Hello Tony! Congratulations to you for your new role as chair, and we wish you lots of success! Hope to meet you in person somtime soon!
Right on into it, you wrote: "Can I ask you (wherever you are and whatever your clinical challenges are) what are the *top 5* things you would like to see the openEHR foundation tackle to move us all in the right direction over the next year/18months and better support your own challenges as a clinician? That might be better communication, better means to get involved, better tools etc etc...whatever you happen to think.." Now, here comes: Myself, I am an academic person, electronics engineer, with 15 years of research experience in a university hospital, doing biosignal analysis, and software development for experimental research in medicine. I moved into teaching and standards, and I am now the head of the national mirror to CEN and ISO TCs for medical informatics, and a founding member of IHE Austria. We had a lot of contact to 13606, hoping that it would evolve into something that would solve the problem of reuseability of medical information models. Over the last year and a half I have been responsible for coordinating work on medical documents in Austria, together with others. This is still going on, as a part of the Austrian national EHR project ELGA. We have put together groups of high ranking medical experts, most of them clinicians, all in all about 80-100 of them, and started the discussion about the contents of medical documents: discharge summaries, laboratory reports, radiology reports, and medication status. The national austrian eHealth strategy recommends to use CDA as an electronic format for this exercise. This has been confirmed by politics, and we therefore were obliged to follow that route. We did some reviews before we started, and it was decided to use the results of the German CDA work within VHITG as a basis. In the middle of the work, we discovered the IHE laboratory technical framework, which contains a very useful laboratory report, see http://www.ihe.net/Technical_Framework/upload/ihe_lab_TF_rel2_1-Vol-3_FT_200 8-08-08.pdf This is also used in national projects in the USA, the Netherlands, and France. We are now in the middle of the discussion, and, (provided we can continue, we do have national elections in September), hope to reach some stability by end of 2008. We are going to keep very close to the mentioned IHE lab report. International standards are among the major goals of the Austrian EHR project. And this is where real trouble begins. People do approach us "experts", asking: Which standard is the right one for capturing medical content. At the moment many in Austria believe that this is HL7 CDA. However, 13606 is a formal international and Austrian standard, and everybody asks us how the situation is going to look like in 5 years. Will it still be CDA, or archetypes, or full 13606, or a combination? What is the direction? What path shall we follow? Where shall we invest our money? Even if it is not finished right now: Is there at least a clear development path which will produce useful results soon? Is the cooperation between CEN, ISO, HL7, openEHR etc. really producing a change, and will it root out the conflicting standards jungle? Even being the formally topmost medical informatics standards person in Austria, and having attended international meetings for years now I must tell them that I do not know. This is a very unpleasant experience, and I would very much like to see some movement here. In order to get something on the way here, I think we need to combine some major forces, and finally show that we can successfully tackle some real world problems on a multi-national scale. - The IHE lab report group does collect clinical input from different countries, and it has carried the document through many iterations, and produced a final release in August 2008. After that much effort, it can well be expected to be of clinical use, and is definitely worth consideration. We do see a lot of vendor interest here, and things are being implemented, tested, and put to practical use. - openEHR is the home of archetypes, a very relevant technology, and also has a lot of international clinical input and expertise, and the tailwind of 13606 being a formal international standard. (- HL7 is the home of CDA, and therefore connected deeply) Would it be possible to connect these two (or all three?) groups, generate archetypes from the IHE lab report, and show how this agreed clinical content can usefully be documented and reused with the archetype technology? About people: I put Francois Macary in cc here, he is coordinating the IHE lab report work, and also responsible from a national view in France. Francois, we did talk about these things recently on the phone. I also cc to Andries Hamster, who is coordinting the lab report work from the Netherlands side, and Harry Rhodes, who is active in HITSP in the USA. Alexander Mense and Stafan Sabutsch are part of the CDA work in Austria, representing HL7 Austria. Frank Oemig is very active in HL7, in Germany and internationally. Wolfgang Dorda and his