ASTM E1715-01(2008)
(Practice)Standard Practice for An Object-Oriented Model for Registration, Admitting, Discharge, and Transfer (RADT) Functions in Computer-Based Patient Record Systems
Standard Practice for An Object-Oriented Model for Registration, Admitting, Discharge, and Transfer (RADT) Functions in Computer-Based Patient Record Systems
SIGNIFICANCE AND USE
RADT Object Model as a Basis for Communication—The RADT object model is the first model used to create a common library of consistent entities (objects) and their attributes in the terminology of object analytical models as applied to the healthcare domain. These object models can be used to construct and refine standards relating to healt care information and its management. Since the RADT object model underpins the design and implementation of specific systems, it provides the framework for establishing the systematics of managing observations made during health care. The observations recorded during health care not only become the basis for managing an individual's health care by practitioners but are also used for research and resource management. They define the common language for abstracting and codifying observations. The inconsistency and incompleteness of the data recorded in paper records is well known and has been noted by the Institute of Medicine's study (4). The ability to build the recommended EHR begins with RADT, as noted in Practice E 1239. A more detailed specification of the RADT process and its specific functional domain shall begin with a formal model. Furthermore, following agreement on the initial model, that model shall evolve as knowledge accumulates and the initial view of the healthcare domain extends to other social and psychologic processes that link healthcare with other functional domains of society. The management of lifelong cases of care, such as those of birth defects in newborns, will involve interactions with social work and educational functional domains of experience. It has been recognized for some time (5) that a “healthcare team,” in the broader sense, is involved in dealing with these complex cases. The RADT model is the core to linking these functional domains together in a transparent way. For that reason, the object terminology is used to enable the most global view and vernacular that will facilitate communication amo...
SCOPE
1.1 This practice is intended to amplify Practice E 1239 and to complement Practice E 1384 by detailing the objects that make up the reservation, registration, admitting, discharge, and transfer (RADT) functional domain of the computer-based record of care (CPR). As identified in Practice E 1239, this domain is seminal to all patient record and ancillary system functions, including messaging functions used in telecommunications. For example, it is applicable to clinical laboratory information management systems, pharmacy information management systems, and radiology, or other image management, information management systems. The object model terminology is used to be compatible with other national and international standards for healthcare data and information systems engineering or telecommunications standards applied to healthcare data or systems. This practice is intended for those familiar with modeling concepts, system design, and implementation. It is not intended for the general computer user or as an initial introduction to the concepts.
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Designation: E1715 − 01(Reapproved 2008) An American National Standard
Standard Practice for
An Object-Oriented Model for Registration, Admitting,
Discharge, and Transfer (RADT) Functions in Computer-
Based Patient Record Systems
This standard is issued under the fixed designation E1715; the number immediately following the designation indicates the year of
original adoption or, in the case of revision, the year of last revision. A number in parentheses indicates the year of last reapproval. A
superscript epsilon (´) indicates an editorial change since the last revision or reapproval.
1. Scope E1633 SpecificationforCodedValuesUsedintheElectronic
Health Record
1.1 This practice is intended to amplify Practice E1239 and
E1639 Guide for Functional Requirements of Clinical Labo-
to complement Practice E1384 by detailing the objects that
ratory Information Management Systems (Withdrawn
make up the reservation, registration, admitting, discharge, and
2002)
transfer (RADT) functional domain of the computer-based
E1744 Practice for View of Emergency Medical Care in the
record of care (CPR). As identified in Practice E1239, this
Electronic Health Record
domain is seminal to all patient record and ancillary system
F1629 Guide for Establishing Operating Emergency Medi-
functions, including messaging functions used in telecommu-
cal Services and Management Information Systems, or
nications. For example, it is applicable to clinical laboratory
Both
information management systems, pharmacy information man-
2.2 ANSI Standard:
agement systems, and radiology, or other image management,
ANSI X3.172 Dictionary of Information Systems
information management systems. The object model terminol-
2.3 IEEE Standard:
ogy is used to be compatible with other national and interna-
IEEE 1157.1 Trial Use Standard for Healthcare Information
tional standards for healthcare data and information systems
Interchange—Information Modelling (6 June 1994)
engineeringortelecommunicationsstandardsappliedtohealth-
2.4 Other Document:
care data or systems. This practice is intended for those
HL-7 v2.4 Data Communication Standard
familiar with modeling concepts, system design, and imple-
mentation.Itisnotintendedforthegeneralcomputeruseroras
3. Terminology
an initial introduction to the concepts.
