Re: [Hardhats-members] XML data export

[A. Forrey]

Greg, Joseph, Hardhats:
These efforts do complement each other. Historically, there have been 
sveral efforts and in the early 1990s the CEN TC-251 had an active effort 
going to block out the conceptual framework for the EHR at the same time 
that DHCP and CHCS were actively being intoduced into their respective 
agencies. In 1995 briefly these groups began and effort called "Common Data 
Model" to get a common basic conceptual framework. In Australia a working 
group arose that joined with one that spawned out of the TC-251 effort 
called GEHR - Good (maybe Generalized) EHR. By this time the ASTM 
standards for the Structure and Content of the EHR had arisen with active 
VA participation and some of these ideas got into VistA but some did not. 
The VA TReatment Planning module which was done for Mental Health was very 
good and lead to inclusions in the ASTM standards but did not become part 
of VistA which used textual constructs to deal with Treatment Planning and 
linkage to Clinical Orders> The Amer Dental Assoc Stds Committee on Dental 
Informatics produced a comprehensive Concept Model and then a detailed 
Specification for implementation. The health informtics standards activity 
became fragmented without a Common Data Model until very recently the 
evolution that Joseph refers to below realtes to the convergence needed to 
provide the "Common Clear Targets" needed by industry (including VSA) to 
make the efforts of all truly productive. Hence, the hardhats/WV effort on 
VistA must focus on the "Enterprise View, Life Cycle Principles" whcih 
Rick articulaltes and which MDC worked on in 1998 and 1999 when MTA when 
on a holiday from which it has now hopefully returned. With a unified view 
of the conceptual content which has an implemented tangible example in 
VistA, hardhats/WV can solidly articulate a demonstrable process by which 
it can help potential adopter enterprises develop its business model and 
the open arguments for how VistA can satisfy that busienss model. Of 
course other Suppliers (either Open or Proprietary) can develop the same 
apporach which involves the top three levels of John Zachman's framework 
that Richard Davis wrote about. It is in the lower three levels of Zachman 
that hardhats/WV/VSA must make their case about how the M data management 
infrastructure and the VistA Design have developed not only a superior 
technolgic implementation of the conceptual content but also a superior 
framework for managing and evolving the the full information architecture 
including M and non-M components.

 Collaborative activities getting the 
basic posture (model framework and implementation evolution) in place for 
use of the open basic architecture will set the stage for both industry
(who can provide technical services to those healthcare enterprises not 
having a full technical support structure) that will help train the 
enterprises staff in those non-technical responsibilities that complement 
the talents of the Suppliers. This posture can be complementary and be 
competitive with the fully proprietary segement of the market through the 
cooperative, collaborative and comprehensive programs of the 
Hardhats/WV/VSA organizations. This forum should be directed at how to 
make that happen.

 On Mon, 13 Jun 2005, Joseph Dal Molin wrote:

At one point I think the OpenEHR folks actually met with VA staff... not sure 
what the impression was. I have known the OpenEHR gang for years, quite a 
smart lot, ever since we started the openhealth list in '99...I think they 
are doing good work but I have never been able to really study it well enough 
to be able to critique it. I guess I have become too practical....and believe 
that it will be easier to evolve from VistA than to create a totally new 
VistA....only time will tell. :-)

Joseph

Greg Woodhouse wrote:
Just to clarify...I didn't mean to imply OpenEHR doesn't contribute
anything new. What I DID mean is that I do not yet see it (after maybe
an hour or two of reading).

--- Greg Woodhouse <[EMAIL PROTECTED]> wrote:


Everybody does seem to be getting. I just went to OMG to download the
MOF standard, and notice that on their main page they are talking
about
their involvement with EHR standards, too. Of course, there is HL7
who,
in addition to the RIM and CDA has an EHR-S effort underway. I know
about CCR, but it's only a small part of what ASTM is doing. I've
been
looking at the OpenEHR web site, but am still trying to digest it at
see if I can get a handle on what is genuinely new about archetypes.
I
think the language is a bit confusing, because in mathematical logic,
ontologies typically refer to what is left if you omit contingent
information from your model (actually a model is basically an
ontology
+ contingent information).

--- "A. Forrey" <[EMAIL PROTECTED]> wrote:


There are ASTM standards on the  Structure and Conent of the EHR

that

are consistent with ADA standards on the EHR; These are conceptual
content standards that have had historic support of AHIMA. Thye also have
some consistency with HL7 messaaging structures and have been in touch
with the Open EHR folks. Efforts are underway to reactivate a dilaog that
began in 1995 on a "Common Data Model" but subsequently many went of to 
play
"king of the Mountain" in their pigeonholes. A key issue currently is to
map the "Continuity of Care Record - CCR" to the existing EHR models and

then

to VistA. VistA has a lot of representing and EHR as a series of text 
(date-timed) but the recent Report of the ONCHIT clealry noted to
tension be tween structured models for the EHR and those for structured

text(

which is just electronic represntation of paper record notes). WHat
is of interest for VistA is what its eveolutionary trajectory will be

with 
respect to this conceptual content and how it will fit into the
"business model" of healthcare which ( according to IOM 2003) is patient
Centered care and Multidisciplinary teams; Resource Management is 
supportive
and enabling but has had prime focus for 40 yrs (at least). economists
have noted that when healthacre recognbizes that the business model for 
healthcare in not that of a supermarket it will progress. A key
question: Is the DVA now using a Supermarket Model and worrying about
Technology as prime focus or is it really (as the 2005 Person-Centered 
heslth
record Book tries to say) looking at the REAL Healthcare business model?
Time will tell.


On Mon, 13 Jun 2005, Joseph Dal Molin wrote:


Greg have you looked into the OpenEHR initiative....it is

attempting to 
develop a usable EHR standard.

Joseph

Greg Woodhouse wrote:

Of course, if you just dump the progress notes to a file, won't

they

still be in a "proprietary" format? It seems that what you need

is

an

EHR standard that supports interoperability. This is where I

hope

to go

with Triton and/or Orpheus.

--- Kevin Toppenberg <[EMAIL PROTECTED]> wrote:



I want the practice to be able to say, we don't want
to use VistA anymore, dump all the progress notes to a
DVD so we can import them into another system.

Kevin


--- "Gillon, Joseph" <[EMAIL PROTECTED]> wrote:



I assume you know about the RPC to get notes by
patient/provider for a given
time interval, and you need something else?

-----Original Message-----
From: [EMAIL PROTECTED]


[mailto:[EMAIL PROTECTED]


On Behalf Of Kevin
Toppenberg
Sent: Monday, June 13, 2005 4:13 PM
To: Hardhats Sourceforge
Subject: [Hardhats-members] XML data export

One of my goals for my site has been the ability to
get data back out of VistA in a painless manner. For
me this means XML. And I am rapidly nearing the
point
where I plan on finishing this project.

I have a couple of approaches I could take, and I'd
like input from the list

1. Write a custom program that dumps progress notes
(currently the only unique data being stored in our
VistA) in XML format.  I think I could very easily
do
this.

2. Writing an extension to fileman's data export
abilities, to include an option for XML.  This would
be the better option in the long run, but probably
would be a good deal more difficult for me.  I would
need to fully understand the current system to
decide
how best to integrate.  Usha recently posted about
her
difficulty using the export functions.  I don't
think
anyone responded with an answer.

What do export templates do?  What file are they
stored in?

Has anyone else already done this?  Anything I
should
know before I rush off to reinvent the wheel?

Thanks
Kevin



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