Hi Wayne and others, I agree with you that openEHR offers the most elegant and yet implementable methodology to build EHR that makes "sense".
As both a clinician and an informatician (my mom still doesn't understand what my profession is!) I think we (meaning most of the health informatics community) are too much focused on solutions rather that the requirements or factors which may result in satisfactory implementations. Interoperability is a great buzzword nowadays - but do we all agree on what this is all about? What are the requirements, what are the essential elements? Achieving systems that can interoperate (systems interoperability) needs first to achieve information interoperability. I strongly believe that interoperability at large in healthcare is not all about information models, XML, CCR, HL7, Webservices or whatever. But this is all bout people - and perhaps the medical profession itself. A good strategy would probably be to introduce formal information management courses in the medical curriculum. Once a consensus is reached on common terminology and processes then we can talk about systems interoperability and all those fancy technologies and standards. Coming to my first argument, openEHR is the only formalism that is offering methods and tools for establishing a common language and reusable clinical models couple with a best of breed reference model and many many open source tools and artifacts for creating those models and systems. I may be biased here because my Ph.D. research was based on openEHR methodology - but I am interested with others' views on this. As Wayne has pointed out, global standardisation efforts in this area (EHR/PHR/EMR etc) have finally boiled down to HL7 and its allies vs. CEN/openEHR. I think if EHR projects, no matter how big and strong, are not designed by using these are doomed to death - wasting lots of money, effort, lives and hopes. And complying with these standards is not a matter of writing interfaces or plugins - it means seriously investing and redesign. Cheers, Koray Atalag, MD, Ph.D Clinton Bedogni Research Fellow The University of Auckland, Department of Computer Science, Private Bag 92019, Auckland 1142, New Zealand Tel: +64 (9) 373 7599 ext. 87199 Fax: +64 (9) 308 2377 Email: [EMAIL PROTECTED] Stephen Beller wrote: > > Please explain what you mean by CCR or HL7 CDA *concepts* . Do you > mean the > actual strings/terms used within the XML markup tags that define the data > elements? > > Steve > > From: openhealth@yahoogroups.com <mailto:openhealth%40yahoogroups.com> > [mailto:openhealth@yahoogroups.com > <mailto:openhealth%40yahoogroups.com>] On > Behalf Of Mark Spohr > Sent: Tuesday, December 09, 2008 9:25 PM > To: openhealth@yahoogroups.com <mailto:openhealth%40yahoogroups.com> > Subject: Re: [openhealth] Patient Portals and PHR's > > The issue isn't really about converting the format of the data since this > can easily be done with any number of tools (the Mirth Project offers > a very > capable HL7 interface engine which can do lots of useful format > conversions.... mirthproject.org open source). > The issue is that the Indivio PHR does not seem to support the CCR or HL7 > CDA concepts in it's default configuration. It seems that everyone is > encouraged to add their own concepts to it which is an invitation to data > chaos. It doesn't do any good to be able to send the data from one system > to another if the receiving system doesn't understand the concepts > that are > being sent. Google Health and Health Vault each collect data using these > concepts so that they have the same definitions to the sender and the > receiver and can be understood. > > Again, I must apologize if I have gotten this wrong. My understanding is > just from reading their web site where there is no mention of CCR and CDA > but there is a piece about how easy it is to define your own > concepts... we > definitely don't want this if we want to exchange information. > > .Mark > > On Tue, Dec 9, 2008 at 10:12 PM, Stephen Beller <[EMAIL PROTECTED] > <mailto:sbeller%40nhds.com> > <mailto:sbeller%40nhds.com> > wrote: > > > I offered an Excel-based macro that converts an XML-based CCD to a clean > > CSV, which I assume the FOSS PHRs can consume thereby solving this > > limitation. We've successfully incorporated that macro to import the CCD > > medication data into our in our Excel-based Personal Health Profiler > > report. > > There has been no offers from the community to convert the Excel > macro to > > an > > open source script, however. It's available at > > https://sourceforge.net/projects/convertxmltocsv/ > <https://sourceforge.net/projects/convertxmltocsv/> > > > > Steve > > > > > > > > From: openhealth@yahoogroups.com > <mailto:openhealth%40yahoogroups.com> > <mailto:openhealth%40yahoogroups.com> > [mailto:openhealth@yahoogroups.com > <mailto:openhealth%40yahoogroups.com> > <mailto:openhealth%40yahoogroups.com> ] > On > > Behalf Of Mark Spohr > > Sent: Tuesday, December 09, 2008 2:57 PM > > To: openhealth@yahoogroups.com <mailto:openhealth%40yahoogroups.com> > <mailto:openhealth%40yahoogroups.com> > > Subject: Re: [openhealth] Patient Portals and PHR's > > > > > > > > XML is only a representation standard and is relatively unimportant. > What > > is of concern is that the software doesn't seem to support the CCR > or