ARCHETYPE Therapeutic direction (openEHR-EHR-CLUSTER.therapeutic_direction.v1)

Name: Therapeutic direction
License: http://creativecommons.org/licenses/by-sa/4.0/

ARCHETYPE ID	openEHR-EHR-CLUSTER.therapeutic_direction.v1
Concept	Therapeutic direction
Description	Structured details of a single therapeutic direction for an ordered item, such as a medication or blood transfusion order.
Use	A 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 generally be used in the context of a parent INSTRUCTION archetype. It has been specifically designed for use within a complex Medication order including IV medication, or for fluid orders in the context of transfusion or dialysis.
Purpose	To 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.
References	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
Authors	Author name: Ian McNicoll Organisation: freshEHR Clinical Informatics Email: ian@freshehr.com Date originally authored: 2017-03-22
Other Details Language	Author 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=openEHR Foundation, references=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.openehr, original_publisher=openEHR Foundation, custodian_namespace=org.openehr, MD5-CAM-1.0.1=8E48FD73FBF88E927DD20879DB2D9775, build_uid=ce856a71-af6c-4a3e-a3b0-47b14fb70b10, revision=1.4.1}
Keywords	medication, order, prescribe, therapy, substance, drug, therapeutic, otc, therapeutic good, pharmaceutical, product, posology, treatment, transfusion
Lifecycle	published
UID	0f42a76b-6cb6-4d7d-8330-14f5c168c9d9
Language used	en
Citeable Identifier	1013.1.2753
Revision Number	1.4.1
All	Archetype [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= German: Natalia Strauch, Darin Leonhardt, Medizinische Hochschule Hannover, PLRI für medizinische Informatik/ Medizinische Hochschule, Strauch.Natalia@mh-hannover.de, leonhardt.darin@mh-hannover.de Norwegian Bokmål: Silje Ljosland Bakke, Marit Alice Venheim, Helse Vest IKT AS, silje.ljosland.bakke@helse-vest-ikt.no, marit.alice.venheim@helse-vest-ikt.no Portuguese (Brazil): Beatriz de Faria Leao, BLEAO Informática em Saúde, bfleao@terra.com.br, MD, PhD , subjectOfData=unconstrained, archetypeTranslationTree=null, topLevelToAshis={identities=[], other_participations=[], events=[], details=[], provider=[], 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 or openEHR-EHR-CLUSTER.dosage.v2 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 at0067::Indefinite [The direction should be continued indefinitely.] at0068::Indefinite - not to be discontinued [The direction should be continued indefinitely with a strong recommendation that it never be discontinued.] Duration >=0 seconds Text Interval of Duration Lower: >=0 seconds Upper: >=0 seconds , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0172], code=at0172, itemType=ELEMENT, level=1, text=Number of administrations, description=The 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=CHOICE, bindings=null, values=Choice of: Count min: >=1 Interval of Count Lower: min: >=0 Upper: min: >=1 , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0177], code=at0177, itemType=ELEMENT, level=1, text=Review criterion, description=After a number of administrations for when a review is required., comment=For example: '3 administrations' or 'Two weeks'., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of: Quantity Count Text , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0178], code=at0178, itemType=ELEMENT, level=1, text=Order start date/time, description=The date and optional time to commence the administration., 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=/items[at0179], code=at0179, itemType=ELEMENT, level=1, text=Order stop date/time, description=The date and optional time when it is planned to cease the administration., 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=/items[at0090], code=at0090, itemType=SLOT, level=1, text=Repetition timing, 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_nondaily.v1 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 or openEHR-EHR-CLUSTER.conditional_medication_rules.v1 and specialisations, extendedValues=null]], description=[], protocol=[], ism_transition=[], context=[], data=[], activities=[], relationships=[], credentials=[], target=[], source=[], state=[], content=[], contacts=[], capabilities=[]}, 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= (Cardinality: 1.., unordered), 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 or openEHR-EHR-CLUSTER.dosage.v2 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 at0067::Indefinite [The direction should be continued indefinitely.] at0068::Indefinite - not to be discontinued [The direction should be continued indefinitely with a strong recommendation that it never be discontinued.] Duration >=0 seconds Text Interval of Duration Lower: >=0 seconds Upper: >=0 seconds , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0172], code=at0172, itemType=ELEMENT, level=1, text=Number of administrations, description=The 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=CHOICE, bindings=null, values=Choice of: Count min: >=1 Interval of Count Lower: min: >=0 Upper: min: >=1 , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0177], code=at0177, itemType=ELEMENT, level=1, text=Review criterion, description=After a number of administrations for when a review is required., comment=For example: '3 administrations' or 'Two weeks'., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of: Quantity Count Text , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0178], code=at0178, itemType=ELEMENT, level=1, text=Order start date/time, description=The date and optional time to commence the administration., 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=/items[at0179], code=at0179, itemType=ELEMENT, level=1, text=Order stop date/time, description=The date and optional time when it is planned to cease the administration., 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=/items[at0090], code=at0090, itemType=SLOT, level=1, text=Repetition timing, 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_nondaily.v1 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 or openEHR-EHR-CLUSTER.conditional_medication_rules.v1 and specialisations, extendedValues=null]], minIndents={}, termBindingRetrievalErrorMessage=null]