Hi All, just back from the New Zealand's national health informatics conference - HINZ. A big thing for a small country - I must say it was as impressive as HIC and Medinfo! Related with the topic I had a chance to present our work - a full-fledged implementation of our openEHR based endoscopy application and it drew significant attention. However compared to the existence of HL7 this was miniscule. I am not going to talk why this is the case but focus on some ideas which might help us to get openEHR better adoption. I have expressed these ideas personally with some of you but here is the full list:
- openEHR is not embracing: meaning, apart from a handful of core people fulltime employed to work on this, there is no model of 'organic engagement' - it is not tangible by ordinary people. And also a few others, like me, who are lucky enough to get paid to do work on openEHR from academia/research side or like Rong from a super dedicated vendor like Cambio. So how can one folk from company X can be an 'openEHRer' ? and why that should be compensated? Commercial organisations usually are reluctant to fund such activities if an employee is not taking some responsibility and that creates some visibility/traction. - In a similar vein, as Shinji pointed out, I fully agree with creating some 'touch points' to the openEHR by means of establishing local branches or 'leads' so to speak which was in the air some time ago but never started. But this has to be carefully aligned with the bigger openEHR otherwise different messages might start going out. I rather prefer establishing working or interest groups, perhaps facilitated by a more intuitive Web 2.0 tool than these discussion lists - possibly integrated with CKM. Mainly around clinician engagement and requirements capture and doing some 'bottom-up' wild-type modelling. I think there is now many of us who could dedicate some time to facilitate these discussions and come up with tangible results - Specs must continue to go with the core group with input from community. But perhaps this input process could be made more effective and all embracing. - I've had quite training on HL7, mainly CDA stuff, recently - and I agree with Seref that openEHR is big and difficult but relatively speaking much easier than HL7 v3. We must effectively communicate this and potential cost savings to vendors and programmes - and most importantly prove it! I think we have more than enough evidence now to make this publicly visible. - I personally think the imperfections in tooling is not a barrier to the adoption - they can do 90% of the job initially. I think it'd be too much of a burden on the already overloaded people who are putting so much and going all those extra miles. - I strongly believe (and thus research on) that the main catch of openEHR is on the future-proofness of health information systems as Tom pointed out in his very first paper. So why did we got stuck in this 'interoperability' whirlpool? Apart from the national programs and people caring for safety and quality of healthcare (well obviously not too much otherwise we'd be living in a world of health interoperability wouldn't we?) nobody has incentives to adopt interoperability standards. And national programs do not want to make exclusive commitments. I've listened at Medinfo, the Singapore experience, where one of the panelists was HL7 chair I reckon, that it was v3. But I knew they've considered and used openEHR models and used Ocean tools and raised this during Q &A. So everybody is trying to be super smart and say the right things but in reality experimenting with other alternatives. At HINZ epSOS we shown as the flagship project for v3 in Europe and so is Swedish national EHR project. Correct me if I am wrong but both should be openEHR/13606 based?? Adopting openEHR is still risky business at the end of the day... - In New Zealand we are going little more smarter and have started a myriad of trials/proof of concept projects before making any commitment on standards, but the overall architecture is inevitably HL7 dominated as there is a strong NZ affiliate working very efficiently. However I am hoping to start a few openEHR based projects and prove that they can work together. I am not sure if this is good or bad from the larger openEHR perspective, through the very open minded and respected NZ chair Dr. David Hay and with very prompt response from Hugh, there'll be an openEHR stream in the Sydney HL7 WG meeting which is international where I am hoping that the message will be that these are not absolutely mutually exclusive and there are ways of working together. Let's be practical they don't have any (real) means to capture clinical requirements and model plus no way to query and we don't (yet) have something tangible as CDA for persistence and for messaging like v2.x. There might be some opportunity to come up with some new ideas?? Who knows... I think we should really get over the attitude of seeing everything HL7 is doing wrong and conversely they should stop seeing openEHR as an enemy. There is a lot of really good work going on in HL7 and IHE SIG and WGs - especially around getting clinical requirements. I think the chances of wider adoption might be bigger if/when this alienation comes to an end so that vendors can confidently use and see for themselves what is working and not working for them without making any prior commitment. Just my thoughts though - I've already proven to be a terrible businessman so read at your own risk! - I've also came across a new slogan in the HL7 workshop: SDO consolidation. They've mentioned about the current MoUs they have with other SDOs as blockers and want to override them and make them get out of the healthcare scene - such as X12 or ASTM. I think I've also heard ISO along the lines ;) This is interesting and very conquering I think and may have some implications for openEHR in future. I personally don't think the current clinical information representation using v3 RIM methodology will survive for long and this space looks like to be filled pretty good with SNOMED+Archetypes. Perhaps because of this I am clearly witnessing more and more ignorance and even non-promotion of SNOMED / IHTSDO in HL7 rounds ;) So my overall point is, if you want to convince people to adopt openEHR, you need lots of proponents who are armed with knowledge and some form of recognition, to go out and disseminate. In my talks when I introduce myself I usually use the phrase 'openEHR fan' rather than member because technically nobody is. I am also a 'founding member of HL7 Turkish Affiliate' - and in some occasions when this is announced a crowd of people surround me! Cheers, -koray From: openehr-clinical-bounces at openehr.org [mailto:[email protected]] On Behalf Of Thomas Beale Sent: Friday, 5 November 2010 10:52 a.m. To: openehr-clinical at openehr.org Subject: Re: Why is OpenEHR adoption so slow? On 04/11/2010 20:59, pablo pazos wrote: Hi Thomas, I didn't mean that we have to follow the HL7 structure and ways of funding. They have good and bad things, as you point. One of the good things is that a set of small regional communities are stronger than a huge central community, because they have common interests, common language, common culture, etc. For example I spend more than 15 mins on writing emails to the lists because of the language, when I spend 3 mins writing to lists in spanish. Reading the english only specs is another thing that discourages people with no formation in the language. I certainly appreciate this - I spend time reading specifications in other languages, and it is slow, since I am not perfectly bilingual. We do have some translations of specifications, but not much. Good translations are expensive and they also have to be maintained. For example, the french translation of the ADL spec is excellent, but now out of date, and there is no business model to support its updating. Again, I think we can build some money to improve the tools, like making courses, events (like the IHE Connectathon), selling books, t-shirts, coffe cups, etc (donations are always welcome). I'm against a paid membership, it closes a community that claims to be open, this is not a gym :D well, its why we never did that. I think your ideas are good, the only concern I have is that I think there still has to be a sufficiently strong central part of the organisation to help organise materials, resources, and run the governance structure; at the moment there is not enough funding to do what would be needed to support local orgs. But I would very much like to see openehr.cl, .br, .uy, etc. Just an idea: I think the Service Model is very green yet, but when it go a little more mature, we can make automated tests to test the implementations, and they can have an OpenEHR certificate that the software meets the specification (a paid certificate). we can already test with XML schemas. You are right, the service models will be a key basis for conformance testing, but it will take some more time to get the required maturity. - thomas -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.openehr.org/mailman/private/openehr-clinical_lists.openehr.org/attachments/20101105/79b29f80/attachment.html>
