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Re: A question of Demographics
Dear Jinny
Roles
I agree with your idea of combining all patient demographics, whether
Patient related or not. I think that the information about a person
should all be linked to that person and i would make a slight
modification to your model thus (use courier to view the diagram):
---------- ------------- ---------
| Person | 0..1 m | Role | |Time |
| |-----------------------| |-----| Period|
|________| |___________| |_______|
| |m
| |
---------------- |
| Person | m |
| property |----------------------
|______________| <<context for person property
Thus the role is the context in which the information is held. This
means that we can share information eisily, whilst also being able to
identify the origin or nature. Role may be that of the person about
whom we are holding the information (patient), but it might be
another role (provider) providing us with the information about where
the information was originated (ie the same person property may have
more than one role as context (patient and provider)).
Encounters
By relationships between patients and providers, I meant both
financial and clinical realtionships - indeed I meant any
relationship. WRT general definition of encounter, I think it is
necessary to define the fundamental business processes that are going
on, rather than try to define the word. For example, we know from
the Helsinki discussions that the word encounter means very different
things in the USA, Belgium and the UK.
I hope this helps
Peter
> > I think Patient Demographics is just as much a part of the patient
> > record as it is a part of the management of the encounter. However,
> > *Person* Demographics may be thought of as having a broader role,
> > where some persons have no patient role at all, but are nontheless
> > described in some detail (this would especially apply to clinicians).
> there is a model that i have inmind for demographiccs, i dont know how to
> explain in words, but I'll try.....
>
> I believe we would like one model that captures all demographic
> information, whether it is of a patient or a non-patient.
> Tell me, are we looking to model 'persons' (read non-patients) as one
> entity and patients as a different peer entity? Ofcourse, given a patient
> you should know who the person is.
> Lets go back to the roles that I mentioned before. Supose we treat patient
> as one of many roles a person can have, then "Patient demographics" is
> nothing but a combination of 1."Person demographics" for that patient and
> 2. some demographic information that is specific to patients. do I make
> sense? Maybe this figure will help:
>
>
> ---------- ------------- ---------
> | Person | 1 m | PersonRole| |Time |
> | |-----------------------| |-----| Period|
> |________| |___________| |_______|
> | |
> | |
> ---------------- -------------
> | Person | | Role-based|
> | demographics | |properties |
> |______________| |___________|
>
>
> PersonRole may have many subtypes: Patient, Guarantor, Nurse, Physician
> etc.. Time period is basically to capture the time during which this role
> was active. For that matter all demographic properties will also have some
> time period since names, addresses etc change all the time.
>
> > A Person has some properties which are not dependent upon role.
> > Examples would be: DoB, Gender, Primary language, ethnicity,
> > Primary name, home address, next of kin. We might also include such
> > things as professional qualifications, experience, demonstrable
> > skills, although we might argue that these have some broad role or,
> > at least, domain.
> yes, i agree that there are some role-based and some person based
> properties. At the same time, we are mostly interested in a peron only if
> they have a role in our organization. In other words, we collect
> name from a person when he is, say, a patient. So, shouldnt we somehow
> keep track of which role provided "name" (which according to the above
> paragraph is a property of a person)?
>
> > corbamed/98-03-10: Person Demographics
> I have read this article several times and find it most informative!
>
> > On the other hand we have very role dependent properties for a
> > person. A nurse may be authorised to perform certain types of
> > professional activities in certain organisational contexts, for
>
> Or: a patient has a relationship with a guarantor (another role), and this
> is a role-based property. it would be a good idea to identify the roles in
> a healh care organization and find their corresponding role-based
> properties. Any work that has been done here...?
>
> > It's a seriously heavy topic that kept us very busy at the CORBAmed
> > meeting in Helsinki. The relationships between healthcare providers
> > and patients can be various. Examples:
>
> From my understanding 1,2 and 3 are, loosely speaking, encounters. And as
> for 5; according to the CHIC report it is classified as an episode made up
> of (at some level) encounters.
> In 4, are you referring to plan of care?
> Anyway, I think we must try to define encounters so atleast we can start
> defining the line where encounters end and other clinical events (orders
> etc..) begin. Do you agree?
> BTW, you use the word "relationships" for the following 5 points. What
> exactly do you mean by that?
>
> > 1. An encounter that is the basic unit of accounting and is set up on
> > at the start of a period of care, and continues to exist as a charging
> > reference until deemed to be complete (whenever that may be). (In the
> > UK we sometimes call this a "completed consultant episode").
> >
> > 2. An inpatient or outpatient visit.
> >
> > 3. A visit to a particular specialist: say cardiologist or
> > radiologist/radiographer.
> >
> > 4. The *clinical* responsibility that a medic, nurse or PAM has for a
> > patient, the nature of that responsibility, its start timepoint and
> > end timepoint.
> >
> > 5. An episode of a disease or morbidity, the clinical activities
> > performed to manage, control or cure it, its start and end
> > timepoints and who defined that episode.
> >
> > I'm sure others can think of more.
> >
> > Peter Nicklin
> >
> > _____________________________________________________________________
> > Peter Nicklin, NHS IMC,
> > c/o CHSR, 21 Claremont Place, Newcastle Upon Tyne, NE2 4AA, UK
> > Tel: +44 191 230 3614 Fax: +44 191 230 4563 Mobile: +44 831 198319
> > X400: imc/G=Peter/S=Nicklin/O=nhs_imc/OU=cbs@mhs.attmail.com
> >
>
>
> Jinny.
>
>
_____________________________________________________________________
Peter Nicklin, NHS IMC,
c/o CHSR, 21 Claremont Place, Newcastle Upon Tyne, NE2 4AA, UK
Tel: +44 191 230 3614 Fax: +44 191 230 4563 Mobile: +44 831 198319
X400: imc/G=Peter/S=Nicklin/O=nhs_imc/OU=cbs@mhs.attmail.com
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