Hi William
I am sure there is a little tension on what you are proposing and what is actually going on. I think we in the openEHR community do have considerable experience in how to do this, what can go wrong and why. We all have a lot to learn yet. It is typical of the current health standards process that one or two people, who have time on their hands, write something and everyone else argues. Ney sayers are seen as defending their position, but they may be coming from a sensible position. All I can say is that Heather Leslie probably has the most experience of anyone on the planet in this area, so it might be worth trying to get beneath the surface of her concerns. The alternative may be an irrelevant ISO standard (to join the others!). Cheers, Sam From: openEHR-clinical [mailto:[email protected]] On Behalf Of William Goossen Sent: Monday, 7 January 2013 7:44 PM To: openehr-clinical at lists.openehr.org Subject: RE: openEHR-clinical Digest, Vol 11, Issue 6 I agree Jan, The examples we have evolved the last years to reflect DCM 13972 changes over time. I think that Heather should ask if it needs to be clear if an archetype / DCM / hl7 template / Ceml and such are published, hence ready for use, or drafts and not safe to use. If all in CKM is safe to use, that would be one method to comply to DCM statement on publication status. If a colour scheme in CKM differentiates the ripe from the green that is confirming to the DCM statement on publication status. The DCM standard specifies that any creator of models Shall state if they are ready to go. It would be better for OpenEHR to work on compliance to these obvious common sense instead of obstructing a standard we all would benefit from. Vriendelijke groet, William Goossen Verzonden met mijn Winphone Nokia Lumia 800 _____ Van: openehr-clinical-request at lists.openehr.org <mailto:openehr-clinical-request at lists.openehr.org> Verzonden: 7-1-2013 10:05 Aan: openehr-clinical at lists.openehr.org <mailto:openehr-clinical at lists.openehr.org> Onderwerp: openEHR-clinical Digest, Vol 11, Issue 6 Send openEHR-clinical mailing list submissions to openehr-clinical at lists.openehr.org <mailto:openehr-clinical at lists.openehr.org> To subscribe or unsubscribe via the World Wide Web, visit http://lists.openehr.org/mailman/listinfo/openehr-clinical_lists.openehr.org or, via email, send a message with subject or body 'help' to openehr-clinical-request at lists.openehr.org <mailto:openehr-clinical-request at lists.openehr.org> You can reach the person managing the list at openehr-clinical-owner at lists.openehr.org <mailto:openehr-clinical-owner at lists.openehr.org> When replying, please edit your Subject line so it is more specific than "Re: Contents of openEHR-clinical digest..." Today's Topics: 1. Re: openEHR-clinical Digest, Vol 11, Issue 3 (Talmon (CRISP)) 2. RE: openEHR-clinical Digest, Vol 11, Issue 3 (Heather Leslie) ---------------------------------------------------------------------- Message: 1 Date: Mon, 7 Jan 2013 08:36:12 +0100 From: "Talmon (CRISP)" <[email protected] <mailto:talmon at maastrichtuniversity.nl> > To: For openEHR clinical discussions <openehr-clinical at lists.openehr.org <mailto:openehr-clinical at lists.openehr.org> > Subject: Re: openEHR-clinical Digest, Vol 11, Issue 3 Message-ID: <6824C2AB-CBD0-4D48-8048-8968D2378624 at maastrichtuniversity.nl <mailto:6824C2AB-CBD0-4D48-8048-8968D2378624 at maastrichtuniversity.nl> > Content-Type: text/plain; charset="Windows-1252" Dear Heather Apart from implementation issues and current compliance, the question to answer for this particular example is whether or not it is useful to know what the status of an artifact is? When someone sends me an archetype in ADL, it is relevant for me to know what the status of that archetype is. It will allow me to make an informed decision how to use (or not to use) that archetype. Although it may be in the email to which the archetype was send, later on, that email may get lost. So it is better to have it as meta data of the archetype. (At least from my perspective). More in general, 13972 should specify the useful components of detailed clinical models. We all want interoperability and safe use of clinical models. I think the most constructive approach is to argue why certain SHALL statements may not be necessary (or too mandatory) to support these goals. The argument that "My current implementation is not compliant, hence it has to change" is less compelling for others. Any standardization work implies for some (if not all) approaches that work needs to be done to become compliant. BTW, I have noticed that the "Dutch DCM" approach has evolved over the years to accomodate what has been in successive drafts of 13972, not that the drafts followed what was put