Thanks Rodrigo, Very helpful comments.
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 9 September 2011 13:42, Rodrigo Filgueira <rfilgue at gmail.com> wrote: > Dear All, > > > > Having tried for long to make my activity on this subject sustainable in > Uruguay I feel that not only there is a need for tools but also support in > terms of advocacy. > > > > I have not followed the internal negotiations and processes that led to > Brazil adopting this model, but a lot of work was surely put into advocating > for OpenEHR not exclusively from a technical perspective. From my experience > decision makers find this subject very blurry, so even being technically > sound is often not enough. > > > > It is also the case that IT and Health is installed in the political arena, > so there is a tendency to put a lot of value into short term wins. Although > the benefits of long term development are clear (OpenEHR), reality may not > move in that direction because of short sighted decision makers and also > lack of investment. > > > > Three areas where advocacy support would be very welcome: > > > > - Identifying short term wins while building a long term strategy. > > - Academic collaboration with relevant universities. > > - Explaining the social benefit of IT in healthcare. > > > > Other initiatives which would help sustain local/regional teams have to do > with making the local counterparts visible in the international scenario. > International/central validation of the activity and competencies of local > members would very much help them to advocate and position OpenEHR. > > > > my two cents > > On 8 September 2011 17:04, Tony Shannon <tony.shannon at nhs.net> wrote: >> >> Thanks Pablo >> >> It's great to see the proposals generate these discussions, which was >> our intention as these discussions were needed.. >> >> Regarding tools, I'm a keen advocate for open source tools and believe >> better tools will be key to more widespread use of openEHR.. >> ..but know I you cant get them for free, so if we want more tools we can >> share... >> -the community needs to agreed a prioritised set of open source tools >> -we need to establish how much they will cost >> -we need to find ways to channel funds from those who need the tools to >> those who are willing to do the work.. >> >> regards, >> >> Tony >> >> Dr. Tony Shannon >> Consultant in Emergency Medicine, Leeds Teaching Hospitals >> Clinical Lead for Informatics, ? ?Leeds Teaching Hospitals >> Honorary Research Fellow, University College London >> +44.789.988 5068 ? ? ? ? ? ?tony.shannon at nhs.net >> >> >> On 07/09/2011 18:49, pablo pazos wrote: >> > Hi David, >> > >> > You mention a big issue: we want to build local archetype and template >> > repositories but we don't have the tools to do it in a coordinated way >> > with the openEHR CKM. >> > >> > I think it would be great to have an open & free CKM to start with, and >> > a common generic API to connect our local CKMs to regional CKMs and >> > regional CKMs to the global CKM in a controlled way (in this scenario >> > the versioning of artefacts is a big issue and I think it is not solved >> > at the tool level yet). >> > >> > AFAIK the to install the global CKM we have to buy some licenses. >> > >> > -- >> > Kind regards, >> > Ing. Pablo Pazos Guti?rrez >> > LinkedIn: http://uy.linkedin.com/in/pablopazosgutierrez >> > Blog: http://informatica-medica.blogspot.com/ >> > Twitter: http://twitter.com/ppazos<http://twitter.com/ppazos> >> > >> > ?> Date: Wed, 7 Sep 2011 17:47:09 +0100 >> > ?> From: rmhidxi at live.ucl.ac.uk >> > ?> To: openehr-clinical at openehr.org; Martin.Severs at port.ac.uk >> > ?> Subject: Re: openEHR Transition Announcement (about regional/national >> > openehr organizations) >> > ?> >> > ?> 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 >> > ?> _______________________________________________ >> > ?> openEHR-clinical mailing list >> > ?> openEHR-clinical at openehr.org >> > ?> http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-clinical >> >> -- >> >> >> >> ******************************************************************************************************************** >> >> 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-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 >
