Just to say, I think it would be great to support the excellent efforts represented in this discussion, to work towards locally governed repositories of archetypes/templates, evolving synergistically in the sort of way being outlined. There is an important parallel with requirements for governance of terminology.
I tried very hard to align openEHR within the IHTSDO governance framework for combining local and global initiative for this sort of entity, but failed in this because the politics was too hard, as we reported at the time. IHTSDO seemed, and to me still seems to have the greatest chance of achieving useful progress towards effective standards and governance for clinical content, and openEHR should stay as close as possible to them in this, I believe. There are many clinical and professional issues still to be explored and resolved as to how terminology and archetypes should best coexist within such a framework. There are also licensing issues and realistically the licensing of archetypes for use in patient care at different levels will have to be acceptable to those groups responsible for ethico-legal standards that regulate the clinical professions, and, more immediately, for control of the licensing of international terminologies. Thus archetype/template licensing was always bound to be a very thorny and politicised issue for openEHR and, as a board charged with protecting the openEHR IP for the ultimate good of the healthcare community, we had to hear arguments from both within and outside the Foundation in deciding how we should hold the position. In truth, no one really knows how this issue will play out and we have to remain flexible in our policy, as we have said. I have been involved in working groups at a national level on reform of copyright law, where the kind of argument that is put forward within openEHR lists is advocated for publication more widely, with similar push back from interests dependent on controlling completely legitimate special interests. For what it's worth, I personally am in favour of society moving towards minimally restrictive licensing of knowledge artefacts, such as archetypes and terminologies, consistent with good order. I recognise that the many different perspectives in play about the underlying issues mean there will be fierce debate and honest disagreement about what that means and how it can be achieved. 'Twas ever thus! One of the huge difficulties I have observed over the past few years or so has been the ever growing number of ab initio and, in terms of outcome, mutually destructive, efforts to define and create standardised clinical content repositories - from hospital provider and clinical specialty to national, company product, regional and international levels. This is happening in many domains beyond healthcare, of course. There is a need for much more experiment in evolving good practice but there will never, I feel, be complete unification of such entities. Even if by some gargantuan effort, something is established globally, it would tend to fragment at more local levels, much as language itself has an organic existence between the universal and the local forms. Not easy to accommodate this basic truth when building and seeking to meet the evolving requirements of what are essentially very complex socio-technical entities like standard repositories of clinical content! What is needed, in my mind, is effective and accessible tooling to support shared discipline and methodological approach to these challenges, such that there can be improved, but never perfect or enduring, interoperability between domains. That's where openEHR has been trying to help things move forward. One final point, here. The marrying of global and local data in computer systems is being highlighted all over the place, well beyond the confines of health care records, although it's probably true that the health record carries one of the most complex set of requirements in this regard. I have seen it called the problem of 'hyper' but have no idea why that term is used. I suspect there may be useful research to be done in looking across 'hyper' requirements in a variety of different domains where content repositories are being built. Maybe one of the university groups active in openEHR is taking or might take an interest in this topic. David I On 07/09/2011 09:24, Ian McNicoll wrote: Thanks Erik, These feel like very sound proposals, in particular the focus on bottom-up local development. Pablo, Shinji - would Erik's suggestions be the kind of support that you would hope to have? Ian Dr Ian McNicoll office +44 (0)1536 414 994 fax +44 (0)1536 516317 mobile +44 (0)775 209 7859 skype ianmcnicoll ian.mcnicoll at oceaninformatics.com Clinical Modelling Consultant, Ocean Informatics, UK openEHR Clinical Knowledge Editor www.openehr.org/knowledge Honorary Senior Research Associate, CHIME, UCL BCS Primary Health Care www.phcsg.org On 7 September 2011 08:31, Erik Sundvall<erik.sundvall at liu.se> wrote: > Hi! > > On Wed, Sep 7, 2011 at 08:38, Ian McNicoll > <Ian.McNicoll at oceaninformatics.com> wrote: >> So, my question back, is >> "What sort of support would you like to see, given that significant >> central resourcing is not likely in the short term?" > [...] >> Would it be sufficient for the Foundation to give 'official status' to >> regional affiliates e.g. openEHR Japan, or are there other practical >> suggestions as to how best to support regional affiliates? > I would guess that an 'official status' recognition and thus links in > online (and some offline) information resources would be a major > thing, more imoportant than funding, especially if this also allowed > the regional organisation to arrange "official" openEHR > gatherings/conferences etc. It would be reasonable if the local > organisation could keep money left over from such (possibly partly > commercially sponsored) gatherings/conferences. > > Of course it would be reasonable if the foundation had some > requirements on official local organisations, like having: > - open membership > - statutes matching regional democratic traditions and the openEHR > goals (internal governance rules or whatever the swedish word > "stadgar" should be translated to) > - proper accounting and audit > - a duty to have a dialogue with the central openEHR foundation > regarding plans involving using the openEHR tradmark for events etc > - ...probably more... > > For local organisations I think bottom up comunity driven governance > with elected boards etc is the only way to go, not top-down. > > Best regards, > Erik Sundvall > erik.sundvall at liu.se http://www.imt.liu.se/~erisu/ Tel: +46-13-286733 > > _______________________________________________ > openEHR-clinical mailing list > openEHR-clinical at openehr.org > http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-clinical > _______________________________________________ openEHR-clinical mailing list openEHR-clinical at openehr.org http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-clinical
