ARCHETYPE Therapeutic direction (openEHR-EHR-CLUSTER.therapeutic_direction.v0)

ARCHETYPE IDopenEHR-EHR-CLUSTER.therapeutic_direction.v0
ConceptTherapeutic direction
DescriptionStructured details of a single therapeutic direction for an ordered item, such as a medication or blood transfusion order.
UseA direction describes one or more sequential therapeutic administration patterns, coupled with an overall direction duration and details of any repetitive pattern of intended administration outside a single day. For example: '1 tab in the morning, 1 tab at night, for 3 weeks, on Mondays, Wednesdays and Fridays'. This cluster allows multiple occurrences to enable representation of a complete set of dosage directions for a single medication order. The cluster can be renamed in template or at run-time to represent a specific dosing event such as 'loading dose', 'bolus'. This archetype will gnerally be used in the context of a parent INSTRUCTION archetype, primarily Medication order but also for transfusion and dialysis orders.
PurposeTo record structured details of a single therapeutic direction for an ordered therapeutic/prescribable item. Each direction generally applies for a given duration, or fixed number of administrations.
ReferencesDerived from: <Add reference to original resource here>
Medication instruction, Draft Archetype [Internet]. nehta, Australia, nehta Clinical Knowledge Manager [cited: 2015-12-15]. Available from: http://dcm.nehta.org.au/ckm/#showArchetype_1013.1.838

Intermountain Healthcare Medication order model, Personal Communication to Sam Heard by Dr Stan Huff.

Royal Australian College of General Practitioners. Fact Sheet: Medicines List. 2010.

NHS HSCIC Messaging Implementation Manual (GP2GP messages) http://www.uktcregistration.nss.cfh.nhs.uk/trud3

