ARCHETYPE Discharge summary (openEHR-EHR-ADMIN_ENTRY.discharge_summary.v0)

ARCHETYPE IDopenEHR-EHR-ADMIN_ENTRY.discharge_summary.v0
ConceptDischarge summary
DescriptionUsed for discharged patient only.
PurposeThis archetype was designed for presenting the discharged data.
ReferencesDerived from: <Add reference to original resource here>
- Tyler M; Boyer A; Martin S; Neiman J, Bakel LA, Brittan M. Development of a discharge readiness report within the electronic health record - a discharge planning tool. Journal of Hospital Medicine, v9«.9, n.8. 2014.
Copyright© openEHR Foundation, HiGHmed
AuthorsAuthor name: Priscila Maranhao; Gustavo Bacelar
Organisation: MEDCIDES/FMUP; VirtualCare
Email: priscilamaranhao@gmail.com; gbacalar@gmail.com
Date originally authored: 2017-06-27
Other Details LanguageAuthor name: Priscila Maranhao; Gustavo Bacelar
Organisation: MEDCIDES/FMUP; VirtualCare
Email: priscilamaranhao@gmail.com; gbacalar@gmail.com
Date originally authored: 2017-06-27
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=HiGHmed, references=Derived from: - Tyler M; Boyer A; Martin S; Neiman J, Bakel LA, Brittan M. Development of a discharge readiness report within the electronic health record - a discharge planning tool. Journal of Hospital Medicine, v9«.9, n.8. 2014. , original_namespace=org.highmed, original_publisher=HiGHmed, custodian_namespace=org.highmed, MD5-CAM-1.0.1=FFF8C6A6D1CCF30F6FF5B70CB57F52B7, build_uid=f9876465-7f7e-464e-8360-4203ea903104, revision=0.0.1-alpha}
Keywords
Lifecyclein_development
UID28d27d74-3405-4799-aad9-364ebd28f539
Language useden
Citeable Identifier1246.145.791
Revision Number0.0.1-alpha
AllArchetype [runtimeNameConstraintForConceptName=null, archetypeConceptBinding=null, archetypeConceptDescription=Used for discharged patient only. , archetypeConceptComment=null, otherContributors=Ricardo Correia, FMUP, Portugal
Pedro Vieira-Marques, FMUP, Portugal
Duarte Ferreira, FMUP, Portugal, originalLanguage=en, translators=
  • German: Kim Sommer, Antje Wulff, MHH, Peter L. Reichertz Institut für Medizinische Informatik der TU Braunschweig und der Medizinischen Hochschule Hannover, antje.wulff@plri.de

    • , subjectOfData=unconstrained, archetypeTranslationTree=null, topLevelToAshis={relationships=[], source=[], capabilities=[], activities=[], details=[], context=[], ism_transition=[], other_participations=[], data=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0040], code=at0040, itemType=ELEMENT, level=2, text=Discharge status, description=Discharge status. , 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[at0002], code=at0002, itemType=ELEMENT, level=2, text=Clinical condition of the patient, description=Clinical condition of the patient. , comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • Cured [Patient is cured. ]
    • Improved [Patient is improved]
    • Same state [The patient is in the same state of admission. ]
    • Worse [The patient is worse than on admission. ]
    • Deceased [The patient died during hospitalization. ]
    • Undetermined. [Undetermined. ]
    • *Sonstige(en) [*Sonstige(en)]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0011], code=at0011, itemType=ELEMENT, level=2, text=Discharge date/time, description=Date/Time the patiente was discharge. , 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[at0038], code=at0038, itemType=ELEMENT, level=2, text=Lenght of stay, description=Lenght of stay on hospital , comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_QUANTITY, bindings=null, values=Property: Time
    Units:
    • yr
    • h
    • mo
    • wk
    • d
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0051], code=at0051, itemType=ELEMENT, level=2, text=Discharge instructions , description=Discharge instructions to patients. , 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[at0050], code=at0050, itemType=ELEMENT, level=2, text=Additional information, description=Comments, 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[at0058], code=at0058, itemType=CLUSTER, level=2, text=Attending doctor, description=The attending doctor providing services to the patient. , comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0058]/items[at0059], code=at0059, itemType=ELEMENT, level=3, text=ID, description=*, 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[at0058]/items[at0060], code=at0060, itemType=ELEMENT, level=3, text=Family name, description=*, 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[at0058]/items[at0061], code=at0061, itemType=ELEMENT, level=3, text=Last name, description=*, 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[at0062], code=at0062, itemType=CLUSTER, level=2, text=Referring doctor, description=Clinician who referred patient to the consulting doctor. , comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0062]/items[at0065], code=at0065, itemType=ELEMENT, level=3, text=ID, description=*, 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[at0062]/items[at0064], code=at0064, itemType=ELEMENT, level=3, text=Family name, description=*, 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[at0062]/items[at0063], code=at0063, itemType=ELEMENT, level=3, text=Last name, description=*, 