Marcus... suggested reading as emotional fashion accessory to flame-proof helmet:
"Dealing With Disrespect: Handling your critics, no matter what they throw at you" Jono Bacon http://dealingwithdisrespect.com/jonobacon-dealingwithdisrespect-1ed.pdf :-) Joseph On 15-03-13 11:22 AM, Marcus Baw wrote: > At the risk of upsetting people, I am going to stick my neck out here > in support of Gustavo. > > It has long puzzled me why a technology like openEHR - which is > intended to foster sharing of Archetypes for the "universal use case" > and trying to conquer the massive problem of international > interoperability - has so many different CKMs, all doing their own > thing albeit with some sharing. > > I think if the community knew that what it had built was going to be > shared with the entire world by default (like Wikipedia) then there > would be more motivation to participate. I have been involved with a > couple of archetype reviews but if someone asked me where those > archetypes are now I wouldn't be sure. UK CKM? Scotland CKM? HSCIC CKM? > > Apologies if this email gives away how little I know about openEHR or > about how archetypes are shared in the real world*, but I would second > Gustavo's call for a single, openly accessible, point of origin for > canonical archetypes. > > * [I am one of a pretty small number of openEHR-trained individuals in > the UK - so if I still don't get it yet, what's the hope for real > direct-clinician-generated archetypes covering all of medicine.] > > I am attaching a heavy steel flame-proof helmet as I press Send. ;-) > > Here to Learn > > M > > > On 13 March 2015 at 14:46, Gustavo Bacelar <gbacelar at gmail.com > <mailto:gbacelar at gmail.com>> wrote: > > Dear Heather and everyone, > I'm really sorry, but you completely misunderstood the point. I'm > not critisizing you or Ian, on the contrary. I've always > appreciated your work and I'm a big fan of you both (I'm proud to > say it in public). I was not discussing the persons, but the > policies. I don't think Ocean is an enemy, never mentioned it. > > Differently of Wikipedia, where it doesn't matter to have other > similar wiki competitors, openEHR must have a single knowledge > repository to support semantic interoperability. The knowledge > repository of openEHR, be it CKM or not, must take advantage of > the community. > > I agree with you that community is not as active as it should be, > but that's just because the current model doesn't help them to. I > know you and Ian are overloaded, and I don't blame you, but that's > exactly why we need to change the policy. If we want a more active > community, we must provide the means to achieve it. > > You asked me what do I propose and what am I going to do about it. > I'm already doing something. > > I want openEHR to be much bigger. I propose a more liberal > approach for CKM governance. I propose openEHR doesn't focus only > on National governments and big industry players, but also on > startups and small companies. > > During the last couple of years, I can tell you I've promoted > openEHR in Brazil, in Portugal and even in USA. I've presented > lots of keynotes and courses free of charge, started an unfunded > project for public care, created a website in Portuguese > (www.openehrbrasil.com.br <http://www.openehrbrasil.com.br>), > written papers and white papers in Portuguese. More recently, I'm > writing a book (an introductory guide) to be distributed for free. > All about openEHR with zero resources (and the list is probably > missing many things, like ophthalmology archetypes). > > Kind regards, > Gustavo Bacelar > > > 2015-03-13 5:10 GMT+00:00 Heather Leslie > <heather.leslie at oceaninformatics.com > <mailto:heather.leslie at oceaninformatics.com>>: > > Thanks Evelyn, > > > > Even I forget the real roots? We should document it so we > don?t lose the provenance. > > > > Regards > > > > Heather > > > > *From:*openEHR-clinical > [mailto:openehr-clinical-bounces at lists.openehr.org > <mailto:openehr-clinical-bounces at lists.openehr.org>] *On > Behalf Of *Evelyn Hovenga > *Sent:* Friday, 13 March 2015 2:53 PM > > > *To:* 'For openEHR clinical discussions' > *Subject:* RE: How to fix CKM biggest issue > > > > Thanks you for this historical overview Heather. I?d like to > add that the original CKM was developed, maintained and funded > by Central Queensland University. It was taken over by Ocean > Informatics when that University decided to shut down its > entire HI Research Centre at the end of 2007. > > > > Evelyn > > EHE logo tree > > > > > > Dr Evelyn J.S.Hovenga, FACS > > CEO & Director > > * eHealth Education Pty Ltd, RTO 32279* > > www.ehe.edu.au <http://www.ehe.edu.au/> > e.hovenga at ehe.edu.au <mailto:e.hovenga at ehe.edu.au> > Mob. 0408309839 > > > > *From:*openEHR-clinical > [mailto:openehr-clinical-bounces at lists.openehr.org] *On Behalf > Of *Heather Leslie > *Sent:* Friday, 13 March 2015 1:12 PM > *To:* For openEHR clinical discussions > *Subject:* RE: How to fix CKM biggest issue > > > > Hi Gustavo and the openEHR community, > > > > I?m really sad and disappointed if Gustavo?s opinion is > mirrored elsewhere in the openEHR community. > > > > I?m sure it reflects a frustration with the slow process over > past years. But anyone who has bothered to ask me about how I > feel about the progress will hear that I am much more > frustrated than any of you. > > > > We, as the openEHR community really need to do a bit of soul > searching. From my point of view we?ve all been very passive > about this modelling work, all waiting for someone else to do > it or take responsibility for it. > > > > The reality is that when Ocean first launched the openEHR CKM, > the work fell to Ocean people. Either Ocean funded it OR Ian > and I did the editorial work in our own time? no other option, > and has been