3.1 Definitions—General terms are defined in accordance
2. Referenced Documents
with ANSI X3.172.
2.1 ASTM Standards:
3.2 Definitions of Terms Specific to This Standard:
E1238 Specification for Transferring Clinical Observations
3.2.1 functional domain, n—thatareaofactivitythatencom-
Between Independent Computer Systems (Withdrawn
passes a given function. (HL-7, v2.4)
2002)
3.2.2 healthcare domain, n—that functional domain encom-
E1239 Practice for Description of Reservation/Registration-
passing all aspects of the delivery of health care, both preven-
Admission, Discharge, Transfer (R-ADT) Systems for
tive and corrective, to patients, and the management of
Electronic Health Record (EHR) Systems
resources enabling that care to be delivered. (HL-7, v2.4)
E1384 Practice for Content and Structure of the Electronic
Health Record (EHR)
4. Background
4.1 Object Representation of RADT Processes—Practice
This practice is under the jurisdiction ofASTM Committee E31 on Healthcare
E1239 provides the experiential background of the functions in
Informatics and is the direct responsibility of Subcommittee E31.25 on Healthcare
RADT. These functions are common to all systems that deal
Data Management, Security, Confidentiality, and Privacy.
with patient data. The minimal essential data elements for
Current edition approved Sept. 15, 2008. Published December 2008. Originally
approved in 1995. Last previous edition approved in 2001 as E1715 – 01. DOI:
10.1520/E1715-01R08.
2 4
For referenced ASTM standards, visit the ASTM website, www.astm.org, or Available fromAmerican National Standards Institute (ANSI), 25 W. 43rd St.,
contact ASTM Customer Service at service@astm.org. For Annual Book of ASTM 4th Floor, New York, NY 10036, http://www.ansi.org.
Standards volume information, refer to the standard’s Document Summary page on Available from Institute of Electrical and Electronics Engineers, Inc. (IEEE),
the ASTM website. 445 Hoes Ln., P.O. Box 1331, Piscataway, NJ 08854-1331, http://www.ieee.org.
3 6
The last approved version of this historical standard is referenced on AvailablefromHealthLevelSeven,900VictorsWay,Suite122,AnnArbor,MI
www.astm.org. 48108.
Copyright © ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959. United States
E1715 − 01 (2008)
RADT were identified and characterized partly in Practice yet been agreed on formally. The objects included here are
E1239. Table 1 of that guide identifies a logical data structure thosethatinvolvedatagenerallyassociatedwithadministrative
for the data elements, but it does not relate these elements to and demographic functions in patient care but that may also be
constituent “entities” or “objects” in the sense that they are linkedwithotherfunctionaldomainsinvolvedwithhealthcare.
now used in analysis. Entity-relationship modeling is one
4.2 Inclusion of Emergency Medical Systems Functions—
major technique used (1) to establish the conceptual“ things”
This practice also takes note of the recent work of the
and their relationships involved in this overall functional
emergency medical systems (EMS) standardsASTM Subcom-
domain. “Objects” (2, 3) is another term for these things, and
mittee F30.03.03 on Data Management Systems in defining the
the object concept involves very specific characteristics asso-
pre-hospital and associated emergency room data (Guide
ciated with a defined object such as encapsulation and inheri-
F1629) required for emergency medical service system man-
tance. Common ground exists between entity and object
agement.Thehospitalandemergencyroomdataareasubsetof
representations of models. However, the object terminology is
that identified in Practice E1384 and is consistent with the
still evolving into a clearly established dictionary associated
statement of Steen and Dick (4) that EMS data are part of the
with object modeling at the analysis (2), design (3), and
primary record of care. This concept has already been recog-
implementation (3) levels of information systems engineering.
