Regarding Derek's comments, I would ask whether from the health professional point of view especially that of clinicians, e-health standards (terminology, devices, measurements, etc) is a technical 'thing' ?
I would also ask developers when they specify the data domain of attributes on HL7 RIM model classes and the relationships whether they fall into a technical implementation level of detail ? In other words, where do you draw the line between domain knowledge (conceptual level) and the specifications of the model. The way I see it, the more you try to agree and describe in great detail these specifications or design a base to start generalizing the more you start dealing with technical implementation.... By the way, MS Word (Office Open XML STANDARD) is indeed a great example since you referred to that. It is Microsoft's IMPLEMENTATION of an XML-based file format to represent word processing, spreadsheets, presentation documents. There are numerous solutions based on office open XML formats to support electronic health records. There is another very popular open document format (an OASIS STANDARD) for open office applications which is a different IMPLEMENTATION developed by Sun Microsystems for the same task (document representation). Both of these STANDARDS-IMPLEMENTATIONS are used nowadays in a large scale from users and developers ! Conclusion: If 'technical' people have only arrived at specifications of these standard and they have not implemented it, I doubt whether they would have been so popular around the world. Athanassios From: [email protected] [mailto:openehr-clinical-bounces at openehr.org] On Behalf Of Derek Meyer Sent: Friday, May 06, 2011 2:15 PM To: For openEHR technical discussions; 'For openEHR clinical discussions' Subject: Re: One model vs One framework in e-health ..... Hi, My 2 cents: A standard is not a technical 'thing' - its an agreement between people to behave in a predefined way. Developing the predefined approach is the easy part - getting the agreement is much harder. To achieve this, the advantages of agreeing have to outweigh the advantages of independence. This does happen - the MS Word format is the de facto standard for word processing documents, despite its limitations. In health care I think its more likely we will see an evolutionary struggle, with different standards at first co-existing in different niches, and then converging in an awkward but workable way. Everyone adopting a single, rational overarching solution would result in a better solution but we live in an imperfect world. BWs Derek. On 06/05/11, "Athanassios I. Hatzis, PhD" <hatzis at healis.gr> wrote: Hi Thomas, I will agree with you, yes there has to be a generic health information model but in my opinion it has to span over all three main layers of software architecture Physical/persistence layer Conceptual/Application/Object layer User interface layer/Serialized representation (XML,etc....) RIMBAA technology matrix describes in the best way the different paths one can follow to solve parts of the generic problem. The big challenge in my opinion is that there has not been an OPEN IMPLEMENTATION of a generic framework to cover all these layers. I have studied a bit the underlying structure of openEHR archetypes/templates, where you are linking/binding user interface fields with clinical/admin entries of the conceptual layer in one serialized object (ADL). By the way I am not convinced that there has to be strong binding between user interface and the conceptual layer (RIM). But clearly you are leaving out the mapping of data captured from the forms (templates) to the company that is going to provide the database management system in order to store permanently the user data. Of course the aggregation of user data is also important in that case and I cannot see any open approach that is taken from your side to cover or support that process. Obviously I can also realize that there has to be a business model and profit out of that story and if everything is open and free then many might go out of business. Anyway, let me continue a bit on ONE GENERIC e-health FRAMEWORK. One reason I started the MEDILIG approach is because I realized that there has not been an extensive, generic, easy to follow, standalone, OPEN ER schema in e-health to cover the persistence layer am I wrong ? Developers do need to work with an open database schema because that schema is closely related to the conceptual/object model for programming purposes, business logic is shared between the two as developers do know. Question: Has anyone thought to IMPLEMENT an open conceptual framework and generate from there a generic ehealth database model because that is what I am exactly trying to implement using the programming environment of Microsoft Entity framework and the RIM model of HL7. In fact this way I am turning MEDILIG to an entity framework standardized through HL7 RIM and HL7 vocabularies. One may realize the consequences of such an implementation. Developers can built user interfaces of any kind, produce serializations, do mappings from any forms created with other software tools, and make it easier to connect or redesign legacy ehealth applications and databases. Or at least that is the way I envisage it to happen.... One idea I have is that the framework can be specialized according to each specialty and therefore you can make it even easier for a developer to approach and implement a specific solution for an individual, a clinic, a lab, etc.... What I DO NOT have is capital, resources or even an employer interested in such a business plan, where I can understand it up to a point ???!!! Best luck to all Athanassios PS1: Apologies to the non-technical audience for getting a bit into technical details ;=) PS2: The approach I am suggesting is taking the developer at the center of the solution and attempts to standardize concepts, terms, properties, etc around him. One the other hand the user interface design should take the clinician/health professional at the center and try to standardize the software world around him. You have already achieved that at a great level I believe. Then the two worlds have to be linked/mapped. From: [email protected] [mailto:openehr-clinical-bounces at openehr.org] On Behalf Of Thomas Beale Sent: Thursday, May 05, 2011 7:21 PM To: Openehr-Technical; For openEHR clinical discussions Subject: on the possibility of 'one information model' in e-health this is an often debated question, and after coming across (for the 100th time) just such a debate recently online, I thought it might be interesting to try to get to the bottom of the question in some way. The basic idea posted here <http://wolandscat.net/2011/05/05/no-single-information-model/> . It is of course not scientific work, but I would be interested in the views of others on this concept. - thomas beale -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.openehr.org/mailman/private/openehr-technical_lists.openehr.org/attachments/20110506/292f10fb/attachment.html>