Standards for medication and medical device records – technical annex [Internet]. RCP London. [cited 2015 Dec 15]. Available from: https://www.rcplondon.ac.uk/projects/outputs/standards-medication-and-medical-device-records-technical-annex
Copyright© openEHR Foundation, HiGHmed
AuthorsAuthor name: Ian McNicoll
Organisation: freshEHR Clinical Informatics
Email: ian@freshehr.com
Date originally authored: 2017-03-22
Other Details LanguageAuthor name: Ian McNicoll
Organisation: freshEHR Clinical Informatics
Email: ian@freshehr.com
Date originally authored: 2017-03-22
OtherDetails Language Independent{licence=This work is licensed under the Creative Commons Attribution-ShareAlike 4.0 License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/4.0/., custodian_organisation=HiGHmed, references=Derived from: Medication instruction, Draft Archetype [Internet]. nehta, Australia, nehta Clinical Knowledge Manager [cited: 2015-12-15]. Available from: http://dcm.nehta.org.au/ckm/#showArchetype_1013.1.838 Intermountain Healthcare Medication order model, Personal Communication to Sam Heard by Dr Stan Huff. Royal Australian College of General Practitioners. Fact Sheet: Medicines List. 2010. NHS HSCIC Messaging Implementation Manual (GP2GP messages) http://www.uktcregistration.nss.cfh.nhs.uk/trud3 Standards for medication and medical device records – technical annex [Internet]. RCP London. [cited 2015 Dec 15]. Available from: https://www.rcplondon.ac.uk/projects/outputs/standards-medication-and-medical-device-records-technical-annex, current_contact=Ian McNicoll, freshEHR Clinical Informatics, UK , original_namespace=org.highmed, original_publisher=HiGHmed, custodian_namespace=org.highmed, MD5-CAM-1.0.1=9E43C411DDFEDCC4E470583425B8FE7F, build_uid=8f4f6896-8fb0-4883-beb3-f0f567a2ce85, revision=0.0.1-alpha}
Keywordsmedication, order, prescribe, therapy, substance, drug, therapeutic, otc, therapeutic good, pharmaceutical, product, posology, treatment, transfusion
Lifecyclein_development
UID05851f8b-6cd5-4222-855a-4111ab261e1f
Language useden
Citeable Identifier1246.145.24
Revision Number0.0.1-alpha
AllArchetype [runtimeNameConstraintForConceptName=null, archetypeConceptBinding=null, archetypeConceptDescription=Structured details of a single therapeutic direction for an ordered item, such as a medication or blood transfusion order., archetypeConceptComment=null, otherContributors=Vebjørn Arntzen, Oslo University Hospital, Norway
Koray Atalag, University of Auckland, New Zealand
Silje Ljosland Bakke, Nasjonal IKT HF, Norway (openEHR Editor)
Marcus Baw, openGPSoC / BawMedical Ltd, United Kingdom
John Bennett, NEHTA, Australia
SB BHATTACHARYYA, Sudisa Consultancy Services, India
SBhusan Bhattacharyya, Sudisa Consultancy Services, India
Sharmila Biswas, Australia
Lars Bitsch-Larsen, Haukeland University hospital, Norway
Stephen Chu, NEHTA, Australia (Editor)
Matthew Cordell, NEHTA, Australia
Gail Easterbrook, Flinders Medical Centre, Australia
David Evans, Queensland Health, Australia
Hildegard Franke, freshEHR Clinical Informatics Ltd., United Kingdom
Sarah Gaunt, NEHTA, Australia
Heather Grain, Llewelyn Grain Informatics, Australia
Trina Gregory, cpc, Australia
Robert Hausam, Hausam Consulting LLC, United States
Sam Heard, Ocean Informatics, Australia (Editor)
Evelyn Hovenga, EJSH Consulting, Australia
Mary Kelaher, NEHTA, Australia
Robert L'egan, NEHTA, Australia
Russell Leftwich, Russell B Leftwich MD, United States
Heather Leslie, Ocean Health Systems, Australia (openEHR Editor)
Colin Macfarlane, Elsevier, United Kingdom
Susan McIndoe, Royal District Nursing Service, Australia
David McKillop, NEHTA, Australia
Ian McNicoll, freshEHR Clinical Informatics, United Kingdom (openEHR Editor)
Chris Mitchell, RACGP, Australia
Stewart Morrison, NEHTA, Australia
Andrej Orel, Marand d.o.o., Slovenia
Chris Pearce, Melbourne East GP Network, Australia
Vladimir Pizzo, Hospital Sírio Libanês, Brazil
Camilla Preeston, Royal Australian College of General Practitioners, Australia
Margaret Prichard, NEHTA, Australia
Norwegian Review Summary, Nasjonal IKT HF, Norway
Cathy Richardson, NEHTA, Australia
Robyn Richards, NEHTA - Clinical Terminology, Australia
Anoop Shah, University College London, United Kingdom
Iztok Stotl, UKCLJ, Slovenia
John Taylor, NEHTA, Australia
Nyree Taylor, Ocean Informatics, Australia
Richard Townley-O'Neill, NEHTA, Australia
John Tore Valand, Helse Bergen, Norway (openEHR Editor)
Ines Vaz, UFN, Portugal
Kylie Young, The Royal Australian College of General Practitioners, Australia, originalLanguage=en, translators=Norwegian Bokmål: Silje Ljosland Bakke, Nasjonal IKT HF
Portuguese (Brazil): Beatriz de Faria Leao, BLEAO Informática em Saúde, bfleao@terra.com.br, MD, PhD
, subjectOfData=unconstrained, archetypeTranslationTree=null, topLevelToAshis={relationships=[], identities=[], provider=[], content=[], events=[], data=[], credentials=[], capabilities=[], target=[], items=[ResourceSimplifiedHierarchyItem [path=/items[at0057], code=at0057, itemType=ELEMENT, level=1, text=Direction sequence, description=The intended position of this direction within the overall sequence of directions., comment=For example: ''1' '2', '3'. Where multiple dosage directions are expressed, the 'Direction sequence' makes the order in which they should be executed explicit. For example: (1) 1 tab daily for 3 days, (2) 1 tab twice daily for 4 days, (3) 1 tablet for 7 days. , uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=min: >=1

, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0176], code=at0176, itemType=SLOT, level=1, text=Dosage, description=The combination of a medication dose and administration timing for a single day., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
openEHR-EHR-CLUSTER.dosage.v1 and specialisations, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0066], code=at0066, itemType=ELEMENT, level=1, text=Direction duration, description=The length of time for which this direction should be applied., comment=For example: 'for 7 days','Indefinite'. An example of a set of multiple directions, with varying durations might be ... '1 tablet daily for 3 days, 2 tablets daily for 4 days, then 3 tablets Indefinite'., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
  •  Coded Text
    • Indefinite [The direction should be continued indefinitely.]
    • Indefinite - not to be discontinued [The direction should be continued indefinitely with a strong recommendation that it never be discontinued.]
  •  Duration
    >=0 seconds
  •  Text
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0172], code=at0172, itemType=ELEMENT, level=1, text=Maximum number of administrations, description=The maximum number of administrations to be given for this direction., comment=Example: 'Give once only' = 1 or '400mg 12hrly for 3 doses' = 3., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=min: >=1

, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0090], code=at0090, itemType=SLOT, level=1, text=Direction repetition, description=Structured details about pattern of repetition for each set of daily directions., comment=For example: 'every 3 days', 'on Thursdays and Sundays', '3 days after onset of menstruation'., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
openEHR-EHR-CLUSTER.timing_repetition.v0 and specialisations, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0156], code=at0156, itemType=SLOT, level=1, text=Additional details, description=Further details about an ordered item direction., comment=For example, conditional instructions such as insulin /glucose infusion rates dependent on blood glucose, or detailed administration instructions for particular preparations., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
openEHR-EHR-CLUSTER.conditional_medication_rules.v0 and specialisations, extendedValues=null]], protocol=[], ism_transition=[], contacts=[], activities=[], context=[], other_participations=[], state=[], details=[], description=[], source=[]}, topLevelItems={items=ResourceSimplifiedHierarchyItem [path=ROOT_/, code=at0000, itemType=CLUSTER, level=0, text=null, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=null, extendedValues=null]}, addHierarchyItemsTo=items, currentHierarchyItemsForAdding=[ResourceSimplifiedHierarchyItem [path=/items[at0057], code=at0057, itemType=ELEMENT, level=1, text=Direction sequence, description=The intended position of this direction within the overall sequence of directions., comment=For example: ''1' '2', '3'. Where multiple dosage directions are expressed, the 'Direction sequence' makes the order in which they should be executed explicit. For example: (1) 1 tab daily for 3 days, (2) 1 tab twice daily for 4 days, (3) 1 tablet for 7 days. , uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=min: >=1

, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0176], code=at0176, itemType=SLOT, level=1, text=Dosage, description=The combination of a medication dose and administration timing for a single day., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
openEHR-EHR-CLUSTER.dosage.v1 and specialisations, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0066], code=at0066, itemType=ELEMENT, level=1, text=Direction duration, description=The length of time for which this direction should be applied., comment=For example: 'for 7 days','Indefinite'. An example of a set of multiple directions, with varying durations might be ... '1 tablet daily for 3 days, 2 tablets daily for 4 days, then 3 tablets Indefinite'., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
  •  Coded Text
    • Indefinite [The direction should be continued indefinitely.]
    • Indefinite - not to be discontinued [The direction should be continued indefinitely with a strong recommendation that it never be discontinued.]
  •  Duration
    >=0 seconds
  •  Text
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0172], code=at0172, itemType=ELEMENT, level=1, text=Maximum number of administrations, description=The maximum number of administrations to be given for this direction., comment=Example: 'Give once only' = 1 or '400mg 12hrly for 3 doses' = 3., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=min: >=1

, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0090], code=at0090, itemType=SLOT, level=1, text=Direction repetition, description=Structured details about pattern of repetition for each set of daily directions., comment=For example: 'every 3 days', 'on Thursdays and Sundays', '3 days after onset of menstruation'., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
openEHR-EHR-CLUSTER.timing_repetition.v0 and specialisations, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0156], code=at0156, itemType=SLOT, level=1, text=Additional details, description=Further details about an ordered item direction., comment=For example, conditional instructions such as insulin /glucose infusion rates dependent on blood glucose, or detailed administration instructions for particular preparations., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
openEHR-EHR-CLUSTER.conditional_medication_rules.v0 and specialisations, extendedValues=null]], minIndents={}, termBindingRetrievalErrorMessage=null]