Stef Verlinden wrote: > > *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. >
there are undoubtedly places where there is only a single central message switch, but there are many places where this is not the case - I know this from personal experience, and conversations with message system implementers. I would expect that health computing environments where the messages sources have been centralised and converted into correct versions, correct coding, correct identifiers etc would be in the minority. I don't know if there are any surveys on this, but in the first instance it would be useful if people onthis list were to respond with their experience of the level of use of centralised message switches. > 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. > it is, the problem is rationalising the context from each message with that recorded in other rmessages in order to get a coherent picture of some aspect of the patient situation. This gets difficult very quickly if there is not a standardised approach to modelling context in messages, or if messages modelled by different groups including differing levels of context information. - thomas