in the "Dutch DCM" approach. Regards Jan On 7 jan. 2013, at 08:00, Heather Leslie <heather.leslie at oceaninformatics.com <mailto:heather.leslie at oceaninformatics.com> > wrote: > Hi William, > > Perhaps you can clarify better if I use a concrete example such as 5.8.12.2.2 which is a SHALL (or mandatory) statement.. There is a subcomponent within this normative statement labelled: ?Publication Status of the detailed clinical model?, with a description: ?This is the status of the detailed clinical model in relation with publication in the registry or repository: Not For Use (i.e. teaching); Approved for testing; Approved for Production Use; Withdrawn; Superseded; Rejected(en); Obsolete.? > > I interpret this as saying it is mandatory for a clinical model specification to contain a statement about the model?s publication status. > > openEHR archetypes currently don?t contain the publication status within the archetype specification itself. So I conclude that, at present, openEHR archetypes cannot be compliant with 13972 in regards to this normative statement. > > I know that some other detailed clinical models contain a version history that incorporates a publication status as well, but that is not the case with the archetype as a logical model. > > Regards > > Heather > > From: openEHR-clinical [mailto:openehr-clinical-bounces at lists.openehr.org] On Behalf Of William Goossen > Sent: Monday, 7 January 2013 5:19 PM > To: openehr-clinical at lists.openehr.org <mailto:openehr-clinical at lists.openehr.org> > Subject: RE: openEHR-clinical Digest, Vol 11, Issue 3 > > Hi Heather, > > Thanks for your reply. > > In general ISO 13972 describes what good models should look like, not how my models should look. Sorry to see that misunderstanding repeated. > > And it specifies characteristics of the models. If CKM is the means of implementation, why bother. If you version the models you new the requirements of ISO for instance. > > OpenEHR is even based on these foundations that you refer to other parts for particular characteristics. > > So I could not disagree more about such matters. And that is why the governance is in and separated from the model. > > E.g. If it says that any DCM should have an ID, in normal situations it must be in the file or in the file and. But there are other means to guarantee the uniqueness. > > I am afraid you are judging the DCM work too much from an current CKM implementation side. Please go back a step to the principles: why do we need these characteristics? Because there are alternative s to archetypes. That is why this TS 13972 exists, to facilitate the 99% of EHR systems that cannot manage archetypes. > You already have the 13606 series you can refer to. > > Vriendelijke groet, > > William Goossen > > Verzonden met mijn Winphone Nokia Lumia 800 > Van: openehr-clinical-request at lists.openehr.org <mailto:openehr-clinical-request at lists.openehr.org> > Verzonden: 7-1-2013 4:46 > Aan: openehr-clinical at lists.openehr.org <mailto:openehr-clinical at lists.openehr.org> > Onderwerp: openEHR-clinical Digest, Vol 11, Issue 3 > > Send openEHR-clinical mailing list submissions to > openehr-clinical at lists.openehr.org <mailto:openehr-clinical at lists.openehr.org> > > To subscribe or unsubscribe via the World Wide Web, visit > http://lists.openehr.org/mailman/listinfo/openehr-clinical_lists.openehr.org > > or, via email, send a message with subject or body 'help' to > openehr-clinical-request at lists.openehr.org <mailto:openehr-clinical-request at lists.openehr.org> > > You can reach the person managing the list at > openehr-clinical-owner at lists.openehr.org <mailto:openehr-clinical-owner at lists.openehr.org> > > When replying, please edit your Subject line so it is more specific > than "Re: Contents of openEHR-clinical digest..." > > > Today's Topics: > > 1. RE: openEHR-clinical Digest, Vol 11, Issue 1 (Heather Leslie) > > > ---------------------------------------------------------------------- > > Message: 1 > Date: Mon, 7 Jan 2013 14:45:37 +1100 > From: "Heather Leslie" <heather.leslie at oceaninformatics.com <mailto:heather.leslie at oceaninformatics.com> > > To: "'For openEHR clinical discussions'" > <openehr-clinical at lists.openehr.org <mailto:openehr-clinical at lists.openehr.org> > > Subject: RE: openEHR-clinical Digest, Vol 11, Issue 1 > Message-ID: <[email protected] <mailto:[email protected]> > > Content-Type: text/plain; charset="us-ascii" > > HI William, > > > > My comments below. > > > > Heather > > > > From: openEHR-clinical [mailto:openehr-clinical-bounces at lists.openehr.org] > On Behalf Of William Goossen > Sent: Saturday, 5 January 2013 5:53 AM > To: openehr-clinical at lists.openehr.org <mailto:openehr-clinical at lists.openehr.org> > Subject: RE: openEHR-clinical