group at Medical University of Vienna are deep into 13606 for many years, and seem to me one of the few who really understand. Bernd Blobel keeps telling me that above 13606, CDA and the rest we do need a lot more specifications on how to build and connect and check things formally and mathematically. Over the years I slowly tend to believe him there. We might realise exactly what he means once we realise that a few things really do not fit together. I can see him jumping in happily then, saying: "I kept telling you that since 1981, and here is the solution". May we be able to gracefully realise, learn, adapt and use it when the time comes. Sure a lot are missing here. Going through this will not be a smooth ride, and we will have to prove many novel ideas in practice. The hope is that in the end we will be able to show clinicians and vendors exactly what CDA is for, and where it obviously is more efficient to use archetypes. We do have the Istanbul ISO / CEN meeting in October, and it would make me very happy to see at least some starategic / formal light on the horizon by then. Comments are very welcome, should you find the time, and I would be very happy to discuss this further with whoever is interested. Well, this is it from Vienna for the moment. Again, all the best for your chairmanship, I am sure this is an interesting experience, and I am happy to be at least a small part of it. Greetings from Austria, and see you soon, Stefan Sauermann Acting Program Director Biomedical Engineering Sciences (Master) University of Applied Sciences Technikum Wien Hoechstaedtplatz 5, 1200 Vienna, Austria Tel: ++43-(0)1- 333 40 77 - 988 sauermann at technikum-wien.at http://www.technikum-wien.at -----Urspr?ngliche Nachricht----- Von: openehr-clinical-bounces at openehr.org [mailto:openehr-clinical-bounces at openehr.org] Im Auftrag von Tony Shannon Gesendet: Mittwoch, 03. September 2008 00:42 An: For openEHR clinical discussions Betreff: Re: Chair of openEHR Clinical Review Board (CRB) .. your views please Dear All, I am very honoured to be invited to take up this important role as Chair of the Clinical Review Board within the openEHR Foundation. Please allow me to introduce myself and my interest in openEHRs mission. I would welcome your feedback and views as I explain below. - I qualified as a doctor in Dublin and now work as a Consultant in Emergency Medicine based in Leeds, spending half of my week working with NHS Connecting for Health which is delivering the National Programme for IT here in England. For many years I have been well aware that we as clinicians are very dependent on effective information management. Indeed we must address this challenge to firstly survive and then hopefully thrive as 21st century healthcare pressures increase.. As my work in Informatics has grown over the last years, I have increasingly understood that these challenges are only a part of a wider international struggle to change many health care systems in very fundamental ways. Much of my work within NHS Connecting for Health has been centred around what I call a "Healthcare Change Challenge" involving people, process and technology change. Indeed it was research in that area and the potential offered by standards to support that change that helped me come across openEHR. When I first came across openEHR I must admit it took me some time to understand what it offered. Over a little time it became much clearer and a "lightbulb" came on, as it appeared to offer a potential solution to several of the "wicked problems" I had been struggling with for some years. It is a credit to the initial minds behind this work that openEHR has provided, to me at least, a way to tackle the complex challenge that informatics provides. The openEHR archetypes and templates offer many obvious advantages and indeed I find the openEHR reference model with its simple but clear relationship with key generic clinical processes a key strength of openEHRs approach, which no other standard does so well.. We have been quietly using openEHR to develop clinical content models (archetypes and templates) within the NHS for some time now, building up a Clinical Content Service. This service aims to develop (for the first time in the NHS) clinically driven, open standards based, reusable, shareable, clinical content models. In doing so we are trying to reduce duplication of effort, encourage consistencies and standardisation of clinical records where appropriate, though we have some way to go to see them used in action within vendor EHR systems..something we continue to pursue... While it is a quiet start, I feel that it is only the beginning, as I expect that vendors will increasingly appreciate the enormous potential on offer, by providing more native support for openEHR than they currently offer. In due course I also believe that, given the right tools, that more ownership and control of health ICT development will quite naturally end up in the hands of those who need it most, i.e. the clinicians. - I must admit I have stayed silent on this mailing list until now, watching the varied email exchanges on many