the way for years. Truth is, after a couple of > years and getting a couple of hundred archetypes publicly > available on CKM, I was really burned out and unwell. No-one > seemed to notice the effort, to be honest. Certainly no-one > seemed to appreciate it. I stopped doing the work in my own > time and reclaimed my evenings and weekends. I hoped that > there would be a cry of outrage from the community ? ?Why has > the CKM work stopped?? But no one noticed; no one said > anything, for at least 18 months, possibly more. > > > > This passivity has astounded me. > > > > Over 2 years ago, there was a bit of an epiphany ? a special > strategic board meeting was held in London where others were > invited, including myself. The attendees all agreed that one > of the highest priorities was to get archetypes published. I > was able to present calculations on how much it would cost to > fund some editorial work to get this happening. Nothing happened. > > > > Finally, in the second half of last year, the Industry Group > has been able to offer the first funded work to Ian and myself > to try to fast track some archetypes through to publication. > This is the first funding that has been raised in the openEHR > community for this critical modelling work ever. The scope is > clearly limited to publishing 69 archetypes. Unfortunately > there was no extra allocated for the extra time required to > train or mentor others to do the work. > > > > The Industry Sprint hasn?t been as fast or as focussed as > either Ian or I would like as we both have ?day jobs? that > require our attention as well. However you will have seen a > flurry of activity in the past couple of weeks ? 9 archetypes > have been refined and sent out for review in the past 10 days. > I really appreciate that the Industry Group has collaborated > and committed to this support. And of course it is really > exciting that this is one of the first times we will see > potential competitive vendors working together to get clinical > content standardised ? breaking down the siloes! > > > > So the situation IS changing? > > > > And in addition, we need to recognise what we do have ? an > amazing set of building blocks and an approach to clinician > engagement that has not been emulated in any other domain or > standards work. This current openEHR approach is world-leading > and with fairly modest resources we can do a lot more that > needs to be done. > > > > The community has a fantastic problem. As of today we have > 1300 users from 85 countries registered on the openEHR CKM. > What a spectacular resource we have at our finger tips; 381 > people have specifically volunteered to review and 199 to > translate archetypes ? all through word of mouth, no > advertising. We have a purpose-built tool has been developed > and provided free of charge to the community for over 7 years > in order to manage the library, collaboration and governance > of information models use that. We have only two trained > Editors and a handful of others with limited experience and > zero resources committed to managing it. So far it has been > run on the ?smell of an oily rag? ? not sure how that will > translate outside of Australia ? and this needs to change to > become sustainable. > > > > From a tooling point of view, CKM has been purpose-designed > and gradually enhanced to do all the things that Gustavo > dreams of ? projects and incubators (acting as sandpits for > raw archetype development); multiple roles for reviewers, > editors, CKAs have all been there for at least a year; > archetypes can be proposed in the next release of CKM. > Community participation is the focus, and the capability is > not currently being leveraged as it could, and the healthy > tension between ?bottom-up? and ?top down? can be managed. But > the real problem is that there are not enough people trained > as Editors, and no one resourced to manage/govern the work. > > > > Bringing on new Editors is absolutely welcome ? both Ian and I > are very keen to share the Editorial and Clinical Knowledge > Administrator load more broadly, because otherwise the CKM > work is not sustainable. All this talk of the community being > unable to participate is not actually fair or reasonable ? > when I?ve put out a call for Editors we?ve had a few people > volunteer, true. To be honest though, most of those that I > have discussed it with in more detail have then declined when > I?ve explained the amount of commitment or they?ve simply > participated in an editorial meeting. For those remaining, > they need training and then ongoing mentoring. But who is to > do this? How is this to be resourced? It absolutely does need > to be resourced appropriately. > > > > By contrast, I have been working under contract with the > Norwegian CKM team recently ? they have been resourced to > develop archetypes and develop processes for governance and in > many aspects after only one year of activity they are now more > advanced than the openEHR community. We are working closely > with the Norwegian CKM team to ensure that we can develop > processes for collaboration between CKMs. Silje Bakke from the > Norwegian CKM agreed last week to co-edit the > Problem/Diagnosis archetype with me and that archetype was > sent out for review last night. other archetypes have had > guest editors involved as well, under Ian and my mentorship. > > > > Key learning: in order for the openEHR work to accelerate, > there needs to be modest financial resources committed to the > archetype standardisation work, beyond the very limited scope > of the sprint, and the resources need to be dedicated, not > fitting it in between other work committments. > > > > As an aside, personally, I?m sick and tired of personally > being considered a ?blocker?. If only you can imagine how keen > I am to upskill