Digest, Vol 11, Issue 1 > > > > Dear Heather, > > I understand you have additional comments for the ISO DTS 13972. That is > fine and important for this round. > > What strikes me is that you see a disconnect between clinical models such as > open EHR archetypes and governance procedures and tools such as CKM with the > ISO DTS 13972. > > [HL>] As far as I can understand, there are some items that you are > mandating in normative statements for inclusion within the logical models > that we manage within the Knowledge Governance environment, not in the > models themselves. > > > > As you say OpenEHR has a long term experience in clinical modelling. That is > way that is used as an important example in this ISO work in particular on > the repository side, that is based on Sebastian Gardes original > presentation in Brisbane where this work started in 2007. I hope that the > change requests you submitted and that were accepted by the ISO expert team > do reflect the CKM changes over time. > > [HL>] It is not about reflecting any CKM changes, but aspects that have not > been addressed yet in 13972. Many of the normative statements reflect the > way you manage your DCMs that you have developed but are not embracing the > ways that CKM operates. I can't speak for other approaches and how well > 13972 embraces a range of modelling approaches such as those I identified in > https://docs.google.com/document/d/1lltQDkoYb3bsp8fw_J7zw9T9ZK9dr3GChq872A3- > -Pk/edit > > > > of course the ISO work focuses on the conceptual parts like in the > archetypes, and the logical parts such as dataelements, datatypes, code > bindings and so on, like archetypes. But it leaves implementation > specifications to other parts, where the difference with OpenEHR is > intentionally maintained. > > I am quite puzzled by your comments by the way. I think ISO DTS 13972 is a > standard that strongly supports clinical modelling, including OpenEHR > archetypes, but to enhance semantic interoperability > > [HL>] Absolutely. That is why I have tried to be involved. > > > > also clinical models based on alternative paradigms are taken into account. > > > That is very important to offer other legacy systems a migration strategy to > connect. > > This is also appreciated in the CIMI work in which we cooperate. The CIMI > reference model is consistent with the ISO 13972 clinical model > specification. > Only is you specify patient demographics, location and provider data in each > model, or as a separate reused model is a minor difference nothing more than > a style issue. > > I look forward to your comments. > > Vriendelijke groet, > > William Goossen > Project lead ISO13972 DTS. > > Verzonden met mijn Winphone Nokia Lumia 800 > > _____ > > Van: openehr-clinical-request at lists.openehr.org <mailto:openehr-clinical-request at lists.openehr.org> > <mailto:openehr-clinical-request at lists.openehr.org> > Verzonden: 4-1-2013 9:11 > Aan: openehr-clinical at lists.openehr.org <mailto:openehr-clinical at lists.openehr.org> > <mailto:openehr-clinical at lists.openehr.org> > Onderwerp: openEHR-clinical Digest, Vol 11, Issue 1 > > Send openEHR-clinical mailing list submissions to > openehr-clinical at lists.openehr.org <mailto:openehr-clinical at lists.openehr.org> > <mailto:openehr-clinical at lists.openehr.org> > > To subscribe or unsubscribe via the World Wide Web, visit > http://lists.openehr.org/mailman/listinfo/openehr-clinical_lists.openehr.org > > or, via email, send a message with subject or body 'help' to > openehr-clinical-request at lists.openehr.org <mailto:openehr-clinical-request at lists.openehr.org> > <mailto:openehr-clinical-request at lists.openehr.org> > > You can reach the person managing the list at > openehr-clinical-owner at lists.openehr.org <mailto:openehr-clinical-owner at lists.openehr.org> > <mailto:openehr-clinical-owner at lists.openehr.org> > > When replying, please edit your Subject line so it is more specific > than "Re: Contents of openEHR-clinical digest..." > > > Today's Topics: > > 1. ISO/DTS 13972 DCM ballot (Heather Leslie) > 2. RE: ISO/DTS 13972 DCM ballot (Evelyn Hovenga) > 3. RE: ISO/DTS 13972 DCM ballot (Heather Leslie) > > > ---------------------------------------------------------------------- > > Message: 1 > Date: Fri, 4 Jan 2013 12:37:09 +1100 > From: "Heather Leslie" <heather.leslie at oceaninformatics.com <mailto:heather.leslie at oceaninformatics.com%0b> > <mailto:heather.leslie at oceaninformatics.com> > > To: "For openEHR clinical discussions" > <openehr-clinical at lists.openehr.org <mailto:openehr-clinical at lists.openehr.org%0b> > <mailto:openehr-clinical at lists.openehr.org> >, "For openEHR technical > discussions" <openehr-technical at lists.openehr.org <mailto:openehr-technical at