ISO_639-1 en false 2015-06-08 Silje Ljosland Bakke, Bergen Hospital Trust, Norway Ian McNicoll, freshEHR Clinical Informatics, United Kingdom John Tore Valand, Haukeland Universitetssjukehus, Norway Heather Leslie, Ocean Informatics, Australia in_development 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/. Nasjonal IKT Avgrenet fra: <Legg til en referanse til den originale ressursen her> no.nasjonalikt Nasjonal IKT no.nasjonalikt 19219F7AA7ED0836F163A3D01F391D06 950313cd-5bc6-4dd0-acc3-3c4128d4467a 0.0.1-alpha

ISO_639-1 nb __unknown__ © Nasjonal IKT HF

ISO_639-1 en For recording a narrative description and clinical interpretation of the findings observed during the physical examination of the penis. Use to record a narrative description of the overall findings observed during the physical examination of the penis. This initial draft archetype consists only of the core examination pattern data elements (as per CLUSTER.exam_pattern) and will likely be expanded further over time as specific clinical requirements are identified. This archetype has been specifically designed to be used in the 'Examination detail' SLOT within the OBSERVATION.exam archetype, but can also be used within other OBSERVATION or CLUSTER archetypes, where clinically appropriate. Use to provide a framework in which CLUSTER archetypes can be nested in the 'Examination findings' SLOT to record additional structured physical examination findings - for example, CLUSTER.exam_urethra. The CLUSTER.exclusion_exam archetype can be nested within the 'Examination not done' SLOT to optionally record explicit details about the examination not being performed. Use to incorporate the narrative descriptions of clinical findings within existing or legacy clinical systems into an archetyped format, using the 'Clinical Description' data element. Not to be used for recording data not related to the physical examination of the penis. Not to be used for recording the clinical history - use specific OBSERVATION and CLUSTER archetypes. For example OBSERVATION.story and CLUSTER.symptom. Not to be used to record stand-alone clinical observations or measurements or test results - use specific OBSERVATION archetypes. For example OBSERVATION.blood_pressure or OBSERVATION.imaging_exam. © Nasjonal IKT HF

ISO_639-1 nb ? 78c81ec5-54e0-4fea-99c9-0b1f41dfdd37 openEHR-EHR-CLUSTER.exam_penis_v0_8.v0 1.4 at0000 CLUSTER true true false false 1 1 at0000 items true true false false 1 1 ELEMENT true true false false 0 1 at0002 value true true false false 0 1 DV_BOOLEAN true true false false 1 1 value true true false false 1 1 BOOLEAN true true false false 1 1 true false ELEMENT true true false false 0 1 at0003 value true true false false 0 1 DV_TEXT true true false false 1 1 CLUSTER true false true 0 at0004 archetype_id/value matches {/openEHR-EHR-CLUSTER\.exam_skin(-[a-zA-Z0-9_]+)*\.v0|openEHR-EHR-CLUSTER\.exam_urethra(-[a-zA-Z0-9_]+)*\.v0/} Boolean 2007 false String archetype_id/value attribute C_STRING openEHR-EHR-CLUSTER\.exam_skin(-[a-zA-Z0-9_]+)*\.v0|openEHR-EHR-CLUSTER\.exam_urethra(-[a-zA-Z0-9_]+)*\.v0 constraint CLUSTER true false true 0 at0005 archetype_id/value matches {/openEHR-EHR-CLUSTER\.multimedia(-[a-zA-Z0-9_]+)*\.v1/} Boolean 2007 false String archetype_id/value attribute C_STRING openEHR-EHR-CLUSTER\.multimedia(-[a-zA-Z0-9_]+)*\.v1 constraint ELEMENT true false true 0 at0006 value true true false false 0 1 DV_TEXT true true false false 1 1 ELEMENT true true false false 0 1 at0007 value true true false false 0 1 DV_TEXT true true false false 1 1 CLUSTER true false true 0 at0008 archetype_id/value matches {/openEHR-EHR-CLUSTER\.exclusion_exam(-[a-zA-Z0-9_]+)*\.v1/} Boolean 2007 false String archetype_id/value attribute C_STRING openEHR-EHR-CLUSTER\.exclusion_exam(-[a-zA-Z0-9_]+)*\.v1 constraint false false true false true 1 Examination of the penis Findings observed during the physical examination of the penis. No abnormality detected Statement that no abnormality was detected (NAD) on physical examination. Record as True if no abnormality was detected on examination. Specific statements about the examination can be included in the 'Clinical Interpretation' data element. Clinical description Narrative description of the overall findings observed during the physical examination. Examination findings Structured details about the physical examination findings. Multimedia representation Digital image, video or diagram representing the physical examination findings. Clinical interpretation Single word, phrase or brief description that represents the clinical meaning and significance of the physical examination findings. Comment Additional narrative about the physical examination findings, not captured in other fields. Examination not done Details to explicitly record that this examination was not performed. Undersøkelse av penis Funn gjort ved klinisk undersøkelse av penis *No abnormality detected(en) *Statement that no abnormality was detected (NAD) on physical examination.(en) *Record as True if no abnormality was detected on examination. Specific statements about the examination can be included in the 'Clinical Interpretation' data element.(en) *Clinical description(en) *Narrative description of the overall findings observed during the physical examination.(en) *Examination findings(en) *Structured details about the physical examination findings.(en) *Multimedia representation(en) *Digital image, video or diagram representing the physical examination findings.(en) *Clinical interpretation(en) *Single word, phrase or brief description that represents the clinical meaning and significance of the physical examination findings.(en) *Comment(en) *Additional narrative about the physical examination findings, not captured in other fields.(en) *Examination not done(en) *Details to explicitly record that this examination was not performed.(en)