Hi Thomas, I agree that the essence of this issue is to detect "generic/reusable patters" or "ontological components", and then derive our "information models" from these components.
Just two thoughts: 1. A marketing issue: If these patterns are directly derived from some existent IM, then we will have the same trouble of defining one common IM: my model is better than yours, so we'll never agree. I think we must represent and present these patterns as ontological components, trying to avoid the copy&paste of the pattern from one o the other IM. I know that de openEHR IM is derived from an ontologial analisys of thereality,so we can see it as a concrete ontology for healthcare information, but it is not presented as a concrete ontology, is presented as an IM to be implemented on software. I don't know if I mess up this explanation, just want to tell that we must be careful in the way we present, represent and name things if we want a global agreement. 2. The current openEHR IM is great for dealing with clinical record information and micro clinical processes (Instructions, Activities, Actions and the associated state machine), but not for the macro processes that embrace the micro clinical processes, and for building computerized information systems we need those processes modeled also. For example, if a traumatized patient comes to the ER in an ambulance, and then is derived to an ICU, we have a global process of "trauma care", then we have macro processes like "prehospitalary care", "emergency care", and "ICU care". In each of these macro processes we have multiple workflows excecuted in paralel, and different types processes but interdependent like administrative (patient identification, human resource assignation, etc), clinical (observations, actions, evaluation, etc), accounting (resource ussage), and financial (healthcare costs). so, if we model patters or ontological components, I think these must represent (in a generic way) the macro processes, not only the micro-clinical processes. -- Kind regards, Ing. Pablo Pazos Guti?rrez LinkedIn: http://uy.linkedin.com/in/pablopazosgutierrez Blog: http://informatica-medica.blogspot.com/ Twitter: http://twitter.com/ppazos Date: Mon, 9 May 2011 14:11:07 +0100 From: thomas.be...@oceaninformatics.com To: openehr-clinical at openehr.org Subject: Re: on the possibility of 'one information model' in e-health CC: openehr-technical at openehr.org On 09/05/2011 13:51, pablo pazos wrote: Hi Thomas, I've left a comment in your blog but is not appearing, so I comment your idea here. I don't think today it can be possible to have one information model agreed by all the medical informatics community, but I think if we can agree in a common metamodel like an ontology that represent the more generic concepts in medicine, like people, processes, resources, records, etc, we will be one step closer to a common IM. yes, that's pretty much what I was suggesting. Because if we can agree on that ontology, all the information models in healthcare MUST follow the ontology, so, different information models can live together, but they model the same concepts (semantically speaking). With different models, but semantically equivalent, the point of convergency will be closer. information models, at least abstract ones are in effect an ontology in themselves: they are a description of information that either exists, or we want to exist. So it seems reasonable that a pragmatic UML model, with an appropriate level of abstraction can be used for just this purpose - to describe and agree on key patterns. If this were true, it would mean that the challenges for agreement are: agree on the list of patterns; I have proposed some basic ones; your list above implies another set of candidates to help agreement, some kind of rating system would probably be needed so that at least some 'core' patterns could be agreed, even if some patterns / concepts remained beyond agreement for each pattern, agree its abstract definition. this means defining as much of the pattern in the IM as can be agreed, and not more. An example of one of the patterns, modelled in UML is the 'history of events' one here. Could this or something like it be agreed across e-health for interoperably representing the common concept of a history of events? If sufficient patterns could be agreed, then an 'information model' consisting of these would in effect be a 'common information model' for the medical informatics community - whose scope is interoperable representation of the patterns contained within. It seems to me that this would be a great step forward. - thomas _______________________________________________ openEHR-technical mailing list openEHR-technical at openehr.org http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-technical -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.openehr.org/mailman/private/openehr-technical_lists.openehr.org/attachments/20110511/394cba8b/attachment.html>
