ARCHETYPE Health risk assessment (openEHR-EHR-EVALUATION.health_risk.v1)

Name: Health risk assessment
License: http://creativecommons.org/licenses/by-sa/3.0/

ARCHETYPE ID	openEHR-EHR-EVALUATION.health_risk.v1
Concept	Health risk assessment
Description	Assessment of the potential and likelihood of future adverse health effects as determined by identified risk factors.
Use	Use to record known risk factors for an identified disease, condition, or other potentially adverse health issue, and/or an evaluation of the likelihood of the individual experiencing it in the future. As risk factors may be gradually identified over time and the overall risk reassessed as a result, the 'Date identified' will record the date on which each risk factor has been identified and the 'Last updated' data element will record the last time that the whole assessment was updated.
Purpose	To record known risk factors for an identified disease, condition, or other potentially adverse health issue, and/or an evaluation of the likelihood of the individual experiencing it in the future. This archetype has been deliberately left open and broad in scope. The 'Health Risk' could be determined from risk factors from any or all of: medical; biomarker; lifestyle; social; occupational hazard; or environmental domains. The intent of this archetype is to document potential risk at a point in time, and to support decision-making that may reduce the identified risk, whether by clinicians or the individual themselves.
References	Health Risk, draft archetype, NEHTA Clinical Knowledge Manager [Internet]. Australia: National eHealth Transition Authority. Authored: 2006 Apr 23. Available at: http://dcm.nehta.org.au/ckm/#showArchetype_1013.1.1276 (accessed 2015 Mar 04). Archetype originated from the openEHR CKM.
Copyright	© openEHR Foundation
Authors	Author name: Sam Heard Organisation: Ocean Informatics Email: sam.heard@oceaninformatics.com Date originally authored: 2006-04-23
Other Details Language	Author name: Sam Heard Organisation: Ocean Informatics Email: sam.heard@oceaninformatics.com Date originally authored: 2006-04-23
OtherDetails Language Independent	{licence=This work is licensed under the Creative Commons Attribution-ShareAlike 3.0 License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/3.0/., custodian_organisation=openEHR Foundation, references=Health Risk, draft archetype, NEHTA Clinical Knowledge Manager [Internet]. Australia: National eHealth Transition Authority. Authored: 2006 Apr 23. Available at: http://dcm.nehta.org.au/ckm/#showArchetype_1013.1.1276 (accessed 2015 Mar 04). Archetype originated from the openEHR CKM., current_contact=Heather Leslie, Ocean Informatics, heather.leslie@oceaninformatics.com, original_namespace=org.openehr, original_publisher=openEHR Foundation, custodian_namespace=org.openehr, MD5-CAM-1.0.1=65D0CC64E5D5CFA5CA44B57B9AC40D39, build_uid=33dd9e54-8348-4c5a-a246-3046fb6ed302, ip_acknowledgements=This artefact includes content from SNOMED Clinical Terms® (SNOMED CT®) which is copyrighted material of the International Health Terminology Standards Development Organisation (IHTSDO). Where an implementation of this artefact makes use of SNOMED CT content, the implementer must have the appropriate SNOMED CT Affiliate license - for more information contact http://www.snomed.org/snomed-ct/get-snomedct or info@snomed.org., revision=1.1.9}
Keywords	assessment, risk, evaluation, adverse, factor, health, issue, estimated, management, risk factor, risk stratification
Lifecycle	published
UID	70e1c139-739e-42be-992a-bb1891d222e8
Language used	en
Citeable Identifier	1246.145.1103
Revision Number	1.1.9
All	Archetype [runtimeNameConstraintForConceptName=null, archetypeConceptBinding=null, archetypeConceptDescription=Assessment of the potential and likelihood of future adverse health effects as determined by identified risk factors., archetypeConceptComment=null, otherContributors=Tomas Alme, DIPS, Norway Nadim Anani, Karolinska Institutet, Sweden Anne Pauline Anderssen, Helse Nord RHF, Norway Vebjørn Arntzen, Oslo universitetssykehus HF, Norway (Nasjonal IKT redaktør) Koray Atalag, University of Auckland, New Zealand Silje Ljosland Bakke, Helse Vest IKT AS, Norway (Nasjonal IKT redaktør) Lars Bitsch-Larsen, Haukeland University Hospital, Bergen, Norway Rong Chen, Cambio Healthcare Systems, Sweden Stephen Chu, Queensland Health, Australia Lisbeth Dahlhaug, Helse Midt - Norge IT, Norway Shahla Foozonkhah, Iran ministry of health and education, Iran Einar Fosse, UNN HF, Norwegian Centre for Integrated Care and Telemedicine, Norway Sebastian Garde, Ocean Informatics, Germany Gyri Gradek, Senter for medisinsk genetikk og molekylærmedisin, Haukeland Universitetssykehus, Norway Heather Grain, Llewelyn Grain Informatics, Australia Mikkel Gaup Grønmo, FSE, Helse Nord, Norway (Nasjonal IKT redaktør) Kristian Heldal, Telemark Hospital Trust, Norway Anca Heyd, DIPS ASA, Norway Tom Jarl Jakobsen, Helse Bergen, Norway Lars Karlsen, DIPS ASA, Norway Lars Morgan Karlsen, Nordlandssykehuset Bodø, Norway Heather Leslie, Ocean Informatics, Australia Hallvard Lærum, Direktoratet for e-helse, Norway Luis Marco Ruiz, Norwegian Center for Integrated Care and Telemedicine, Norway Ian McNicoll, freshEHR Clinical Informatics, United Kingdom (openEHR Editor) Rune Pedersen, Universitetssykehuset i Nord Norge, Norway Norwegian Review Summary, Nasjonal IKT HF, Norway Jussara Rotzsch, UNB, Brazil Line Sæle, Nasjonal