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[at0033], code=at0033, itemType=CLUSTER, level=2, text=Discharge doctor , description=Discharge doctor informations. , comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0033]/items[at0034], code=at0034, itemType=ELEMENT, level=3, text=ID, description=*, 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[at0033]/items[at0035], code=at0035, itemType=ELEMENT, level=3, text=Family name, description=*, 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[at0033]/items[at0036], code=at0036, itemType=ELEMENT, level=3, text=Last name, description=*, 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[at0066], code=at0066, itemType=SLOT, level=2, text=Last patient location, description=*, comment=null, 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], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0067], code=at0067, itemType=SLOT, level=2, text=*Cluster(en), description=**(en), comment=null, 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]], credentials=[], target=[], items=[], content=[], description=[], contacts=[], state=[], events=[], provider=[], identities=[], protocol=[]}, 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=0..*, subCardinalityText=Minimum of 0 items, dataType=ITEM_TREE, bindings=null, values=null, extendedValues=null]}, addHierarchyItemsTo=data, currentHierarchyItemsForAdding=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0040], code=at0040, itemType=ELEMENT, level=2, text=Discharge status, description=Discharge status. , 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[at0002], code=at0002, itemType=ELEMENT, level=2, text=Clinical condition of the patient, description=Clinical condition of the patient. , comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • Cured [Patient is cured. ]
    • Improved [Patient is improved]
    • Same state [The patient is in the same state of admission. ]
    • Worse [The patient is worse than on admission. ]
    • Deceased [The patient died during hospitalization. ]
    • Undetermined. [Undetermined. ]
    • *Sonstige(en) [*Sonstige(en)]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0011], code=at0011, itemType=ELEMENT, level=2, text=Discharge date/time, description=Date/Time the patiente was discharge. , 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[at0038], code=at0038, itemType=ELEMENT, level=2, text=Lenght of stay, description=Lenght of stay on hospital , comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_QUANTITY, bindings=null, values=Property: Time
    Units:
    • yr
    • h
    • mo
    • wk
    • d
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0051], code=at0051, itemType=ELEMENT, level=2, text=Discharge instructions , description=Discharge instructions to patients. , 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[at0050], code=at0050, itemType=ELEMENT, level=2, text=Additional information, description=Comments, 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[at0058], code=at0058, itemType=CLUSTER, level=2, text=Attending doctor, description=The attending doctor providing services to the patient. , comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0058]/items[at0059], code=at0059, itemType=ELEMENT, level=3, text=ID, description=*, 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[at0058]/items[at0060], code=at0060, itemType=ELEMENT, level=3, text=Family name, description=*, 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[at0058]/items[at0061], code=at0061, itemType=ELEMENT, level=3, text=Last name, description=*, 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[at0062], code=at0062, itemType=CLUSTER, level=2, text=Referring doctor, description=Clinician who referred patient to the consulting doctor. , comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0062]/items[at0065], code=at0065, itemType=ELEMENT, level=3, text=ID, description=*, 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[at0062]/items[at0064], code=at0064, itemType=ELEMENT, level=3, text=Family name, description=*, 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[at0062]/items[at0063], code=at0063, itemType=ELEMENT, level=3, text=Last name, description=*, 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[at0033], code=at0033, itemType=CLUSTER, level=2, text=Discharge doctor , description=Discharge doctor informations. , comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0033]/items[at0034], code=at0034, itemType=ELEMENT, level=3, text=ID, description=*, 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[at0033]/items[at0035], code=at0035, itemType=ELEMENT, level=3, text=Family name, description=*, 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[at0033]/items[at0036], code=at0036, itemType=ELEMENT, level=3, text=Last name, description=*, 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[at0066], code=at0066, itemType=SLOT, level=2, text=Last patient location, description=*, comment=null, 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], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0067], code=at0067, itemType=SLOT, level=2, text=*Cluster(en), description=**(en), comment=null, 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]], minIndents={}, termBindingRetrievalErrorMessage=null]