No I did not. Honestly, it requires corrections and even after that, it would probably only go under wiki. I'm not sure if this could be a publication :)
Best Regards Seref On Mon, Nov 22, 2010 at 1:44 PM, Pariya Kashfi <hajar.kashfi at chalmers.se>wrote: > Hi Seref, > Have you published this interesting document somewhere except your weblog? > I want to cite this in an article. > > Best Regards > Pariya > > MSc; PhD Candidate > Department of Computing Science and Engineering > Chalmers University of Technology > http://www.chalmers.se/cse/EN/people/kashfi-hajar > > > > > > > > On Nov 2, 2010, at 1:32 PM, Seref Arikan wrote: > > Hi Pablo, > A very useful insight into the issues indeed. This is one topic that may > end up being a quite long discussion, but I feel it is a topic that is worth > laying out, not only today, but every couple of years or so, to see where we > are. > > I'll provide my personal views here. openEHR is not a small specification. > It is not a simple one either. Considering the problem it is trying to > solve, I do not expect it to be. Therefore, the complexity of implementation > is significant. The nature of the problem openEHR is trying to solve > inevitably creates the blind men and the elephant situation > http://en.wikipedia.org/wiki/Blind_men_and_an_elephant > In explaining what openEHR is, we are faced with the problem of > communicating the whole picture. In my experience, partial views or > decriptions of openEHR lead to confusion, even if every bit of information > provided is correct. Technical people and clinicians alike have a hard time > seeing the big picture, and who can blaim them? The picture is really, > really big. > > Be warned: the kind of statements I've just started to make are usually > perceived so that one gets the message "this needs to change". No. When I > say openEHR is complex, openEHR is big, openEHR is not easy to implement, I > don't mean openEHR is more complex than it needs to be, or openEHR is bigger > than it needs to be, or openEHR is harder than it should be to implement. > > We are attempting to solve a huge problem, and complexity of the solution > will enevitably rise in response. The instinct to simplify the solution > usually cripples the solution by pruning its support for less frequently > required features, but most of the time, this leads to an unsatisfactory > outcome. Surprisingly, everyone seems to follow the instinct. > > In my opinion, tooling and education are the two most important fronts we > need to make progress. The mechanics of an MRI is very complex, and yet, due > to way it was implemented, it is a practical, useful clinical tool. The > implementation of the very complex solution is designed so that without > knowing anything about the underlying mechanics, it can be used. > > Clinicians and developers need tooling to take control of complex concepts, > and not having enough tooling is leading to lots and lots of angels and > pinheads type of discussions. The chain of problems go like this: not enough > tooling -> not enough implementation -> not enough understanding & feedback > -> lots and lots of hypothetical discussions. > > So if (at least according to me) the biggest problem is tooling, why not > build the tools and solve the problem? Because no one is paying for it. > Whatever we have out there in terms of actual tools and implemenation is > mostly out there thanks to good intentions and hard work of people. I've > opened up the code I'm writing for my PhD, Ocean, Zilics, and people Rong > Chen and Tim Cook are doing the same, but with limited resources it is hard > to trigger a mass adoption. > > We are moving forward, no doubt, but people staying up in the middle of the > night are usually paying the steepest price, and the most interesting thing > in all this is that the expectations are huge. Please do not get me wrong, > I'm not saying this in response to your analysis, but most of the time, when > people encounter openEHR, they are amazingly expecting a piece of software > to install, which will deliver everything openEHR can deliver, out of the > box. And of course they want it to be open source. When they can't find > this, they say it is not there yet. I think this is also related to > education; personally I think that we need to stop people from having > unrealistic expectations, and clearly explain what the offer is, and what it > takes to turn that offer into value added. > > Anyway, this is a big topic, and I can't put everything I have in my mind > into one e-mail. Still wanted to say these bits. BTW, I've written about > openEHR almost two years ago, trying to explain it to novice, though my own > understanding at the time was not very clear. > http://www.serefarikan.com/?p=97 may be of help, next time you're trying > to describe what it is, at least some of it. > > Best Regards > Seref > > > 2010/11/2 pablo pazos <pazospablo at hotmail.com> > >> Hi Thomas, >> >> My opinion is the grade of adoption of a standard depend in some aspects >> of goverment agencies, in some of the