others and share this onerous responsibility > with others; of course at the same time this will ensure that > this approach will be sustainable into the future, and all my > work, passion and vision will have been worth it. If I keep > ?control?, as some choose to view it, then I can be sure that > all this effort will have been in vain. > > > > And I?m thoroughly sick of Ocean involvement being regarded as > ?the enemy?. I?m not going to address accusations of ?conflict > of interest? in this forum ? the assumption of huge commercial > advantage never gets balanced by the huge cost of volunteering > leadership. Perhaps one day one of us will write our memoirs? J > > > > Back to the main point again - the community should be rightly > feeling indignant about a lot of things, but rather than > complaining or ?thinking about it? we need to be actively > doing something about it. We have a new openEHR Management > Board ? I hope they will do something about this? But, also, > if you are one of the indignant what are YOU personally going > to do about it? > > > > I?ve done what I can with essentially zero resources, now what > do you propose?? > > > > Regards > > > > Heather > > > > > > *From:*openEHR-clinical > [mailto:openehr-clinical-bounces at lists.openehr.org] *On Behalf > Of *Gustavo Bacelar > *Sent:* Friday, 13 March 2015 3:51 AM > *To:* For openEHR clinical discussions > *Subject:* Re: How to fix CKM biggest issue > > > > Hi Ian, Sebastian and everyone, > > on early 2009 Microsoft discontinued its encyclopedia, > Encarta. MS Encarta had a limited selection of *professionally > edited content*, but it was defeated by an initiative of > *non-professional edited content*: Wikipedia. By that time, > Wikipedia offered *2.7 million articles* in English, Encarta > had *42,000 entries*. > > > > Encarta did try to adapt, inviting users to submit suggestions > for changes to articles, but those suggestions *first had to > be checked by a member of the Encarta staff*. And Encarta *did > not allow users to submit new entries*. > > > > My point is: openEHR has a *huge potential*, but it is still > too bureaucratic. It must be free to follow its path. > > > > Someone can say: "but the quality of wikipedia is > questionable, the Editors are not professionals!". In 2005, > Nature famously reported > <http://www.jimgiles.net/pdfs/InternetEncyclopaedias.pdf> that > Wikipedia articles on scientific topics contained just four > errors per article on average, compared to three errors per > article in the online edition of Encyclopaedia Britannica. > > > > ?I've been spreading the word about openEHR through courses > (http://goo.gl/KvNCvb) and consulting and I can see more and > more people aware of it, but the barriers are not moving. I've > tested the beta version of CKM, thanks Sebastian! It seems to > be a very important upgrade, including the CKA role. > > > > I understand that the focus of the Editorial group is to get > green ticks, but if there were more Editors would be more > green ticks as well. By mid-2012 there was a Call for CKM > Editors. There were at least three people interested: Domingo > Liotta, ?Pablo Corradini and I. Nothing happened since then. > > > > When it comes to using CKM to local projects, I really think > it would be much better for the community. It a local project > would like to develop new archetypes, it would be better to do > it within an international context instead of developing them > locally. > > > > It is important to separate the interests of openEHR > Foundation from Ocean's, at his time there in conflict. Ocean > wants to sell their products, I don't blame it, but the > international CKM needs to be a central hub for archetype > development. It doesn't matter if its for commercial projects > or not as long as the content: > > * Is of interest and not repeated (e.g. a local version of > an existing archetype) > * Is not a specific admin data for particular use > * Is available in CKM for community. > > Many of the existing archetypes in CKM were created to fulfill > commercial use, so it should be used as a source of resources. > I will use the words on openEHR website and openEHR Wiki: > > > > "The openEHR CKM has gathered an active Web 2.0 community > (...) for *sharing* health information between > individuals, clinicians and *organisations*; between > applications, and across *regional* and *national* *borders*." > > > > ?A moral liberal approach would put more load on the Editors, > but only if we don't increase the Editorial team. It is better > to have many useful incubated archetypes ?than not having then > in CKM. If these archetypes are so important, we will be able > to see and improve them as soon as possible. Let's think about > Encarta. > > > > Best regards! > > -- > > Gustavo Bacelar > > MD + MBA + MSc Med Informatics > > Skype: gustavobacela > > ? r > > LinkedIn: pt.linkedin.com/in/gbacelar > <http://pt.linkedin.com/in/gbacelar> > > > _______________________________________________ > openEHR-clinical mailing list > openEHR-clinical at lists.openehr.org > <mailto:openEHR-clinical at lists.openehr.org> > > http://lists.openehr.org/mailman/listinfo/openehr-clinical_lists.openehr.org > > > > > -- > Gustavo Bacelar > MD + MBA + MSc Med Informatics > Skype: gustavobacela > ?r > LinkedIn: pt.linkedin.com/in/gbacelar > <http://pt.linkedin.com/in/gbacelar> > > _______________________________________________ > openEHR-clinical mailing list > openEHR-clinical at lists.openehr.org > <mailto:openEHR-clinical at lists.openehr.org> > > http://lists.openehr.org/mailman/listinfo/openehr-clinical_lists.openehr.org > > > > > _______________________________________________ > openEHR-clinical mailing list > openEHR-clinical at lists.openehr.org > http://lists.openehr.org/mailman/listinfo/openehr-clinical_lists.openehr.org
