Tim Benson wrote: >Gerard, > >CEN and HL7 messages are just that - messages - from someone, to someone and >about someone at a moment in time. They have more in common with electronic > actually, you have to be careful - CEN messages are closer to this idea; HL7 messages are mostly from machine to machine.
>mail than with database structures. Any attempt to take information from a >message and put it into a database is potentially dangerous and needs to be >done with a real understanding of the data. This can only be done when >messages are rooted in very clearly defined use cases. > Agree - this whole problem was one reason I wrote the "Health Information Standards Manifesto" >The scale of the problem is illustrated by thinking very clearly about ALL >of the potential users of medical records. In UK the Dept of Health >recognises more than 60 medical specialties. If you add in all of the other >clinical specialties then you have at least 100 distinct groups of people >who have their own specialised ways of working and requirements, including >audit and quality control issues, which ultimately determine how they need >their data to be structured. They cannot all use just one structure, >however much we would like this to be the case. > Well here I no longer agree. I agree if we are still using the "old way" of doing things - building a huge model of everything and turning it into software and databases. But as soon as you take the approach that the information is instances of lego bricks, the model is a model of lego bricks, and the particular configurations of lego bricks are defined by domain concept models - which are developed independently of the software and databases - this argument no longer holds water. I see no impediment whatever to to EHR systems which serves all types of users, as long as it is built on this architectural premise. And this premise is also the key to interoperabiity of data _between_ specialisations. - thomas beale - If you have any questions about using this list, please send a message to d.lloyd at openehr.org