lists.openehr.org%0b> > <mailto:openehr-technical at lists.openehr.org> >, "For openEHR > implementation discussions" <openehr-implementers at lists.openehr.org <mailto:openehr-implementers at lists.openehr.org%0b> > <mailto:openehr-implementers at lists.openehr.org> > > Subject: ISO/DTS 13972 DCM ballot > Message-ID: <[email protected] <mailto:[email protected]%0b> > <mailto:[email protected]> > > Content-Type: text/plain; charset="us-ascii" > > Dear Colleagues, > > > > I spent some time yesterday responding to the ballot for ISO/DTS 13972 > Characteristics and Processes of Detailed Clinical Models. My first draft > resulted in 14 pages of comments on identified issues (not typos or > grammatical errors). > > > > There are a number of aspects about the specification that remain > concerning, but one of the main ones is that it is not embracing of all > current international clinical modelling/governance approaches including > that being used by openEHR, with separation between archetypes as logical > models and CKM as the governance/maintenance tool. This means that openEHR > work will not be compliant with the proposed DTS, despite openEHR being > recognised as being one of the world leaders in the clinical modelling > environment. > > > > As I understand it, if the DTS passes this ballot, then it may be published > immediately as an ISO Technical Specification. > > > > There have been a small number of experts who are actively engaged in > openEHR participating in this DTS development, but despite providing > feedback consistently during the past few years, this is still the > unfortunate place in which we find ourselves. > > > > I would encourage you to peruse the DTS and provide feedback as you see fit. > > > > > Unfortunately, it is not permitted to distribute the ISO documents publicly > on a list such as this - you will need to make contact with your ISO > national member body and respond through their official channels. > > > > The deadline for Australian submissions to Standards Australia is 14 > January; so expect that the ISO deadline will be soon after. > > > > Kind Regards > > > > Heather Leslie > > > > > > Dr Heather Leslie > MBBS FRACGP FACHI > Director of Clinical Modelling > <http://www.oceaninformatics.com/> Ocean Informatics > Phone (Aust) +61 (0)418 966 670 > Skype - heatherleslie > Twitter - @omowizard > > > > -------------- next part -------------- > An HTML attachment was scrubbed... > URL: > <http://lists.openehr.org/pipermail/openehr-clinical_lists.openehr.org/attac <http://lists.openehr.org/pipermail/openehr-clinical_lists.openehr.org/attac %0b> > hments/20130104/7f448460/attachment-0001.html> > > ------------------------------ > > Message: 2 > Date: Fri, 4 Jan 2013 15:07:01 +1100 > From: "Evelyn Hovenga" <ehovenga at gmail.com <mailto:ehovenga at gmail.com%20%3cmailto:ehovenga at gmail.com> <mailto:ehovenga at gmail.com> > > To: "'For openEHR clinical discussions'" > <openehr-clinical at lists.openehr.org <mailto:openehr-clinical at lists.openehr.org%0b> > <mailto:openehr-clinical at lists.openehr.org> > > Subject: RE: ISO/DTS 13972 DCM ballot > Message-ID: <[email protected] <mailto:[email protected]%0b> > <mailto:[email protected]> > > Content-Type: text/plain; charset="us-ascii" > > Heather the relevant attachment is missing.. > > > > Happy New Year! > > > > Evelyn > > > > From: openEHR-clinical [mailto:openehr-clinical-bounces at lists.openehr.org] > On Behalf Of Heather Leslie > Sent: Friday, 4 January 2013 12:37 PM > To: For openEHR clinical discussions; For openEHR technical discussions; For > openEHR implementation discussions > Subject: ISO/DTS 13972 DCM ballot > > > > Dear Colleagues, > > > > I spent some time yesterday responding to the ballot for ISO/DTS 13972 > Characteristics and Processes of Detailed Clinical Models. My first draft > resulted in 14 pages of comments on identified issues (not typos or > grammatical errors). > > > > There are a number of aspects about the specification that remain > concerning, but one of the main ones is that it is not embracing of all > current international clinical modelling/governance approaches including > that being used by openEHR, with separation between archetypes as logical > models and CKM as the governance/maintenance tool. This means that openEHR > work will not be compliant with the proposed DTS, despite openEHR being > recognised as being one of the world leaders in the clinical modelling > environment. > > > > As I understand it, if the DTS passes this ballot, then it may be published > immediately as an ISO Technical Specification. > > > > There have been a small number of experts who are actively engaged in > openEHR participating in this DTS development, but despite providing > feedback consistently during the