parts of the openEHR work that continue to develop, trying to learn more all the time. With that in mind I would like to ask this clinical group a single question that I hope might provoke some useful feedback.. Can I ask you (wherever you are and whatever your clinical challenges are) what are the *top 5* things you would like to see the openEHR foundation tackle to move us all in the right direction over the next year/18months and better support your own challenges as a clinician? That might be better communication, better means to get involved, better tools etc etc...whatever you happen to think.. I would like to collate your views, feed them back to the group and then present them to the openEHR CRB and into the emerging openEHR Foundation discussions on strategic direction, which as Professor Ingram has outlined, have recently begun.. This is an important time for openEHR, as increasingly light is being shone on it. I think it is also an exciting time, which we need to take advantage of. I look forward to hearing from you either via this mailing list/ directly to me if you prefer at tony.shannon at nhs.net With kind regards, Tony Dr. Tony Shannon Consultant in Emergency Medicine, Leeds Teaching Hospitals Clinical Lead, Clinical Content Service, NHS Connecting for Health Senior Research Fellow, University College London +44.789.988 5068 tony.shannon at nhs.net Thomas Beale wrote: > [this is a repost of an announcement made a week ago, for those on the clinical list but not on the announce list] > > from Prof David Ingram, CHIME department, University College London: > > I am delighted to announce that Dr Tony Shannon has accepted an > invitation, on behalf of the openEHR Foundation Board, to take over the > chair of the Clinical Review Board. Tony has long experience and > interest in clinical information management, as Clinical Lead for the > Clinical Content Service of NHS Connecting for Health and as Consultant > in Emergency Medicine at Leeds Teaching Hospitals. > > My UCL colleague, Dr Dipak Kalra, has been the founding chair of the CRB > but felt it the right time to step down and make way for a new > appointment, recognising, as we all do, that openEHR governance needs to > spread beyond the founding members at UCL and Ocean Informatics. Dipak, > Sam Heard and I remain as the active directors of the Foundation, but > this, too, may well change quickly, in the period ahead, as we work to > broaden the governance of the Foundation. Ideally, we feel that the > Foundation needs to remain agile and inclusive in its work, while > consolidating its relationships and accountability to users and > international stakeholder organisations, keen to capitalise on its work. > In this transition, we must try to avoid exchanging a crucible of > innovation for a tanker full of treacle. > > Tony Shannon has an honorary appointment as senior research fellow at > UCL and has been active clinically in building wider awareness of and > engagement with the mission of openEHR, for several years. Along with > Tim Cook, a member of the ARB, he has joined Sam, Dipak, Tom Beale and > me in crucial new discussions about how to take the Foundation into its > next stage of development and governance, as its work grows rapidly in > international focus and importance. We have received a number of > approaches for new partnerships and we will be taking these very > seriously and opening discussions more widely within the international > community, including at a session of the WoHIT conference in November, > under the auspices of our collaborating partners in EuroRec. > > openEHR exists to champion the clinical ownership of the fundamental > requirements for effective and useful electronic health records and to > support the discipline, engagement and trust required to help them > succeed. Central to its approach is shared and collaborative research, > development and iterative evaluation, though real world implementations. > > > > * > * > > _______________________________________________ > openEHR-clinical mailing list > openEHR-clinical at openehr.org > http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-clinical *********************************************************************** This message may contain confidential and privileged information. If you are not the intended recipient you should not disclose, copy or distribute information in this e-mail or take any action in reliance on its contents. To do so is strictly prohibited and may be unlawful. Please inform the sender that this message has gone astray before deleting it. Thank you. 2008 marks the 60th anniversary of the NHS. It's an opportunity to pay tribute to the NHS staff and volunteers who help shape the service, and celebrate their achievements. If you work for the NHS and would like an NHSmail email account, go to: www.connectingforhealth.nhs.uk/nhsmail *********************************************************************** _______________________________________________ openEHR-clinical mailing list openEHR-clinical at openehr.org http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-clinical
