Instance structures of ACTION
- Rong Chen
Purpose
This page is created to facilate understanding of the EHR information model specification especially on the class ACTION. All ENTRY subclass like OBSERVATION and EVALUATION have a dedicated instance structures in the section 8.4 of the EHR Information Model specification except ACTION. The ACTION class is arguably the most complex ENTRY class due to its use of standard Instruction state machine.
Clnical Case
The clinical case modelled here is based on an example given by Dr. Andrew Gledhill as part of dicussion around Medication archetype. Basically it's about a medication of Amoxicillin 500 mg IV every 8 hrs for 4 days.
Instance Structures
1. Precribing Medication Order
The prescribing of the medication order should result in creation of the following instance structures:
INSTRUCTION
name = 'medication'
activities[0] =
ACTIVITY "Amoxicillin 500 mg IV, every 8 hrs, 4 days" // to be structrued
ACTION
name = 'medication'
ism_transition =
current_state = 'planned'
2. Administration / Execution of the Medication Order
The execution of the order should result in the following instances in the EHR, normally 12 instances given that the order is followed faithfully.
ACTION
name = 'medication'
ism_transition =
current_state = 'active'
details = 'Amoxicillin 500 mg IV'
3. Completion of the Medication Order
Once the 4 day course of the medicaiton is over, the last action will be created effectly setting the medicaiton order to 'completed' state.
ACTION
name = 'medication'
ism_transition =
current_state = 'completed'
Summary
This is still a very simple and standard scenario. It doesn't cover for instance, suspension of a medication, reviewing of an ongoing medication etc.
Note that in both ACTIONs starting and finishing the medication order, the details of the ACTION is not needed, only when recording the administration of the medication, the details are required in the ACTION, normally copying from the ACTIVITY.