Question on the role of EHR reference models for achieving functional interoperability
information (so that it is human readable by the receiver). I am now wondering why an EHR reference model is seen to be REQUIRED for achieving functional interoperability. If I exchange bare PDF- documents (without any describing metadata) between two EHR systems, then I would say there is a good chance that these docs are readable by a human receiver and thus functional interoperability should be achieved although clearly an EHR reference model is not used. I agree that an EHR reference model alone is not enough to achieve semantic interoperability (agreed archetypes and terminology are missing) and therefore by using an EHR reference model alone one can still only achieve functional interoperability. However, this seems to me as some kind of advanced functional interoperability, where the receiving EHR system knows the basic components (the RM classes and their attributes) from which EHR information is composed. So I have the impression that an EHR reference model helps to achieve some kind of advanced functional interoperability, but I would not say that it is REQUIRED to achieve functional interoperability (refering to the PDF-exchange as a counter-example). What do you think? Thank you for any comments and best regards, Georg -- private -- Gerard Freriks, MD Huigsloterdijk 378 2158 LR Buitenkaag The Netherlands T: +31 252544896 M: +31 620347088 E: gfrer at luna.nl Those who would give up essential Liberty, to purchase a little temporary Safety, deserve neither Liberty nor Safety. Benjamin Franklin 11 Nov 1755 -- next part -- An HTML attachment was scrubbed... URL: http://lists.openehr.org/mailman/private/openehr-technical_lists.openehr.org/attachments/20080625/f86e61db/attachment.html
Question on the role of EHR reference models for achieving functional interoperability
Georg Duftschmid wrote: So I have the impression that an EHR reference model helps to achieve some kind of advanced functional interoperability, but I would not say that it is REQUIRED to achieve functional interoperability (refering to the PDF-exchange as a counter-example). * no reference model = no computability, including queryability. To overcome that, if you use PDFs, plain text etc, you need structured meta-data. As soon as you need that (e.g. like IHE) you need a model of it. As soon as it tries to be more sophisticated, the model becomes more complex. If we want queryable, computable data (e.g. for decision support, research), you have to have models. Otherwise the software doesn't know what the data mean. - thomas beale *
Question on the role of EHR reference models for achievingfunctional interoperability
Hi Thomas, no reference model = no computability, including queryability. To overcome that, if you use PDFs, plain text etc, you need structured meta-data. As soon as you need that (e.g. like IHE) you need a model of it. As soon as it tries to be more sophisticated, the model becomes more complex. If we want queryable, computable data (e.g. for decision support, research), you have to have models. Otherwise the software doesn't know what the data mean. If I understand you right, you argue that a reference model is required if SEMANTIC interoperability (you refer to software that must know what the data mean) has to be achieved. I would fully agree here. What makes me wonder about the statement in ISO 20514 is that they consider an EHR reference model as required for FUNCTIONAL interoperability = In order to achieve semantic interoperability of EHR information, there are four prerequisites, with the first two of these also being required for functional interoperability: a) a standardised EHR reference model, i.e. the EHR information architecture, between the sender (or sharer) and receiver of the information, b) ... They further define functional interoperability in ISO 20514 as the ability of two or more systems to exchange information (so that it is human readable by the receiver). I would think that human readability and thus functional interoperability can also be achieved without a standardised EHR reference model. Cheers, Georg -- next part -- An HTML attachment was scrubbed... URL: http://lists.openehr.org/mailman/private/openehr-technical_lists.openehr.org/attachments/20080625/ea545a7a/attachment.html
Step by step Achetype editing
Hi all, I've just started browsing and investigating two existing archetype editors, hardly could I find a step by step tutorial for creating Archetypes (and then Templates) Is there any recommended resource? Regards paria PhD Student IDC | Interaction Design Collegium Department of Computing Science and Engineering Chalmers University of Technology Email: hajar.kashfi at chalmers.se Office:+46 (0)31 7725407 Mobile Phone: +46 (0)707222815 Postal adress: IT University of G?teborg 412 96 G?teborg, Sweden Visit: Room Simula B, House Svea, Campus Lindholmen
Step by step Achetype editing
On Wed, 2008-06-25 at 15:31 +0200, P?ria Kashfi wrote: Hi all, I've just started browsing and investigating two existing archetype editors, hardly could I find a step by step tutorial for creating Archetypes (and then Templates) Is there any recommended resource? AFAIK there isn't a step-by-step tutorial. There are many resources on the website and I suppose they can be a bit daunting to navigate. There is an ongoing discussion on the openEHR Clinical list on deciding how to select an archetype type to begin creating a specific archetype. To get you started you might refer to this discussion and the very nice presentation that Gerard Freriks just published on the openEHR website. Discussion: http://lists.chime.ucl.ac.uk/mailman/private/openehr-clinical/2008-June/000894.html There are related threads on this so you'll need to read several. Presentation: http://tinyurl.com/6h2vs8 HTH, --Tim -- Timothy Cook, MSc Health Informatics Research Development Services LinkedIn Profile:http://www.linkedin.com/in/timothywaynecook Skype ID == timothy.cook ** *You may get my Public GPG key from popular keyservers or * *from this link http://timothywayne.cook.googlepages.com/home* ** -- next part -- A non-text attachment was scrubbed... Name: signature.asc Type: application/pgp-signature Size: 189 bytes Desc: This is a digitally signed message part URL: http://lists.openehr.org/mailman/private/openehr-technical_lists.openehr.org/attachments/20080625/8172ae38/attachment.asc