IKT HF, Norway Jon Tysdahl, Furst medlab AS, Norway John Tore Valand, Haukeland Universitetssjukehus, Norway (Nasjonal IKT redaktør), originalLanguage=en, translators= German: Jasmin Buck, Sebastian Garde, Anneka Sargeant, Weronika Gujo, Natalia Strauch, University of Heidelberg, Cental Queensland University, Universitätsmedizin Göttingen, Medizinische Hochschule Hannover, Weronika.Gujo@med.uni-heidelberg.de, Strauch.Natalia@mh-hannover.de Swedish: Annika Terner, B3 Healthcare Consulting AB, annika.terner@b3.se, . Finnish: Spanish (Argentina): Alan March, Hospital Universitario Austral, Pilar, Buenos Aires, Argentina, alandmarch@gmail.com Norwegian Bokmål: John Tore Valand, Silje Ljosland Bakke, Marit Alice Venheim, Helse Bergen HF, Nasjonal IKT HF, Helse Vest IKT, Helse Vest IKT AS, marit.alice.venheim@helse-vest-ikt.no, silje.ljosland.bakke@helse-vest-ikt.no Greek: Erasmia Partafylla, Sigmasoft, c.partafylla@sigmasoft.gr Arabic (Syria): Mona Saleh Italian: , subjectOfData=unconstrained, archetypeTranslationTree=null, topLevelToAshis={activities=[], source=[], data=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0002], code=at0002, itemType=ELEMENT, level=2, text=Health risk, description=Identification of the potential future disease, condition or health issue for which the risk is being assessed, by name., comment=Coding of 'Health risk' with a terminology is preferred, where possible. Free text should be used only if there is no appropriate terminology available. For example: risk of cardiovascular disease, with risk factors of hypertension and hypercholesterolaemia., uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0016], code=at0016, itemType=CLUSTER, level=2, text=Risk factors, description=Details about each possible risk factor., comment=null, uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=1.., cardinalityText= (Cardinality: 1.., unordered), subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0016]/items[at0013], code=at0013, itemType=ELEMENT, level=3, text=Risk factor, description=Identification of the risk factor, by name., comment=For example: hypertension and hypercholesterolaemia, which may be used as part of the overall assessment for cardiovascular disease; or a genetic marker. Coding of 'Risk factor' with a terminology, where possible., uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0016]/items[at0017], code=at0017, itemType=ELEMENT, level=3, text=Presence, description=Presence of the risk factor., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0018::Present [The risk factor has been identified for this individual.] [SNOMED-CT::52101004 \| Present (qualifier value)] at0026::Indeterminate [It is not possible to determine if the risk factor is present or absent.] [SNOMED-CT::82334004 \| Indeterminate (qualifier value)] at0019::Absent [The risk factor has not been identified for this individual.] [SNOMED-CT::2667000 \| Absent (qualifier value)] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0016]/items[at0014], code=at0014, itemType=ELEMENT, level=3, text=Description, description=Narrative description about the risk factor., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0016]/items[at0029], code=at0029, itemType=ELEMENT, level=3, text=Date identified, description=The date/time that the risk factor was identified., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0016]/items[at0028], code=at0028, itemType=ELEMENT, level=3, text=Mitigated, description=The risk factor has been identified as present, but then subsequently been mitigated by treatment or investigation., comment=Record as True if the risk factor has been treated or investigated and risk from this risk factor is considered to be lessened. For example: an infant given gentamicin in neonatal intensive care is regarded as having a risk of permanent hearing loss. If diagnostic testing shows no evidence of hearing loss in the first year of life, the risk of later hearing loss is considered to be much reduced, but still possible. This data element allows clinicians to say that the risk has been mitigated but should still be considered as a possibility in future. In practice, the risk factor could be maintained in the risk assessment in case it might impact the individual's health at a future time, but flagging that its contribution to risk calculation may not be as great as if it had not been previously treated or investigated. , uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_BOOLEAN, bindings=null, values=Allowed values: {true}, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0016]/items[at0012], code=at0012, itemType=ELEMENT, level=3, text=Link to evidence, description=Identification of the path to the archetype or data node for the evidence of risk., comment=null, uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_URI, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0016]/items[at0027], code=at0027, itemType=SLOT, level=3, text=Detail, description=Structured detail about other aspects of the risk factor assessment., comment=For example: Prevalence of the risk factor in family members., uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:* openEHR-EHR-CLUSTER.family_prevalence.v1, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0016]/items[at0030], code=at0030, itemType=ELEMENT, level=3, text=Comment, description=Additional narrative about the risk factor not captured in other