems, Inc.
adr:;;8500 SW Creekside Place;Beaverton;Oregon;97008-7107;USA
version:2.1
email;internet:tim@protocol.com
title:Systems Software Lead
tel;fax:503 526 4200
tel;work:503 526 4392
note:<img src=http://aco.protocol.com/pids/tbrinson.jpg>
x-mozilla-cpt:;0
fn:Tim Brinson
end:vcard