Use to record structured details of a single, complex direction for an ordered or requested service.
This archetype has been designed to be nested within the 'Complex timing' SLOT in the INSTRUCTION.service_request archetype, but may be used within other clinically relevant archetypes, as required. Multiple instances of this archetype may be required to represent a complex order for services, especially ones with changing frequency or patterns of delivery over time.
Each service direction provides detailed guidance about one or more sequential activities, each comprising an amount and an intradaily timing, together with an overall direction duration and details of any repetitive pattern outside a single day. Each activity pair allows for a complex intradaily pattern to be described, such as 2 hours of nursing assistance in the morning and one hour in the evening.
Each service direction may apply for a fixed duration of time, or fixed number of services, which is specified using the 'Total amount' data element.
The total amount for the entire service request, is recorded in the INSTRUCTION.service_request.
For example:
- 'Home nursing assistance for 2 hours in the morning and 1 hour in the evening for a period of 6 weeks, followed by 1 hour in the morning only for a further 6 weeks';
- 'Dialysis blood test package to be carried out: The second Wednesday of the month in January, March, May, July, September and November';
- 'INR daily for one week, weekly for one month, monthly for six months'; or
- 'Vital signs observations every hour for four hours, then every two hours for 12 hours'.
The CLUSTER can be renamed in template or at run-time to represent a specific service direction such as 'First four hours after surgery'.
Organisation: Atomica Informatics
Email: heather.leslie@atomicainformatics.com
Date originally authored: 2017-03-22
Organisation: Atomica Informatics
Email: heather.leslie@atomicainformatics.com
Date originally authored: 2017-03-22
- Licence: This work is licensed under the Creative Commons Attribution-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/4.0/.
- Custodian Organisation: openEHR Foundation
- References: Derived from: Therapeutic direction, Published archetype [Internet]. openEHR Foundation, openEHR Clinical Knowledge Manager [cited: 2017-12-05]. Available from: http://openehr.org/ckm/#showArchetype_1013.1.2753
- Original Namespace: org.openehr
- Original Publisher: openEHR Foundation
- Custodian Namespace: org.openehr
- MD5-CAM-1.0.1: 0EE9628D2B91CB934A0F3D31546F727F
- Build Uid: 40cda3d0-9891-468c-86a2-c9a024383b2a
- Revision: 1.0.1
For example: ''1' '2', '3'. Where multiple directions are expressed, the 'Direction sequence' makes the order in which they should be executed explicit. For example: (1) 4 times daily for 3 days, (2) 2 times daily for 4 days, (3) 1 time daily for 7 days.
min: >=1
For example: "At 07:00 every Monday, 30 minutes duration, for the next three months".
For example: home nursing request for 2 hours in the morning as one activity and 1 hour in the evening as a second activity.
min: >=1
Represented either as the number of services or the duration of service/s.
Choice of:
Count
min: >=1
Duration
>=1 second
Include:
openEHR-EHR-CLUSTER.timing_
For example: 'for 7 days','Indefinite'. An example of a set of multiple directions, with varying durations might be '1 time daily for 3 days, 2 times daily for 4 days, then 3 times Indefinite'.
Choice of:
Coded Text- Indefinite [The direction should be continued indefinitely.]
- Duration
>=1 second 
Text
For example: 'every 3 days', 'on Thursdays and Sundays', '3 days after onset of menstruation'. This SLOT is not for timings within a 24 hour interval.
Include:
openEHR-EHR-CLUSTER.timing_
Example: 'Perform once only' = 1; or '30 hours'.
Choice of:
- Count
min: >=1 - Duration
>=1 second
Include:
All not explicitly excluded archetypes
Vebjørn Arntzen, Oslo University Hospital, Norway (openEHR Editor)
Koray Atalag, University of Auckland, New Zealand
Heidi Aursand, Oslo universitetssykehus, Norway
Silje Ljosland Bakke, Helse Vest IKT AS, Norway (openEHR Editor)
Marcus Baw, openGPSoC / BawMedical Ltd, United Kingdom
John Bennett, NEHTA, Australia
SB 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
Mikkel Gaup Grønmo, FSE, Helse Nord, Norway (Nasjonal IKT redaktør)
Heather Grain, Llewelyn Grain Informatics, Australia
Trina Gregory, cpc, Australia
Robert Hausam, Hausam Consulting LLC, United States
Sam Heard, Ocean Informatics, Australia (Editor)
Anca Heyd, DIPS ASA, Norway
Roar Holm, Helse Vest IKT A/S, Norway
Evelyn Hovenga, EJSH Consulting, Australia
Gunnar Jårvik, Nasjonal IKT HF, Norway
Lars Morgan Karlsen, DIPS ASA, Norway
Mary Kelaher, NEHTA, Australia
Robert L'egan, NEHTA, Australia
Liv Laugen, Oslo University Hospital, Norway, Norway (openEHR Editor)
Russell Leftwich, Russell B Leftwich MD, United States
Heather Leslie, Atomica Informatics, Australia (openEHR Editor)
Colin Macfarlane, Elsevier, United Kingdom
Marlene Mann, BN, MCE, CPHIMS-CA, Prosci Certified, Foundation Knowledge Provincial CMIO, Alberta Health Services, Canada
Susan McIndoe, Royal District Nursing Service, Australia
David McKillop, NEHTA, Australia
Ian McNicoll, freshEHR Clinical Informatics, United Kingdom
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
Cathy Richardson, NEHTA, Australia
Robyn Richards, NEHTA - Clinical Terminology, Australia
Ed Schwab,RD, CPHIMS-CA, Foundational Knowledge - Provincial CMIO, Alberta Health Services, Canada
Gro-Hilde Severinsen, Norwegian center for ehealthresearch, Norway
Anoop Shah, University College London, United Kingdom
Line Silsand, Universitetssykehuset i Nord-Norge, Norway
Katrina Simpson-Pineda, RN, BN, Clinical Knowledge Topics - Provincial CMIO, Alberta Health Services, Canada
Iztok Stotl, UKCLJ, Slovenia
Norwegian Review Summary, Nasjonal IKT HF, Norway
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
Marit Alice Venheim, Helse Vest IKT, Norway (openEHR Editor)
Kylie Young, The Royal Australian College of General Practitioners, Australia
- Swedish: Therese Lindberg, Cambio CDS, therese.lindberg@cambio.se
- Norwegian Bokmål: Silje Ljosland Bakke og John Tore Valand, Liv Laugen, Helse Vest IKT og Helse Bergen HF, Oslo University Hospital, Norway, john.tore.valand@helse-bergen.no, liv.laugen@ous-hf.no