Hear, hear.....
Stef Op 5-jan-2008, om 12:01 heeft Gerard Freriks het volgende geschreven: > Dear all, > > -1- > Medicine is an art. > An art practiced by people. > Using imprecise language to document complex processes. > > -2- > The EHR is there to document what needs to be documented. > For now and later. > For here and there. > For us and them. > > > -3- > Points 1 and 2 describe the problem of semantic interoperability: > The semantic interoperability needs a scientific rigor. > People need semantic freedom to document their art in their community. > > Semantic Interoperability demands that we are as precise as we can be, > as language, culture, independent as we can be. > So when we record a size, > we record a size and use international units of measurements. > > In Templates the esteemed healthcare providers must be able to > attach any name to any size (range). > The main thing is that size is expressed in units of measurement > what ever the local name people want to use. > > Creating semantic interoperability in diverse cultures is only > possible as long as we use the real universal scientific meaning > for things and allow, as one of the facets of the thing, as many > display names as local communities need. > > -4- > Things (measuring devices in this case) have characteristics. > Physical characteristics and non-physical characteristics. > In Archetypes and Templates we must be able to record all of the > relevant ones. > Physical things are expressed in physical measurements. Each of > these physical measurements will have different names in each > culture, language, etc. > Non-Physical things are names for the manufacturer, importer. etc > > People use things and give it intention. > By itself things have no intention. > Therefor to use in a list, describing physical characteristics of a > thing, we can not include the subjective (human) intentions. > > When people give physical things a subjective context dependent > name they are free to do this. > Semantic interoperability demands that irrespective of the > subjective name we use for physical things we use objective > physical things to characterize it unequivocally. > > -5- > Archetypes are the essential artifacts that provide stable long > term culture, language, geography, temporal, inflexible, > independent way to make possible real semantic interoperability > between IT-systems that are used by humans for documentation. > Templates are the essential artifacts that provide the unstable, > short and long term, culture, language, geography, temporal, very > flexible and very dependent way to make in a human way co- > operability possible between humans using IT-systems for > documentation. > > -6- > We must study the work of Ontologists like Barry Smith. > They describe two types of Upper Ontology. > SNAP and SPAN. > http://tinyurl.com/3xdtmx > > SNAP and SPAN > stocks and flows > commodities and services > product and process > anatomy and physiology > > > > SNAP and SPAN > SNAP entities > - have continuous existence in time > - preserve their identity through change > - exist in toto if they exist at all > SPAN entities > - have temporal parts > - unfold themselves phase by phase > - exist only in their phases/stages > > > Physical things and their characteristics are SNAP. > The way we name them, group them, are SPAN. > > > -7- > Conclusions > Archetypes must be as precise and scientific as possible. > Archetypes sometimes describe physical things. > Archetypes sometimes describe process things like diagnosis. > Templates must be as imprecise and unscientific as human co- > operation demands. > Templates express the human condition building upon the precise and > scientific Archetypes. > > Archetypes describing physical things in a physical way are SNAP > Archetypes describing process related things are SPAN. > Templates are always SPAN but composed of SPAN and SNAP parts. > > Gerard > > > -- <private> -- > Gerard Freriks, MD > Huigsloterdijk 378 > 2158 LR Buitenkaag > The Netherlands > > T: +31 252544896 > M: +31 620347088 > E: gfrer at luna.nl > > > Those who would give up essential Liberty, to purchase a little > temporary > Safety, deserve neither Liberty nor Safety. Benjamin Franklin 11 > Nov 1755 > > > > > > On Jan 5, 2008, at 4:57 AM, Heather Leslie wrote: > >> Medicine is not an exact science in many ways!! Different names, >> different brands etc as Gerard points out. Presumably there is >> not a BP bladder sizing standard. >> >> Based on the feedback last year on this topic I had enhanced the >> BP archetype. One of the provided references defined a cuff name >> with an approximate bladder size for the cuff which seemed to make >> good sense to me ? see attached. >> >> In protocol the cuff options are included as internal codes with >> ?nominal names? and the explanation (try double clicking on each >> cuff entry) includes the bladder size. I remember someone else >> objecting to ?Standard Adult? ? so now we have Small Adult, Adult >> and Large Adult ? with ?Adult? being the usual/standard size >> available, I guess. >> >> I thought this was a pragmatic way to give a reasonable choice on >> cuff size. >> >> Finger is not currently available as a location ? I have had mixed >> advice about its use. However if there are people out there >> taking their blood pressure with a home system on their finger >> then we should be capturing that data, and should add it ? and >> avoid getting into the advisability of taking a BP from a finger >> reading argument. Also will allow Melvin to use an infant cuff on >> the finger if he wants! >> >> Cheers >> >> Heather > > _______________________________________________ > openEHR-clinical mailing list > openEHR-clinical at openehr.org > http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-clinical -------------- next part -------------- An HTML attachment was scrubbed... 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