Dear Gerhard, You said:
>Why the focus on HL7 only? CEN/TC251 has started work on the EN 13606 and is precisely what you want. HL7 version 3 and >CDA will be to unstable for some time to come. HL7 doesn't adopt the GEHR (CEN) two model approach. >Artifacts based on the present HL7 version 3 RIM will prove to be unimplementable as a system or object. We can be very encouraged that you may get together with HL7 on this. However you (or was it Gunnar Klein) did say in your ?Berlin CEN meeting 2002 presentation (the presentation has disappeared from the www.openehr.org. site) that EN 13606 had limited uptake because it was: a) incomplete or have offered only partial coverage of the healthcare domain; b) unnecessarily complex; c) too generic, leaving the various implementations too much variability in how the models are applied to a given domain; d) flawed, with some classes and attributes not implementable as published; e) requiring expensive re-engineering of systems; f) containing features not required by the purchasers of clinical systems. The time is evidently ripe for a synthesis. I agree about the importance of narrative: You said: >It is a narrative for personal usage. >When information is to be shared the author will select and rewrite parts >of his notes in order to meet a specific request by an other healthcare provider. >This is the way people work. This is the way healthcare providers know how > to work with using paper systems. Perhaps the record is a resource to make stories out of? The original 'syntagm' is just the first, and even that was an interpretation.The 'true' story is unknowable. > I can see that objective information (orders, test results) can be shared by > all without real problems. But people (good healthcare) will need subjective > narrative as recorded in their personal Medical Records. Free text remains indispensable, structured data is just the debris left behind - it's a point of view... Regards Mike Mair - If you have any questions about using this list, please send a message to d.lloyd at openehr.org