CDA > > concepts, thus severely limiting the interoperability (and usability) of > > the > > information. It doesn't do much good to collect information that is > > incompatible with the existing standards. > > > > .Mark > > > > On Tue, Dec 9, 2008 at 7:20 PM, balu raman <[EMAIL PROTECTED] > <mailto:braman20012001%40yahoo.com> > <mailto:braman20012001%40yahoo.com> > > <mailto:braman20012001%40yahoo.com <braman20012001%2540yahoo.com>> > > > wrote: > > > > > I thought CCR and CDA are also XML based. > > > I am sure Indivo can be configured to handle CCR. FOSS may not support > > > everything under the sun, out of the box, but one can value-add any > > > scratch for an itch. That's the beauty of FOSS. > > > > > > balu raman, msee.,ccp > > > > > > =================================================== > > > > > > "In fact, when I die, if I don't hear 'A Love Supreme,' I'll turn > > > > > > back; I'll know I'm in the wrong place." > > > > > > - Carlos Santana > > > > > > > > > > > > Disclaimer: Any resemblance between the above views and > > > > > > those of my creator, my terminal, or the view out my window > > > > > > are purely coincidental. > > > > > > > > > > > > Any resemblance between the above and my own views is > > > > > > non-deterministic. The question of the existence of views > > > > > > in the absence of anyone to hold them is left as an exercise > > > > > > for the reader. The question of the existence of the reader > > > > > > is left as an exercise for the second god coefficient. > > > > > > (A discussion of non-orthogonal, non-integral polytheism is > > > > > > beyond the scope of this article.) > > > > > > --- On Mon, 12/8/08, David Chan <[EMAIL PROTECTED] > <mailto:davidhcchan%40yahoo.com> > <mailto:davidhcchan%40yahoo.com> > > <mailto:davidhcchan%40yahoo.com <davidhcchan%2540yahoo.com>> > wrote: > > > From: David Chan <[EMAIL PROTECTED] > <mailto:davidhcchan%40yahoo.com> <mailto:davidhcchan%40yahoo.com> > <mailto:davidhcchan%40yahoo.com<davidhcchan%2540yahoo.com>> > > > > > > Subject: Re: [openhealth] Patient Portals and PHR's > > > To: openhealth@yahoogroups.com > <mailto:openhealth%40yahoogroups.com> > <mailto:openhealth%40yahoogroups.com> > <mailto:openhealth%40yahoogroups.com<openhealth%2540yahoogroups.com> > > > > > > Date: Monday, December 8, 2008, 9:39 PM > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > I am pretty sure Indivohealth supports CDA. > > > > > > David > > > > > > > > > > > > David H Chan, MD, CCFP, MSc, FCFP > > > > > > Associate Professor > > > > > > Department of Family Medicine > > > > > > McMaster University > > > > > > > > > > > > ____________ _________ _________ __ > > > > > > From: Mark Spohr <[EMAIL PROTECTED] <mailto:mspohr%40nnk.com> > <mailto:mspohr%40nnk.com> > <mailto:mspohr%40nnk.com<mspohr%2540nnk.com>> > > > > > > > > > To: [EMAIL PROTECTED] ups.com > > > > > > Sent: Monday, December 8, 2008 2:12:24 PM > > > > > > Subject: Re: [openhealth] Patient Portals and PHR's > > > > > > > > > > > > One concern I have about Indivo is that it does not seem to support > > either > > > > > > the CCR or CDA interoperability standard that are used by Google > Health > > and > > > > > > HealthVault. They seem to have an XML model and invite people to > develop > > > > > > concepts using archetypes. I don't think this is a wise course... > unless, > > > > > > of course, I misunderstand. > > > > > > > > > > > > .Mark > > > > > > > > > > > > On Mon, Dec 8, 2008 at 4:49 PM, fred trotter <fred.trotter@ gmail.com> > > > wrote: > > > > > > > > > > > > > Hi, > > > > > > > We already have a very strong FOSS PHR project in Indivo > > > > > > > http://www.indivohe alth.org/ > > > > > > > Indivo is FOSS, it is being massively deployed as part of Dossia > > > > > > > http://www.dossia. org/ > > > > > > > > > > > > > > It is already basically the number 3 PHR available after Google > > > > > > > Health and HealthVault. > > > > > > > > > > > > > > Also, Tolvens project has a PHR component. > > > > > > > > > > > > > > If we as a community are looking for something to "get behind" > > > > > > > as far as PHRs go, this seems pretty obvious... Am I missing > > > > > > > something? > > > > > > > > > > > > > > -FT > > > > > > > > > > > > > > -- > > > > > > > Fred Trotter > > > > > > > http://www.fredtrot ter.com > > > > > > > > > > > > > > ------------ --------- --------- ------ > > > > > > > > > > > > > > Yahoo! Groups Links > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > -- > > > > > > Mark Spohr, MD > > > > > > > > > > > > [Non-text portions of this message have been removed] > > > > > > > > > > > > [Non-text portions of this message have been removed] > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > [Non-text portions of this message have been removed] > > > > > > > > > ------------------------------------ > > > > > > Yahoo! Groups Links > > > > > > > > > > > > > > > > -- > > Mark Spohr, MD > > > > [Non-text portions of this message have been removed] > > > > > > > > > > > > [Non-text portions of this message have been removed] > > > > > > ------------------------------------ > > > > Yahoo! Groups Links > > > > > > > > > > -- > Mark Spohr, MD > > [Non-text portions of this message have been removed] > > [Non-text portions of this message have been removed] > > [Non-text portions of this message have been removed]
