Reporting patterns and Questionnaires

Ian McNicollopenEHR Foundation /

Ocean Informatics

Do you smoke? Yes/NoIf Yes …

• What do you smoke? Cigarettes | cigar | eCigs | pipe• How much? ….. cigs per day• When did you start? Dd/mm/yyyy

• What triggers you to start smoking?

• Did you stop after you discovered you were pregnant? Y/N• Did you stop after you were scheduled for surgery? Y/N

• Do you use any other forms of tobacco?

Substance use pattern

Tobacco Use Summary

Detailed Tobacco Use (Diary)

Questionnaires are nasty...

Questionnaires

What is a Questionnaire?– “Did the patient have chest pain?”

Where are they found?– Data entry forms• e.g. Emergency admission with chest pain• Structured, efficient layout on screen, paper• Act as a protocol

– Reporting• Quality indicators• Public health statistics

Why are these so hard to model?

Questionnaire - example

FHIR Questionnaire“There is considerable overlap between the information covered by Questionnaires and other Resources (especially FamilyHistory, MedicationStatement, Observation, Procedure, etc.):

Questionnaire's flexible structure can easily be misused to capture any data, even data that should be captured as separate Resources.”

• http://hl7.org/implement/standards/fhir/questionnaire.html

FHIR Resource

HL7 QRDA

Archetypical

• https://omowizard.wordpress.com/2014/02/21/the-questionnaire-challenge/

SHN Heart Failure Summary

• http://www.openehr.org/ckm/#showArchetype_1013.1.1416

Open-> Closed questioning?

• Tell me about your hair? “Hair is blonde”

• What colour is your hair? “Blonde”

• What colour is your hair? Blonde|Brown|Black

• Are you a blonde? Y/N

Open->Closed

• Increasing constraint on the problem space

• Moves semantics from the Answer (value) to the Question (name)

More Questions than answers

• Do we pay enough attention to the semantics of questionnaires or is this ‘just a UI issue’?

• Can we assert• h/o Diabetes = Yes

– equivalent to • Past History of diabetes ?

• Can we develop a framework of Questionnaire use to guide developers on the ‘Resource’ vs. questionnaire issue?

Questionnaire - example