On Fri, 10 Jun 2005, Richard G. DAVIS wrote:
I understand the "dichotomy" Gregory mentions, and I agree with the views he
has expressed.
I quite agree with the basic thread of what Richrd has said in this
exchange. In fact we have put that exzct situation to both a website on
the EHR here at UW (http://www.ehrweb.org) and in the description of the
VistA architecture that is intended for health informatics education in
both a documnt and a website form. The ideas are also part of draft
document for "A Guide to the Health Informatics Body of Knowledge" that
identifies that these two pespectives are really mutually supportive
rather than in conflict and need to be part of an integrated educational
approach that has "Enterprise view, Life Cycle Principles" that draw on
your 1999 expostulation of the Zachman Principles. As you rightly note the
focus on the technical plaform is a distraction from yje key issues.
First, their must be attention to the Conceptual Content that Kolodner,
Christensen etc in their recent 2005 Book tout for "HealthePeople". The
hardhats and the WV Community must continue to emphasize how the VistA
conceptual content is going to evolve and draw on the contribution of the
various health professional specialty disciplines; with that emphasis the
statements regarding the primacy of the technology will begin to fade.
Technology will always be a factor but not the prime focus.
However, I believe the fundamental issue is less a technical matter and more
an natural 'tension' between concerns for operational
effectiveness--delivery of quality health care, and the interest in
administrative IT that arises from management. These two groups in most any
enterprise you may choose to study are chronically in a state of 'conflict'
due their different priorities and requirements for IT, and information
management architecture.
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