CEN meeting and data types

2007-03-08 Thread Thomas Beale
Grahame Grieve wrote:
 Hi

   
 * there is always the possibility that it can't - because the class 
 model commits to one idea of terminology coordination, while the syntax 
 approach leaves it open
 

 do we know of any case?
   
I don't have a concrete one - so fair enough
   
 * the information model shouldn't dictate to the terminology environment 
 how to represent its artefacts.
 

 I have some sympathy for this. I have been tempted to toast the qualifier
 and push everything into code as you guys have done, for the same reasons.
 But I haven't found any case where the existing qualifier syntax is a
 problem, and there is accepted requirements for originalText on the
 qualifiers (at least, HL7 has accepted them). SO I didn't toast it, but
 I did say in the openEHR mapping that you'd collapse the qualifiers into
 the code phrase. I don't have a strong feeling for whether this would be
 necessary or appropriate for 13606
   
I don't have a problem; I just think we need a clear description of the 
equivalence so mappings are safe.

- thomas
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CEN meeting and data types

2007-03-07 Thread Thomas Beale
Grahame Grieve wrote:
   
 So the HL7 qualifier thing is (mostly) simply a predefined expression syntax 
 for
 post-coordination. It overlaps with terminologies that have their own 
 expression
 syntax - such as SNOMED. The HL7 model does allow a richer expression of the
 details of the construction of the expression - such as which text led to 
 which
 qualifier, but this is, as I said, for precision and pedantry. Not for normal
 everyday use. So the question is, is it better to squeeze things into the
 text of a CODE_PHRASE, or to squeeze things into xml? Either way, you need to
 have a terminology service to do anything useful with the data. So what's the
 difference? I don't have a strong feeling about that.

   
I think the main point here is that CODE_PHRASE and other similar parts 
of the openEHR model (and this applies to any model at all) that are 
modelled using an internal syntax string (which could itself be XML - 
who is to say it isn't?) implies quite strongly that the contents of the 
relevant attributes (CODE_PHRASE.code_string) are the business of some 
outside system, not openEHR itself. In purely technical terms, using a 
class modelling approach for such things may be the same as using the 
syntax approach - i.e. any code_string generated by a terminology server 
can most likely be modelled using a class model as well, something like 
HL7's classes. But
* there is always the possibility that it can't - because the class 
model commits to one idea of terminology coordination, while the syntax 
approach leaves it open
* the information model shouldn't dictate to the terminology environment 
how to represent its artefacts.

The key point about the openEHR approach in this area is that a 
CODE_PHRASE code_string is just a 'key' to a database that just happens 
to be a terminology service. The construction of the keys is the 
latter's business not the business of the client of the service.

- thomas beale
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CEN meeting and data types

2007-03-07 Thread Grahame Grieve
Hi

 So the HL7 qualifier thing is (mostly) simply a predefined expression syntax 
 for
 post-coordination. It overlaps with terminologies that have their own 
 expression
 syntax - such as SNOMED. The HL7 model does allow a richer expression of the
 details of the construction of the expression - such as which text led to 
 which
 qualifier, but this is, as I said, for precision and pedantry. Not for normal
 everyday use. So the question is, is it better to squeeze things into the
 text of a CODE_PHRASE, or to squeeze things into xml? Either way, you need to
 have a terminology service to do anything useful with the data. So what's the
 difference? I don't have a strong feeling about that.

   
 I think the main point here is that CODE_PHRASE and other similar parts 
 of the openEHR model (and this applies to any model at all) that are 
 modelled using an internal syntax string (which could itself be XML - 
 who is to say it isn't?) implies quite strongly that the contents of the 
 relevant attributes (CODE_PHRASE.code_string) are the business of some 
 outside system, not openEHR itself. In purely technical terms, using a 
 class modelling approach for such things may be the same as using the 
 syntax approach - i.e. any code_string generated by a terminology server 
 can most likely be modelled using a class model as well, something like 
 HL7's classes. But
 * there is always the possibility that it can't - because the class 
 model commits to one idea of terminology coordination, while the syntax 
 approach leaves it open

do we know of any case?

 * the information model shouldn't dictate to the terminology environment 
 how to represent its artefacts.