nized in several state statutes that are part of the implementa-
4.1.1 At the analysis level, which is most relevant to
tion of an injury control plan by the Centers for Disease
implementation-independentstandardscreation,thestaticlevel
Control (see Practice E1744). This RADT object model prac-
is first in importance since it identifies the involved objects and
tice extends those data elements already defined in Practice
their static characteristics, such as definitions, relationships,
E1384 by associating them with common RADT objects, as
and inheritance. Subsequently, the service/messages commu-
defined here, that form the basis for a predictable system
nication properties constitute the second level of importance,
behavior for trauma data. The behavior of clinical data will be
because they specify the dynamics of system behavior. How-
defined subsequently in following standards.
ever, messages are more difficult to define since system
4.3 Relationships to Other Systems—This practice also
behavior patterns are more complex. This secondary domain
identifiesthoseobjectsintheRADTfunctionaldomainthatare
also involves the telecommunications aspects that are the focus
required by clinical laboratory information management sys-
of other standards bodies. Because of the distributed and
tems (CLIMS) (Guide E1639), radiology information systems
networked architectures of the newest systems, telecommuni-
(RIS), and other ancillary systems. This model also forms the
cations may be of prime importance in qualifying the defini-
core for a basic ambulatory record system, and specialized
tionsofsystembehavioridentifiedinPracticeE1239.Forallof
variants, in support of clinical specialties in medicine and
thesereasons,itisofspecialimportancetoinitiallyestablishan
dentistry.The object models for these ancillary and specialized
object-oriented static model for the RADT functional domain
electronic health record (EHR) systems are defined in other
that can be the basis for definitions of healthcare data manage-
standards that constitute the “family of models” that extend the
ment and standards setting and serve as a foundation for
RADT function.
modeling telecommunications standards.
4.1.2 While this practice was being developed, a joint
5. Significance and Use
working group (JWG) on data modeling of the then American
5.1 RADT Object Model as a Basis for Communication—
National Standards Institute (ANSI) Healthcare Informatics
The RADT object model is the first model used to create a
Standards Planning Panel (HISPP), now Health Informatics
common library of consistent entities (objects) and their
StandardsBoard(HISB),beganworkonacommondatamodel
attributes in the terminology of object analytical models as
(CDM) for the healthcare information domain. A JWG data
applied to the healthcare domain. These object models can be
modeling convention document (IEEE 1157.1) guides the
used to construct and refine standards relating to healt care
conventions to be used, and this practice reflects those conven-
information and its management. Since the RADT object
tions as they are currently known. It is intended that this
model underpins the design and implementation of specific
practice contribute to establishing the RADTcore of the CDM.
systems, it provides the framework for establishing the sys-
The exact boundaries of the RADTfunctional domain have not
tematics of managing observations made during health care.
The observations recorded during health care not only become
the basis for managing an individual’s health care by practi-
The boldface numbers in parentheses refer to the list of references at the end of
the standard.
tioners but are also used for research and resource manage-
ment. They define the common language for abstracting and
TABLE 1 Data Element Datatypes
codifying observations. The inconsistency and incompleteness
Type Standard Tag/ of the data recorded in paper records is well known and has
Mnemonic
been noted by the Institute of Medicine’s study (4). The ability
Name Name
tobuildtherecommendedEHRbeginswithRADT,asnotedin
Number Num
Practice E1239. A more detailed specification of the RADT
Code Code
Datetime Dtm process and its specific functional domain shall begin with a
Signature Sig
formal model. Furthermore, following agreement on the initial
Text Text
model, that model shall evolve as knowledge accumulates and
Quantity Qty
theinitialviewofthehealthcaredomainextendstoothersocial
E1715 − 01 (2008)
and psychologic processes that link healthcare with other tables of context-insensitive entities. These same terms appear
functional domains of society. The management of lifelong in the tabular representation. The sequential application of
cases of care, such as those of birth defects in newborns, will these relationships, visually from the top down in Figs. 1-4,
involve interactions with social work and educational func- depict the inheritance properties since the objects later in the
tional domains of experience. It has been recognized for some sequence of the relationships inherit the attributes from those
time (5) that a “healthcare team,” in the broader sense, is earlier in the sequence. These concepts are all explained by
involved in dealing with these complex cases. The RADT Coad and Yourdon (2).
