Three PC/PA harmonization issues

The Encounter (ENC) act is a specialization of the Care Provision (PCPR) Act - and yet there are inconsistencies between the Patient Administration models and the Patient Care models when it comes to a number of issues. This proposal seeks to harmonize/address some of these issues.

These issues were initially touched upon during the October 2010 WGM In Cambridge. See also the Requirements for an Universal Encounter model wiki page and the links near the top of that page. Author: Rene Spronk, Ringholm bv, (consultants disclosure:) volunteer work on behalf of HL7 Norway.

Use of Author/Performer/Responsible

The Patient Administration and Patient Care domains are using some of the key participations in slightly different ways; or they are present bin one D-MIM and not in another. This makes it difficult to manage hierarchies in which some of the Acts are CareProvisions and others are Encounters.

From the Patient Administration D-MIM:

• Author:
• Performer:
• Responsible:

From the Patient Care D-MIM:

• Author:
• Performer:
• Responsible:

Recommendation: xxxxxxxxxxx

'Encounter Context' CMET defined by PatientCare

The A_CareEvent[universal] CMET, as used in the Patient Administration D-MIM, is used to identify the 'context' of the encounter. It currently contains a rather minimalistic version of a CareProvision Act. An encounter may be part of either an encounter or a care provision, or it may be part of a concern. (See Requirements for an Universal Encounter model for details). As such this CMET (or a replacement thereof to be included in the Patient Administration D-MIM) should be modified to allow for the proper identification of the context of an encounter.

Note that the modeling depends in part on the outcomes of the discussion regarding the harmonization of some key participations.

Add Reason to CareProvision D-MIM

xx and show why reason in clinical statement is not a solution to the use-case