I have some sympathy for this. I have been tempted to toast the qualifier
and push everything into code as you guys have done, for the same reasons.
But I haven't found any case where the existing qualifier syntax is a
problem, and there is accepted requirements for originalText on the
qualifiers (at least, HL7 has accepted them). SO I didn't toast it, but
I did say in the openEHR mapping that you'd collapse the qualifiers into
the code phrase. I don't have a strong feeling for whether this would be
necessary or appropriate for 13606

Grahame
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CEN meeting and data types

2007-03-07 Thread Gerard Freriks
Graham,

There can not be one model  (or model of systems) that does it all in  
a perfect way.
We must agree that it is best to leave every domain with its own  
problems and models that help solve it.
We must have a standard way to deal with it.

About what is needed for EN13606 (a formal European standard and  
Nationale one in all Member States) I do not know for certain.
On one hand everything in the EHRcom extract traveling between  
systems will be resolved completely. No dependence on services  
somewhere (or not) in between.
But this holds for legacy systems, as we know them.
What we want, and expect to happen, is that those old legacy systems  
are replaced by OpenEHR conformant (EN13606 conformant) systems.
Then the rules will be different, because without several  
standardised services used by EHR-systems of the future we can not  
build the systems of the future..
Provided that those services are based on (European) Standards, no  
doubt.

Gerard


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On 7-mrt-2007, at 0:03, Grahame Grieve wrote:

 I have some sympathy for this. I have been tempted to toast the  
 qualifier
 and push everything into code as you guys have done, for the same  
 reasons.
 But I haven't found any case where the existing qualifier syntax is a
 problem, and there is accepted requirements for originalText on the
 qualifiers (at least, HL7 has accepted them). SO I didn't toast it,  
 but
 I did say in the openEHR mapping that you'd collapse the qualifiers  
 into
 the code phrase. I don't have a strong feeling for whether this  
 would be
 necessary or appropriate for 13606

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CEN meeting and data types

2007-03-06 Thread Grahame Grieve
Hi Sam

some responses

 The first issue to note is the ANY class which contains a number of complex 
 attributes not shown in the package. nullFlavour is dealt with in CEN and 
 openEHR at the ELEMENT level which is far more appropriate in systems - ie 
 test 
 the datavalue, if it is Null then test the flavourOfNull on the element. As 
 HL7 
 does not have the idea of container, this has to be here. All the other 
 attributes are dealt with at different levels (eg Template Id which may apply 
 to 
 an ELEMENT but never to a data value. Adding these to CEN would cause major 
 duplication, increase complexity without benefit and deteriorate performance.

well, the concept of the ISO datatypes (also true for 11404) is that you can
have direct and indirect conformance. If you are claiming indirect conformance
(which will be true for HL7 and openEHR), then you must provide a mapping that
explains how your implementation differs from the ISO datatypes as they stand.

I have drafted an openEHR mapping - but it's just a series of notes at this 
time.
But the openEHR mapping would explain all these things above and ANY would not
have these properties. The same would apply to 13606.

 The next issue is the inheritance hierarchy. In systems one would expect to 
 be 
 able to substitute on the basis of specialisation. While we can write 
 invariants 
 occasionally for good reason to prohibit this in some situations, generally 
 this 
 should apply. What strikes me about the inheritence model here is that it is 
 really a way of constraining the large class 'Term' for particular purposes. 
 Take for instance CV - it is a term that has translations added (CD), and 
 then 
 has qualifiers removed (CE) then has translations removed! While there may be 
 use cases when Term has all the attributes it does, this hierarchy cries out 
 for 
 remodelling!

  Further, is it usable? How would clinicians know which one to use in an 
  archetype?

yeah, I have some sympathy for this point. CE/CV are just constraints on CD, and
defining them as separate types is rather inelegant. For mapping purposes, I'd
simply drop CE and CV from openEHR  13606. Since Term and Translation are 
private
types, that simply leaves CD : coded value. That's not had for clinicians to 
pick
between ;-)

 Translations are the equivalent of the openEHR mapping. By including all the 
 text and qualifiers in translations one may find a good deal of difficulty 
 understanding the meaning.

well, translations may require qualifiers. And the openEHR spec (rightly)
allows this too.

as for text on qualfiers and translations, this is an interesting point.
To be really precise and pedantic, there are use cases for this. But if
you aren't really concerned with being pedantic and precise, you should
be able to ignore these things. I guess this is something I could usefully
add to the spec - that the meaning of the text associated with qualifiers
and translations can never have any independent contribution to the meaning
of the whole term - I'll have to think about how to phrase that properly.