model is the core to linking these functional domains together
in a transparent way. For that reason, the object terminology is 7. Tabular Representation
used to enable the most global view and vernacular that will
7.1 Tables 1 and 2 and Annex A1 provide the detailed
facilitate communication among technical specialties that par-
attributes of the objects and should be compared with Table 1
ticipate in managing some aspect of health care or that build
of Practice E1239 and Annex A1 of Practice E1384, which
systems to manage the required information.
show the integrated logical structure of the computer-based
primary record of care. The latest revision of Practice E1384
5.2 Common Terminology as a Basis for Education—The
associates each data element with an index that uniquely
use of models and their associated terminology implies that
identifies its segment location in Annex A1 and provides a
education of the healthcare practitioners shall incorporate this
definition and references its representation. Certain data ele-
view to a significant extent. While a detailed specification of
ments with coded values have their value sets, which are also
systems requires extensive lexicons of carefully defined terms,
amoreunderstandableterminologyshallevolvefortheprocess identified in that specification by its specific index contained in
Practice E1384 and point to Specification E1633. The defini-
of educating practitioners during their formal education as well
as continuing to educate current practioners concerning how tions,mnemonics,andassociatedattributesoftheobjectsinthe
RADT object model are given in Table A1.1 of Annex A1 of
this new technology can be integrated with their existing
practices. This challenge has yet to be met, but the objects and this practice. The object mnemonics that are used in the
construction of standardized short names for the data elements
modeling concepts presented here are intended to be named
with the most intuitive titles in order to promote clear under- indexed and characterized in Practice E1384 are given as
attributes in this practice. A standardized short name begins
standing during their use in instruction. Nevertheless, relating
with the object mnemonic and ends with a datatype substring
these objects and their properties to everyday practice remains
given in Table 1. The object mnemonics are given in Table 2.
a significant challenge, for both the implementors of systems
Each substring begins with a sequence of uppercase letters
and educators. The perspectives cataloged here can be used in
followed by a sequence of lowercase letters. The beginning
thecreationofsystemdocumentationandcurricularepresented
object mnemonic and ending datatype substrings are required.
in a variety of media.
These characterizations provide the static properties of the
RADTobjectmodel.Theoperationalglobalimplicationsofthe
6. Graphic Representation
dynamic properties of the RADT functional domain will be
6.1 The graphic representation in Figs. 1-4 of the relation-
detailedinfutureversionsofPracticeE1239,whilethespecific
shipsamongtheobjectsdepictsthestaticinheritancepr
...
This document is not anASTM standard and is intended only to provide the user of anASTM standard an indication of what changes have been made to the previous version. Because
it may not be technically possible to adequately depict all changes accurately, ASTM recommends that users consult prior editions as appropriate. In all cases only the current version
of the standard as published by ASTM is to be considered the official document.
An American National Standard
Designation:E1715–99 Designation: E 1715 – 01 (Reapproved 2008)
Standard Practice for
An Object-Oriented Model for Registration, Admitting,
Discharge, and Transfer (RADT) Functions in Computer-
Based Patient Record Systems
This standard is issued under the fixed designation E 1715; the number immediately following the designation indicates the year of
original adoption or, in the case of revision, the year of last revision. A number in parentheses indicates the year of last reapproval. A
superscript epsilon (´) indicates an editorial change since the last revision or reapproval.