industry and some of the academy. >> >> DICOM is a good example of an open standard heavily supported by the >> industry, that's the point of it success. Can't be OpenEHR a de-facto >> standard for EHRs? Like DICOM is for imaging. I think yes, but the progress >> of OpenEHR to solve real the problems and make it usable, is slow. >> >> I think OpenEHR is strong on the academy area. It has poor industry >> penetration (I mean enterprises developing tools and aplying a good part of >> the OpenEHR specification in their systems, and that these systems where >> used in some hospitals). I don't know what's the penetration of OpenEHR on >> goverment agencies. There are some open tools but there is some stillness on >> making improvements on them. >> >> >> For example, here in Latin America, almost nobody knows about OpenEHR in >> the industry area, and very very few knows about it in the academy area. >> >> There are some ideas that may help the difusion and adoption of OpenEHR: >> >> - I think that regional OpenEHR communities are needed to empower the >> adoption and spreading of the standard. In 2009 I send a message to the >> mailing lists, but I get no answer from the community (this mail is below). >> Now we have 36 members from Uruguay, Argentina, Chile, Colombia, Spain, and >> more. They work on goverment agencies, big enterprises (like IBM), >> developers and physicians. I think the international OpenEHR community needs >> to support these regional communities, providing guidelines, general >> objectives, and following their work. Here in South America, only few people >> know about OpenEHR, that's a shame. People in goverment are making >> decissions, without knowing that are good and open standards out there. >> >> - Formal training and education in OpenEHR is needed. It's very hard to >> the newcomer to understand how to use OpenEHR, and people interested on the >> main ideas of OpenEHR may be dissapointed when they try to use it in a >> real-world software application. People in the industry must be trained, but >> how many OpenEHR trainers are out there? >> >> In Set-2010 I've done a hands-on OpenEHR tutorial in Argentina, and people >> (medics and TIC people) where amazed about building their archetypes and >> having a tool that generates the EHR (this is my degree project). This was >> done in the context of the "Argentine Congress of informatics and Health >> 2010". Now, the organizers want to make more time to discuss OpenEHR and its >> posibilities. This is just an example that great things can happen if >> someone has interest. >> >> Regional OpenEHR communities can build courses fucused on the regional >> needs, may be made some money to support the open tool development (*). >> >> - Building and supporting open tools. The current tools have no regular >> updates. We need developers to build new tools and improve the current >> tools. We can use the money of the training courses (*) to pay developers to >> do this job. If this depends only on the free time we have, tools just can >> die before they are implemented. >> >> - In order to help any goverment adoption of OpenEHR, the decission makers >> have some questions that today OpenEHR can't answer. >> - What is the state of the standard? >> - Is it stable? >> - Wich parts are stable? >> - Is there any return of investment study done on efective use of >> OpenEHR? >> - Or just, how much time and money I have to spend to effectively use >> OpenEHR in a real world application? (I have to train people to make things >> happen, not in an investigation project, but in a production project) >> - What real world products are using OpenEHR? >> - How these products are using OpenEHR? (they adopt the RM? the AOM? the >> SM?) >> >> There is page on "who is using OpenEHR" in the portal, but it is outdated. >> My proposal is to do regular polls on the community in order to know: who is >> working on what, and how they're using OpenEHR. >> >> - Formal links with "formal" SDOs are needed. I think that OMG is in tune >> with the way OpenEHR do things. They have the COAS standard, and OpenEHR RM >> is mapped to COAS. This is a good starting point to have something in >> common. >> >> I think there are very good posibilities in the OpenEHR adoption on the >> industry adn goverment areas, but we need to build improve the lines of >> action of the community to reach that. >> >> >> Just my humble opinions. >> Best regards, >> - Pablo. >> >> -------------------------------------------- >> Hi, >> >> We're trying to build an spanish-speakers community about openEHR , I just >> create a google group: http://groups.google.com/group/openehr-es >> >> We want to translate some docs and presentations to generate enough >> knowledge to spread the word about OpenEHR, and other EHR related concepts >> between latin-american and spanish people. >> >> >> Best regards >> Pablo Pazos Gutierrez >> http://pablo.swp.googlepages.com/ >> >> >> ------------------------------ >> Date: Fri, 22 Oct 2010 20:19:29 +0100 >> From: thomas.beale at oceaninformatics.com >> To: openehr-technical at openehr.org >> Subject: Re: Articles on Healthcare, Complexity, Change, Process, IT and >> the role of openEHR etc >> >> >> Hi Derek, >> >> it is very simple. Not being an official standard has been a real problem >> for government agencies, obsessed with official standards. >> >> - thomas beale >> >> >> On 22/10/2010 17:12, Derek Meyer wrote: >> >> Tony, >> >> This is very impressive piece of work. Every since I first came across >> openEHR I have intuitively felt that it is closer to the 'solution' than >> more static attempts at standardization. So why is progress so slow? I've >> appplied some lateral thinking to this, and come up with what many people on >> this list may (at best) think contrarian - but at the risk of being >> flamed.... >> >> The Case for NPfIT 2.0 www.nationalhealthexecutive.com page 52-53. >> >> (I'll go get my hard hat now...) >> >> Best wishes, >> >> Derek. >> >> On 22/10/10, *"Shannon Tony (Leeds Teaching Hospitals NHS Trust)" * >> <tony.shannon at nhs.net> <tony.shannon at nhs.net> wrote: >> >> Late last year I said I would work on some material to help explain >> openEHR in the wider context of healthcare change during 2010. >> >> It has taken me longer that I originally planned but I've recently shared >> some articles online towards that end. >> http://frectal.com/book/ >> >> The articles explore issues such as >> Healthcare under pressure, >> Complexity of healthcare+management+IT, >> Change and the elements within >> Aligning process improvement efforts with IT >> >> In the final articles I explore healthcare change going forward, the need >> for better IT and particularly why I believe openEHR has the potential to >> tackle the complexity and diversity of healthcare.. >> http://frectal.com/book/healthcare-change-the-way-forward/ >> >> http://frectal.com/book/healthcare-change-the-way-forward/healthcare-openehr%e2%80%99s-potential-to-handle-complexity-diversity/ >> >> In the spirit of evolutionary change, they are up in draft form for now, >> so comments on any article are welcome.. >> >> Hope you find it of some interest/value in explaining openEHR's place in >> the wider world. >> Please feel free to share.. >> >> Kind regards >> >> Tony >> >> Dr Tony Shannon >> Consultant in Emergency Medicine, Leeds Teaching Hospitals >> Clinical Lead for Informatics, Leeds Teaching Hospitals >> Chair, Clinical Review Board, openEHR Foundation >> tony.shannon at nhs.net >> +44.789.988.5068 >> >> >> ******************************************************************************************************************** >> >> This message may contain confidential information. If you are not the >> intended recipient please inform the >> sender that you have received the message in error before deleting it. >> Please do 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. >> >> Thank you for your co-operation. >> >> NHSmail is the secure email and directory service available for all NHS >> staff in England and Scotland >> NHSmail is approved for exchanging patient data and other sensitive >> information with NHSmail and GSI recipients >> NHSmail provides an email address for your career in the NHS and can be >> accessed anywhere >> For more information and to find out how you can switch, visit >> www.connectingforhealth.nhs.uk/nhsmail >> >> >> ******************************************************************************************************************** >> >> >> _______________________________________________ >> openEHR-technical mailing list >> openEHR-technical at openehr.org >> http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-technical >> >> >> _______________________________________________ >> openEHR-technical mailing list >> openEHR-technical at openehr.org >> http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-technical >> >> >> >> -- >> [image: Ocean Informatics] *Thomas Beale >> Chief Technology Officer, Ocean Informatics<http://www.oceaninformatics.com/> >> * >> >> Chair Architectural Review Board, *open*EHR >> Foundation<http://www.openehr.org/> >> Honorary Research Fellow, University College >> London<http://www.chime.ucl.ac.uk/> >> Chartered IT Professional Fellow, BCS, British Computer >> Society<http://www.bcs.org.uk/> >> Health IT blog <http://www.wolandscat.net/> >> * >> * >> >> _______________________________________________ openEHR-technical mailing >> list openEHR-technical at openehr.org >> http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-technical >> _______________________________________________ openEHR-technical mailing >> list openEHR-technical at openehr.org >> http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-technical >> >> _______________________________________________ >> openEHR-implementers mailing list >> openEHR-implementers at openehr.org >> http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-implementers >> > > <ATT00001..txt> > > > -------------- next part -------------- An HTML attachment was scrubbed... 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