ARCHETYPE *Problem/Diagnosis!(en) (openEHR-EHR-EVALUATION.problem_diagnoses_zn.v1)

ARCHETYPE IDopenEHR-EHR-EVALUATION.problem_diagnoses_zn.v1
Concept*Problem/Diagnosis!(en)
Description*Any health care condition which may impact on to mental, physical health of patient!(en)
UseZa dokumentiranje negovalnih problem in diagnoz v procesu zdravstvene nege. Lahko se uporabi na različnih področjih: za zapisovanje diagnoz v enem encaunter-u, za razširitev sznama negovalnih problemov in zaključkov opazovanj pacienta, kot npr. pri odpustnem negovalnem dokumentu.
MisuseSe ne uporablja za zapisovanje 'Reason for Encounter' or 'Presenting Complaint', ki omogočajo zbiranje informacij bolj zgodaj v encauntr-u, za katere se ponavadi uporablja EVALUATION archetype. Se ne uporablja za dokumentiranje različnosti diagnoz; za to se uporablja EVALUATION.differential diagnosis archetype.
PurposeZa dokumentiranje negovalnih problem in diagnoz v procesu zdravstvene nege
ReferencesNEHTA Clinical data groups - Problem/Diagnosis V2.0 http://www.nehta.gov.au/data-group-library/data-specifications/dgl-problem-diagnosis.
Australian Standard AS 4700.6-2006 Implementation of Health Level Seven version 2.4 - Part 6: Referral, discharge and health record messaging.
CEN/TC 251/WGII prEN 13940-2:2009.3- Health informatics – System of concepts to support Continuity of care – Part 2: Health care process and workflow.
BS_EN_13940-1_2007 - British Standard. Health informatics - System of concepts to support continuity of care - Part 1: Basic concepts.
Swedish National Process model.
IHE Technical Framework Supplement – Patient Plan of Care (PPOC).
Royal Australian College of General Practitioners - Fact Sheet: Medical History
Mosby's Pocket Dictionary of Medicine, Nursing and Health Professional, 6th Edition, Mosby Elsevier, 2010
AuthorsIme avtorja: Sam Heard
Organizacija: Ocean Informatics
e-Pošta: sam.heard@oceaninformatics.com
Datum izvora: 23/04/2006
Other Details LanguageIme avtorja: Sam Heard
Organizacija: Ocean Informatics
e-Pošta: sam.heard@oceaninformatics.com
Datum izvora: 23/04/2006
OtherDetails Language Independent{references=NEHTA Clinical data groups - Problem/Diagnosis V2.0 http://www.nehta.gov.au/data-group-library/data-specifications/dgl-problem-diagnosis. Australian Standard AS 4700.6-2006 Implementation of Health Level Seven version 2.4 - Part 6: Referral, discharge and health record messaging. CEN/TC 251/WGII prEN 13940-2:2009.3- Health informatics – System of concepts to support Continuity of care – Part 2: Health care process and workflow. BS_EN_13940-1_2007 - British Standard. Health informatics - System of concepts to support continuity of care - Part 1: Basic concepts. Swedish National Process model. IHE Technical Framework Supplement – Patient Plan of Care (PPOC). Royal Australian College of General Practitioners - Fact Sheet: Medical History Mosby's Pocket Dictionary of Medicine, Nursing and Health Professional, 6th Edition, Mosby Elsevier, 2010, MD5-CAM-1.0.1=93CD25E87C16167EFF1380282C08495B}
Keywordsproblem, nega, negovalna diagnoza, skrb
LifecycleAuthorDraft
Language usedsl
Citeable Identifier1075.67.1289
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John Bennett, NEHTA, Australia
Steve Bentley, NHS CfH, United Kingdom
Ian Bull, ACT Health, Australia
Sergio Carmona, Chile
Rong Chen, Cambio Healthcare Systems, Sweden
Stephen Chu, NEHTA, Australia (Editor)
Ed Conley, Cardiff University, United Kingdom
Matthew Cordell, NEHTA, Australia
Paul Donaldson, Nursing Informatics Australia, Australia
David Evans, Queensland Health, Australia
Peter Garcia-Webb, Australia
Anneke Goossen, Results4Care, Netherlands
Heather Grain, Llewelyn Grain Consulting, Australia
Evelyn Hovenga, EJSH Consulting, Australia
Eugene Igras, IRIS Systems Inc, Canada
Mary Kelaher, NEHTA, Australia
Eizen Kimura, Ehime University, Japan
Shinji Kobayashi, Ehime University, Japan
Robert L'egan, NEHTA, Australia
Heather Leslie, Ocean Informatics, Australia (Editor)
Hugh Leslie, Ocean Informatics, Australia (Editor)
Rohan Martin, Ambulance Victoria, Australia
David McKillop, NEHTA, Australia
Ian McNicoll, Ocean Informatics UK, United Kingdom
Chris Mitchell, RACGP, Australia
Stewart Morrison, NEHTA, Australia
Jörg Niggeman, Compugroup, Germany
Andrej Orel, Marand d.o.o., Slovenia
Camilla Preeston, Royal Australian College of General Practitioners, Australia
Cathy Richardson, NEHTA, Australia
Kylie Young, The Royal Australian College of General Practitioners, Australia, originalLanguage=en, translators=Slovenski: mag. Biljana Prinčič, Marand d.o.o., Ljubljana, Slovenija, biljana.princic@marand.si
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