1. Scope
1.1 ThispracticeisintendedtoamplifyGuidePracticeE 1239andtocomplementGuidePracticeE 1384bydetailingtheobjects
that make up the reservation, registration, admitting, discharge, and transfer (RADT) functional domain of the computer-based
record of care (CPR). As identified in GuidePractice E 1239, this domain is seminal to all patient record and ancillary system
functions, including messaging functions used in telecommunications. For example, it is applicable to clinical laboratory
information management systems, pharmacy information management systems, and radiology, or other image management,
information management systems. The object model terminology is used to be compatible with other national and international
standards for healthcare data and information systems engineering or telecommunications standards applied to healthcare data or
systems.This practice is intended for those familiar with modeling concepts, system design, and implementation. It is not intended
for the general computer user or as an initial introduction to the concepts.
2. Referenced Documents
2.1 ASTM Standards:
E 1238 Specification for Transferring Clinical Observations Between Independent Computer Systems
E 1239Guide for Description of Reservation/Registration-Admission, Discharge, Transfer (RADT) Systems for Automated
Patient Care Information Systems Practice for Description of Reservation/Registration-Admission, Discharge, Transfer
(R-ADT) Systems for Electronic Health Record (EHR) Systems
E 1384Guide for Description for Content and Structure of an Automated Primary Record of Care
E1633Specification for Coded Values Used in Computer-Based Patient Record Practice for Content and Structure of the
Electronic Health Record (EHR)
E 1633 Specification for Coded Values Used in the Electronic Health Record
E 1639 Guide for Functional Requirements of Clinical Laboratory Information Management Systems
E 1744Guide Practice for a View of Emergency Medical Care in the Computer-Based PatientElectronic Health Record
F 1629 Guide for Establishing and/or Operating Emergency Medical Services and Management Information Systems, or Both
2.2 ANSI Standard:
ANSI X3.172 Dictionary of Information Systems
2.3 IEEE Standard:
IEEE 1157.1 Trial Use Standard for Healthcare Information Interchange—Information Modelling (6 June 1994)
2.4 Other Document:
HL-7v2.2 v2.4 Data Communication Standard
This practice is under the jurisdiction ofASTM Committee E-31 on Healthcare Informatics and is the direct responsibility of Subcommittee E31.19 on Computer–Based
Patient Record Content and Structure.
Current edition approved Jan. 10, 1999. Published March 1999. Originally published as E 1744–95. Last previous edition E 1744–95.
This practice is under the jurisdiction ofASTM Committee E31 on Healthcare Informatics and is the direct responsibility of Subcommittee E31.25 on Healthcare Data
Management, Security, Confidentiality, and Privacy.
Current edition approved Sept. 15, 2008. Published December 2008. Originally approved in 1995. Last previous edition approved in 2001 as E 1715 – 01.
For referencedASTM standards, visit theASTM website, www.astm.org, or contactASTM Customer Service at service@astm.org. For Annual Book of ASTM Standards
, Vol 14.01.volume information, refer to the standard’s Document Summary page on the ASTM website.
Available from American National Standards Institute, 11 W. 42nd St., 13th Floor, New York, NY 10036.
Available from American National Standards Institute (ANSI), 25 W. 43rd St., 4th Floor, New York, NY 10036, http://www.ansi.org.
Available from IEEE, 445 Hoes Lane, P.O. Box 1331, Piscataway, NJ 08855-1331.
Available from Institute of Electrical and Electronics Engineers, Inc. (IEEE), 445 Hoes Ln., P.O. Box 1331, Piscataway, NJ 08854-1331, http://www.ieee.org.
Available from Health Level Seven, 900 Victors Way, Suite 122, Ann Arbor, MI 48108.
Copyright © ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959, United States.