past few years, this is still the > unfortunate place in which we find ourselves. > > > > I would encourage you to peruse the DTS and provide feedback as you see fit. > > > > > Unfortunately, it is not permitted to distribute the ISO documents publicly > on a list such as this - you will need to make contact with your ISO > national member body and respond through their official channels. > > > > The deadline for Australian submissions to Standards Australia is 14 > January; so expect that the ISO deadline will be soon after. > > > > Kind Regards > > > > Heather Leslie > > > > > > Dr Heather Leslie > MBBS FRACGP FACHI > Director of Clinical Modelling > <http://www.oceaninformatics.com/> Ocean Informatics > Phone (Aust) +61 (0)418 966 670 > Skype - heatherleslie > Twitter - @omowizard > > > > -------------- next part -------------- > An HTML attachment was scrubbed... > URL: > <http://lists.openehr.org/pipermail/openehr-clinical_lists.openehr.org/attac <http://lists.openehr.org/pipermail/openehr-clinical_lists.openehr.org/attac %0b> > hments/20130104/56b1e1e2/attachment-0001.html> > > ------------------------------ > > Message: 3 > Date: Fri, 4 Jan 2013 19:10:46 +1100 > From: "Heather Leslie" <heather.leslie at oceaninformatics.com <mailto:heather.leslie at oceaninformatics.com%0b> > <mailto:heather.leslie at oceaninformatics.com> > > To: "'For openEHR clinical discussions'" > <openehr-clinical at lists.openehr.org <mailto:openehr-clinical at lists.openehr.org%0b> > <mailto:openehr-clinical at lists.openehr.org> > > Cc: For openEHR technical discussions > <openehr-technical at lists.openehr.org <mailto:openehr-technical at lists.openehr.org%0b> > <mailto:openehr-technical at lists.openehr.org> >, For openEHR implementation > discussions <openehr-implementers at lists.openehr.org <mailto:openehr-implementers at lists.openehr.org%0b> > <mailto:openehr-implementers at lists.openehr.org> > > Subject: RE: ISO/DTS 13972 DCM ballot > Message-ID: <[email protected] <mailto:[email protected]%0b> > <mailto:[email protected]> > > Content-Type: text/plain; charset="us-ascii" > > Hi Evelyn, > > > > Happy New Year to you too! > > > > I probably didn't make it clear that I did not intend to share my comments, > certainly not publicly on this list. Apologies > > > > I have shared with it my AU experts so that we can formulate a collective > response for Stds Australia. > > > > I'm certainly happy to have private conversations with anyone interested, > but personally I'd like to see a broader range of international > participation in the feedback (which on the whole has been miniscule in any > previous ballot) and if it is independent of my own views, then it is > probably more valuable :) > > > > > > Regards > > > > Heather > > > > From: openEHR-clinical [mailto:openehr-clinical-bounces at lists.openehr.org] > On Behalf Of Evelyn Hovenga > Sent: Friday, 4 January 2013 3:07 PM > To: 'For openEHR clinical discussions' > Subject: RE: ISO/DTS 13972 DCM ballot > > > > Heather the relevant attachment is missing.. > > > > Happy New Year! > > > > Evelyn > > > > From: openEHR-clinical [mailto:openehr-clinical-bounces at lists.openehr.org] > On Behalf Of Heather Leslie > Sent: Friday, 4 January 2013 12:37 PM > To: For openEHR clinical discussions; For openEHR technical discussions; For > openEHR implementation discussions > Subject: ISO/DTS 13972 DCM ballot > > > > Dear Colleagues, > > > > I spent some time yesterday responding to the ballot for ISO/DTS 13972 > Characteristics and Processes of Detailed Clinical Models. My first draft > resulted in 14 pages of comments on identified issues (not typos or > grammatical errors). > > > > There are a number of aspects about the specification that remain > concerning, but one of the main ones is that it is not embracing of all > current international clinical modelling/governance approaches including > that being used by openEHR, with separation between archetypes as logical > models and CKM as the governance/maintenance tool. This means that openEHR > work will not be compliant with the proposed DTS, despite openEHR being > recognised as being one of the world leaders in the clinical modelling > environment. > > > > As I understand it, if the DTS passes this ballot, then it may be published > immediately as an ISO Technical Specification. > > > > There have been a small number of experts who are actively engaged in > openEHR participating in this DTS development, but despite providing > feedback consistently during the past few years, this is still the > unfortunate place [Het originele bericht is niet volledig opgenomen.] -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.openehr.org/pipermail/openehr-clinical_lists.openehr.org/attachments/20130108/eaaecfb0/attachment-0001.html>
