Hi Thomas Op 19-jun-2008, om 8:22 heeft Thomas Beale het volgende geschreven:
> > I have started a wiki page to help answer some of these questions - > see > http://www.openehr.org/wiki/display/resources/EHR+versus+Messages > Thanks this is very helpful. From the discussion we seen so far (at least here in the Netherlands) the following will 'fire up' the discussion. So in between I've put some questions. I guess many more will follow:-) Can messages be used to build an EHR? A common idea among some people in health ICT is that an EHR can be constructed as a series of accumulated messages. This idea seems particularly prevalent in government, for the obvious reason that if messages, which already exist, could be aggregated within a central database, nothing more would be needed to create an EHR. However, an inspection of what is needed in an EHR and what messages provide show that this is not the case. The following sections explain why. Messages come from more than one source In any non-trivial health information environment, messages come from multiple sources - at least multiple pathology laboratories. The general case is that each such source uses slightly (or maybe radically) different message structures to transmit the same information. Often the software at some sources implement a different version of the same message, while other sources use a different system of messaging altogether. [SV] I don't know if this hold true (and I want to be prepared for the discussion), but one could argue that since the messages used are centrally organized and everybody has to use the same messages if they want to be connected to the switch point/ communication infrastructure this issue is tackled. Isn't one of the arguments that in order to create an (longitudinal) EHR based on data/information stored in different systems, these systems themselves have to be based on a common architecture in order to deal with these (differences in) versions/content and the medico legal issues arising from that. How about context? Obviously a message can be as large as one chooses, but is it technically possible to add all the relevant context in a message. Clearly using a collection of such disparate as an EHR will not work. At a minimum, format, version and message system conversions would have to be made. [SV] is there any literature or are there reports/presentations which support this? It might be easier to 'see' this when it's backed up with examples/ literature. Cheers, Stef -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.openehr.org/mailman/private/openehr-clinical_lists.openehr.org/attachments/20080620/d66a904c/attachment.html>