E 1715 – 01 (2008)
3. Terminology
3.1General terms are defined in ANSI X3.172
3.1 Definitions—General terms are defined in accordance with ANSI X3.172.
3.2 Definitions of Terms Specific to This Standard:
3.2.1 functional domainfunctional domain, n—that area of activity that encompasses a given function. (HL-7, v2.2 (HL-7,
v2.4)
3.2.2 health care domainhealthcare domain, n—that functional domain encompassing all aspects of the delivery of health care,
both preventive and corrective, to patients, and the management of resources enabling that care to be delivered. (HL-7, v2.2
(HL-7, v2.4)
4. Background
4.1 Object Representation of RADT Processes—Guide—Practice E 1239 provides the experiential background of the functions
in RADT. These functions are common to all systems that deal with patient data. The minimal essential data elements for RADT
were identified and characterized partly in GuidePractice E 1239. Table 1 of that guide identifies a logical data structure for the
data elements, but it does not relate these elements to constituent “entities” or “objects” in the sense that they are now used in
analysis. Entity-relationship modeling is one major technique used (1) to establish the conceptual“ things” and their relationships
involved in this overall functional domain. “Objects” (2, 3) is another term for these things, and the object concept involves very
specific characteristics associated with a defined object such as encapsulation and inheritance. Common ground exists between
entity and object representations of models. However, the object terminology is still evolving into a clearly established dictionary
associated with object modeling at the analysis (2), design (3), and implementation (3) levels of information systems engineering.
4.1.1 At the analysis level, which is most relevant to implementation-independent standards creation, the static level is first in
importance since it identifies the involved objects and their static characteristics, such as definitions, relationships, and inheritance.
Subsequently, the service/messages communication properties constitute the second level of importance, because they specify the
dynamics of system behavior. However, messages are more difficult to define since system behavior patterns are more complex.
This secondary domain also involves the telecommunications aspects that are the focus of other standards bodies. Because of the
distributed and networked architectures of the newest systems, telecommunications may be of prime importance in qualifying the
definitions of system behavior identified in GuidePractice E 1239. For all of these reasons, it is of special importance to initially
establish an object-oriented static model for the RADT functional domain that can be the basis for definitions of healthcare data
management and standards setting and serve as a foundation for modeling telecommunications standards.
4.1.2 While this practice was being developed, a joint working group (JWG) on data modeling of the then American National
Standards Institute (ANSI) Healthcare Informatics Standards Planning Panel (HISPP), now Health Informatics Standards Board
(HISB), began work on a common data model (CDM) for the healthcare information domain. A JWG data modeling convention
document (IEEE 1157.1) guides the conventions to be used, and this practice reflects those conventions as they are currently
known. It is intended that this practice contribute to establishing the RADT core of the CDM. The exact boundaries of the RADT
functional domain have not yet been agreed on formally.The objects included here are those that involve data generally associated
with administrative and demographic functions in patient care but that may also be linked with other functional domains involved
with health care.
4.2 Inclusion of Emergency Medical Systems Functions—This practice also takes note of the recent work of the emergency
medical systems (EMS) standardsASTM Subcommittee F30.03.03 on Data Management Systems in defining the pre-hospital and
associated emergency room data (Guide F 1629) required for emergency medical service system management. The hospital and
emergency room data are a subset of that identified in GuidePractice E 1384 and is consistent with the statement of Steen and Dick
(4) that EMS data are part of the primary record of care. This concept has already been recognized in several state statutes that
arepartoftheimplementationofaninjurycontrolplanbytheCentersforDiseaseControl(seeGuidePracticeE 1744).ThisRADT
object model practice extends those data elements already defined in GuidePractice E 1384 by associating them with common
RADTobjects, as defined here, that form the basis for a predictable system behavior for trauma data.The behavior of clinical data
will be defined subsequently in following standards.
4.3 Relationships to Other Systems—ThispracticealsoidentifiesthoseobjectsintheRADTfunctionaldomainthatarerequired
by clinical laboratory information management systems (CLIMS) (Guide E 1639), radiology information systems (RIS), and other
ancillary systems. This model also forms the core for a basic ambulatory record system, and specialized variants, in support of
clinical specialties in medicine and dentistry. The object models for these ancillary and specialized computer-based patientelec-
tronic health record (CPR)(EHR) systems are defined in other standards that constitute the “family of models” that extend the
RADT function.