fields., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0003], code=at0003, itemType=ELEMENT, level=2, text=Risk assessment, description=Evaluation of the health risk., comment=There may be multiple variations on the assessment of risk. The Choice data type allows for recording of the assessment as either free text or value sets (such as low, medium or hig). The proportion data type allows recording of a percentage, a ratio or a fraction. The quantity data type allows recording of a decimal number., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of: Text Proportion Quantity Property: Qualified real Units: , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0020], code=at0020, itemType=ELEMENT, level=2, text=Assessment type, description=Record of whether the risk assessment is a relative or absolute., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0021::Relative risk [Ratio of probability of a health event or condition occurring compared to a population with similar characteristics eg same age and sex.] at0022::Absolute risk [Ratio of probability of a health event or condition occurring compared to the population as a whole.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0023], code=at0023, itemType=ELEMENT, level=2, text=Time period, description=The time period during which the predicted health risk is relevant., comment=That is: the risk of experiencing the identified 'Health risk' in the next <X> years., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DURATION, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0004], code=at0004, itemType=ELEMENT, level=2, text=Rationale, description=Justification for this risk assessment., comment=Details that may be added to this data element may include information about the population subgroups etc against which the determination of risk is assessed., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0015], code=at0015, itemType=ELEMENT, level=2, text=Comment, description=Additional narrative about the risk assessment not captured in other fields., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null]], contacts=[], protocol=[ResourceSimplifiedHierarchyItem [path=/protocol[at0010]/items[at0024], code=at0024, itemType=ELEMENT, level=2, text=Last updated, description=The date this health risk assessment was last updated., comment=This data element may be thought redundant if the data is recorded and stored using COMPOSITIONs within a closed clinical system. However if this information is extracted from its original COMPOSITION context, for example, to be included in another document or message then the temporal context is effectively removed. This 'Last updated' data element has been explicitly added to allow the critical temporal data to be kept alongside the clinical data in all circumstances. It is assumed that the clinical system can copy the date from the COMPOSITION to reduce the need for duplication of data entry by the clinician., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/protocol[at0010]/items[at0025], code=at0025, itemType=ELEMENT, level=2, text=Assessment method, description=Identification of the algorithm or guideline used to make the assessment of risk., comment=For example: Framingham cardiovascular risk calculator., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/protocol[at0010]/items[at0011], code=at0011, itemType=SLOT, level=2, text=Extension, description=Additional information required to capture local content or to align with other reference models/formalisms., comment=For example: local information requirements or additional metadata to align with FHIR or CIMI equivalents., uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:* All not explicitly excluded archetypes, extendedValues=null]], content=[], identities=[], target=[], events=[], provider=[], items=[], state=[], relationships=[], credentials=[], description=[], context=[], ism_transition=[], capabilities=[], other_participations=[], details=[]}, topLevelItems={data=ResourceSimplifiedHierarchyItem [path=ROOT_/data[at0001], code=at0001, itemType=ITEM_TREE, level=0, text=null, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=0..1, cardinalityText=optional, subCardinalityFormal=1.., subCardinalityText= (Cardinality: 1.., ordered), dataType=ITEM_TREE, bindings=null, values=null, extendedValues=null], protocol=ResourceSimplifiedHierarchyItem [path=ROOT_/protocol[at0010], code=at0010, itemType=ITEM_TREE, level=0, text=null, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=0..1, cardinalityText=optional, subCardinalityFormal=0.., subCardinalityText=Minimum of 0 items (Cardinality: 0.., unordered), dataType=ITEM_TREE, bindings=null, values=null, extendedValues=null]}, addHierarchyItemsTo=protocol, currentHierarchyItemsForAdding=[ResourceSimplifiedHierarchyItem [path=/protocol[at0010]/items[at0024], code=at0024, itemType=ELEMENT, level=2, text=Last updated, description=The date this health risk assessment was last updated., comment=This data element may be thought redundant if the data is recorded and stored using COMPOSITIONs within a closed clinical system. However if this information is extracted from its original COMPOSITION context, for example, to be included in another document or message then the temporal context is effectively removed. This 'Last updated' data element has been explicitly added to allow the critical temporal data to be kept alongside the clinical data in all circumstances. 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