Last Thursday & Friday @hughleslie and I presented a two day training course on openEHR clinical modelling. Introductory training typically starts with a day to provide an overview – the “what, why, how” about openEHR, a demo of the clinical modelling methodology and tooling, followed by setting the context about where and how it is being used around the world. Day Two is usually aimed at putting away the theoretical powerpoints and getting everyone involved – hands on modelling.

At the end of Day One I asked the trainees to select something they will need to model in coming months and set it as our challenge for the next day. We talked about the possibility health or discharge summaries – that’s pretty easy as we largely have the quite mature content for these and other continuity of care documents. What they actually sent through was an Antineoplastic Drug Administration Checklist, a Chemotherapy Ambulatory Care Nursing Intervention and Antineoplastic Drug Patient Assessment Tool! Sounded rather daunting! Although all very relevant to this group and the content they will have to create for the new oncology EHR they are building.

Perusing the Drug Checklist ifrst – it was easily apparent it going to need template comprising mostly ACTION archetypes but it meant starting with some fairly advanced modelling which wasn’t the intent as an initial learning exercise.. The Patient Assessment Tool, primarily a checklist, had its own tricky issues about what to persist sensibly in an EHR. So we decided to leave these two for Day Three or Four or..!

This post is inspired by a slightly out-of-control discussion among people in the CIMI group. It’s a good discussion. The latest question that has come up is whether a DCM (Detailed Clinical Model) is a ‘model of use’ (i.e. some kind of data set) or a ‘model of meaning’ (i.e. some kind of ontological definition).

I guess I don’t want to get into what a DCM is, since that seems to be topical, but certainly an archetype is a model of use, not a model of meaning. I would expect DCMs to be the same – they don’t need to replicate the function of SNOMED CT, OGMS, FMA or other terminology / ontology that defines meaning.