Question on the role of EHR reference models for achievingfunctional interoperability
I agree with Thomas and Graham that the initial argument really hinges on whether the most minimum communication of an email with attached clinical pdf, by being human interpretible meets the definition of 'functional interoperabilliy. I would say no, simply because it then makes no distinction between simple communication (which can be extremely helpful) and 'functional interoperability' which I believe carries some notion of computability, helping place the document or information therein, more precisely within the recipient system, but falling short of the precise computability suggested by 'semantic interoperability'. Semantic interoperability is hard to achieve because it requires both technical consensus and human, clinical agreement. I am starting to think that one of the values of archetypes is that they provide a natural levle of granualarity within the record that immediatley supports funtional interoperability, whilst allowing for the organic development of semantic interoperability. As an example, within the NHS, there is a workstream devoted to interoperability between the heath and social care services. Because of the lack of consensus around the data items to be included, it has been decided initially to use a CDA wrapper with some broad 'functional' headings e.g Past Medical History, Mobility Assessment, Continence Assessment. These accord very nicely to probable or actual archetypes which immediately support a level of functional interoperability.The maximal dataset approach allows each archetype to contain mutliple varieties of e.g. mobility assessment and backed by the reference model, enables minimal 'functional' representations of these in non-native systems. Semantic interoperability will only come about when 2 or more agencies agree to share a particular variety of mobility assessment, via further template level constraint, adjusting their internal processes to match but this is a social/organisational commitment, requiring no change in the technical representation on the archetype. Ian Dr Ian McNicoll office / fax +44(0)141 560 4657 mobile +44 (0)775 209 7859 skype ianmcnicoll Consultant - Ocean Informatics ian.mcnicoll at oceaninformatics.com Consultant - IRIS GP Accounts Member of BCS Primary Health Care Specialist Group ? www.phcsg.org 2008/6/25 Thomas Beale thomas.beale at oceaninformatics.com: Georg Duftschmid wrote: They further define functional interoperability in ISO 20514 as the ability of two or more systems to exchange information (so that it is human readable by the receiver). I would think that human readability and thus functional interoperability can also be achieved without a standardised EHR reference model. well, as Grahame implied in his response, you can get into a long definitional discussion on such points. For my part, I am interested in what we want to achieve and what is needed to do it. Some of the key requirements in my view are: computable data adaptable (future-proof) systems content defined by domain experts longitudinally queryable record (requires integrating data from multiple sources) from this point of view, 'functional interoperability' is not much. Not that it is not useful, but we need to be aiming far higher if we want personalised (i.e. preventative), more cost-efficient and safer health care. - thomas ___ openEHR-technical mailing list openEHR-technical at openehr.org http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-technical
Step by step Achetype editing
Hi Paria, The Ocean archetype editor help files are not too bad as a 'technical' guide and these other pages might be helpful openEHR Entry Types FAQs http://www.openehr.org/shared-resources/faqs/entrytypes.html What reference model class to use when? http://www.openehr.org/wiki/pages/viewpage.action?pageId=786529 and, of course, look at existing examples http://www.archetypes.com.au/archetypefinder/archetypefinder Although you may find the discussion pointed to by Tim to be of interest, in my experience, beginners often find the Evaluation or Observation debate confusing because there are many grey-area examples in clinical practice. I take the view that much of this debate, though fun, can be distracting, since other than the clear cases where a clinical concept demands the sophisticated, precise timing/state features of the Observation class, the consequences of mis-labelling e.g a Barthel Score as Evaluation, rather than Observation, are almost nil. One other useful tip, which the 'professionals' find very useful is to use mindmapping software such as Freemind to setup and refine the basic archetype structure, before replicating in the archetype editor. Have fun, Ian Dr Ian McNicoll office / fax +44(0)141 560 4657 mobile +44 (0)775 209 7859 skype ianmcnicoll Consultant - Ocean Informatics ian.mcnicoll at oceaninformatics.com Consultant - IRIS GP Accounts Member of BCS Primary Health Care Specialist Group ? www.phcsg.org 2008/6/25 Tim Cook timothywayne.cook at gmail.com: On Wed, 2008-06-25 at 15:31 +0200, P?ria Kashfi wrote: Hi all, I've just started browsing and investigating two existing archetype editors, hardly could I find a step by step tutorial for creating Archetypes (and then Templates) Is there any recommended resource? AFAIK there isn't a step-by-step tutorial. There are many resources on the website and I suppose they can be a bit daunting to navigate. There is an ongoing discussion on the openEHR Clinical list on deciding how to select an archetype type to begin creating a specific archetype. To get you started you might refer to this discussion and the very nice presentation that Gerard Freriks just published on the openEHR website. Discussion: http://lists.chime.ucl.ac.uk/mailman/private/openehr-clinical/2008-June/000894.html There are related threads on this so you'll need to read several. Presentation: http://tinyurl.com/6h2vs8 HTH, --Tim -- Timothy Cook, MSc Health Informatics Research Development Services LinkedIn Profile:http://www.linkedin.com/in/timothywaynecook Skype ID == timothy.cook ** *You may get my Public GPG key from popular keyservers or * *from this link http://timothywayne.cook.googlepages.com/home* ** ___ openEHR-technical mailing list openEHR-technical at openehr.org http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-technical