5. Significance and Use
5.1 RADT Object Model as a Basis for Communication—The RADT object model is the first model used to create a common
libraryofconsistententities(objects)andtheirattributesintheterminologyofobjectanalyticalmodelsasappliedtothehealthcare
The boldface numbers in parentheses refer to the list of references at the end of the standard.
E 1715 – 01 (2008)
TABLE 2 1 NData Elemes of Objects Cont Dained inthatype
RADT Models
Object NamType Standard Tag/
MnemonicClinical
Activities
Care agreement CAgrmnt
Name Name
Carerecord RLoc
location
Number Num
Clinicalorder/ COrd
service request
Code Code
Clinical admission CADOrd
order
Datetime Dtm
Clinical disposition CDOrd
order
Signature Sig
Clinical transfer CTOrd
order
Text Text
Death certificate DCert
Quantity DCert
Emergency room ERAdm
admission
Emergency room ERAct
activities
Emergency room ERDisp
disposition
Health care HCAVRec
ambulatory visit
receipt
Health care HCAVAct
ambulatory visit
activities
Health care HCAVDisp
ambulatory visit
disposition
Health care HCCEnc
communication
encounter
Health care HCEAct
encounter activity
Health care HCEFup
encounter followup
Health care facility HCFEnc
encounter
Health care facility HCFEAct
encounter
activities
Health care facility HCFEDisp
encounter
disposition
Health care facility HCFERec
encounter receipt
Health care HCReg
registration
Health care visit HCVis
Inpatient activities IAct
Inpatient IAdm
admission
Inpatient transfer ITrns
Inpatient IDis
disposition
Organ/tissue donor Urg
agreement
Pre-hospital run PREHosp
Research study RSCHAgr
agreement
Scheduled SCHAppt
appointment
Scheduled patient SCHPIAppt
appointment
Scheduled SCHEQApptScheduled SCHPRAppt
equipment practitioner
appointment appointment
Scheduled SCHEQtScheduled SCHPRAppt
equipment practitioner
appointment appointment
Scheduled site 3 SCHSITAppt
appointment
Facilities
Health care
E 1715 – 01 (2008)
domain. These object models can be used to construct and refine standards relating to healthhealt care information and its
management. Since the RADT object model underpins the design and implementation of specific systems, it provides the
framework for establishing the systematics of managing observations made during health care. The observations recorded during
health care not only become the basis for managing an individual’s health care by practitioners but are also used for research and
resource management. They define the common language for abstracting and codifying observations. The inconsistency and
incompleteness of the data recorded in paper records is well known and has been noted by the Institute of Medicine’s study (4).
The ability to build the recommended CPREHR begins with RADT, as noted in GuidePractice E 1239. A more detailed
specification of the RADT process and its specific functional domain shall begin with a formal model. Furthermore, following
agreement on the initial model, that model shall evolve as knowledge accumulates and the initial view of the healthcare domain
extends to other social and psychologic processes that link healthcare with other functional domains of society. The management
of lifelong cases of care, such as those of birth defects in newborns, will involve interactions with social work and educational
functional domains of experience. It has been recognized for some time (5) that a “healthcare team,” in the broader sense, is
involved in dealing with these complex cases. The RADT model is the core to linking these functional domains together in a
transparent way. For that reason, the object terminology is used to enable the most global view and vernacular that will facilitate
communicationamongtechnicalspecialtiesthatparticipateinmanagingsomeaspectofhealthcareorthatbuildsystemstomanage
the required information.
5.2 Common Terminology as a Basis for Education—Theuseofmodelsandtheirassociatedterminologyimpliesthateducation
of the healthcare practitioners shall incorporate this view to a significant extent. While a detailed specification of systems requires
extensive lexicons of carefully defined terms, a more understandable terminology shall evolve for the process of educating
practitioners during their formal education as well as continuing to educate current practioners concerning how this new
technolo
...
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