 The issue of qualifiers is a large one and while the argument for the HL7 
 approach is that this provides a syntax for coordination of terms, it is not 
 expressed in the model. CR is ambiguous from my point of view with two terms 
 that are both optional and the value may have translations and qualifiers. 
 Perhaps a computable set of rules will arise for how to control this space 
 but I 
 suspect some gnomes will be required. This approach was first published in 
 GEHR 
 in the early 90s and has been dropped in openEHR as it was deemed unworkable 
 from a semantic point of view. One can argue that the CODE_PHRASE in openEHR 
 is 
 as problematic potentially - but as it is provided by a terminology service, 
 it 
 is far less likely that enthusiastic implementers will start adding data 
 willy 
 nilly.

So the HL7 qualifier thing is (mostly) simply a predefined expression syntax for
post-coordination. It overlaps with terminologies that have their own expression
syntax - such as SNOMED. The HL7 model does allow a richer expression of the
details of the construction of the expression - such as which text led to which
qualifier, but this is, as I said, for precision and pedantry. Not for normal
everyday use. So the question is, is it better to squeeze things into the
text of a CODE_PHRASE, or to squeeze things into xml? Either way, you need to
have a terminology service to do anything useful with the data. So what's the
difference? I don't have a strong feeling about that.

Grahame
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Antw: Re: CEN meeting and data types

2007-02-25 Thread Thomas Beale
Williamtfgoossen at cs.com wrote:
 In een bericht met de datum 22-2-2007 11:36:46 West-Europa 
 (standaardtijd), schrijft Thomas.Beale at OceanInformatics.biz:


 Good points / questions,

 my 2 cents on this:

 I would like to distinghuis between the few datatypes that are basic 
 and work in software, in archetypes, in HL7 v2 and in HL7 v3,  not 
 much but there will be several, and the ones that are technical 
 implementation specific. From clinicians point of view then most day 
 to day data will be represented and they will not have to worry about 
 unimportant technical details (unimportant because smart technicians 
 have found conversion methods to deal with it).

 imho the ISO standard should define the generic real thing. Integer is 
 real, string is real, OpenEHRstring is one technical artifact derived 
 from real thing to work in some software. Next, it should facilitate 
 in preventing battles to make conversions possible.
I am not sure what you mean by this William...there isn't any special 
'OpenEHRstring' - in openEHR, all those 'inbuilt types' are assumed - 
see the Support IM - 
http://svn.openehr.org/specification/BRANCHES/Release-1.1-candidate/publishing/architecture/rm/support_im.pdf
 
- Same goes for Integer, Real, Boolean etc. This was one of the points 
of departure from HL7, which redefined all the basic types (INT, REAL, 
ST, BL etc).

 This can only be solved if we step back from the technical data 
 specification and use the clinical data specification as point of 
 reference, map from there to CEN, Open EHR, ISO, HL7 v2 and v3. It is 
 like the standards, no explosions wanted.
that sounds right, but I am not sure if I have understood you in the way 
intended. The data types in openEHR have largely been driven by clinical 
input (particularly expert pathology input) and archetyping experience. 
But they are of course technical artifacts, else we cannot write software...

- thomas


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CEN meeting and data types

2007-02-23 Thread Grahame Grieve
I will try, anyway.

Grahame


Thomas Beale wrote:
 Gerard Freriks wrote:
 Thomas,

 I agree with you that in the case CEN (13606) adopts the OpenEHR data 
 types they know that it is proven technology.
 Just now, when any moment CEN/tc251 EN13606 will get published, we 
 dearly need proven data types to implement it.

 In the case that CEN will make the choice for OpenEHR, my remaining 
 questions are:
 What harm is done?
 How can CEN/tc251 EN13606 be aligned, some years from now, with the 
 forthcoming ISO data type standard?
 Can it be aligned? Or can't it?

 I think Grahame will ensure that it is not only 'aligned', but safely 
 inter-convertible... - he is working on it now.
 
 - thomas
 
 
 

-- 
Grahame Grieve
CTO, Jiva Medical   Software Integration Tools
CTO, Kestral Computing  Healthcare Applications
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CEN meeting and data types

2007-02-22 Thread Gerard Freriks
Sam,

It would be helpful to provide (more) arguments for your opinion.


Gerard


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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  
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1755





On 22-feb-2007, at 0:42, Sam Heard wrote:

 Dear All

 I have been at the CEN working group meetings representing  
 Standards Australia. It is clear to me that CEN needs to take on  
 the openEHR data types in order to progress quickly. The ISO data  
 types are likely to be appropriate for the HL7 environment and will  
 map to openEHR - but the openEHR data types are ready for  
 archetypes and the cluster element (leaf node) architecture.

 You can have a look at the ISO data type proposal likely to come  
 through HL7 soon at:

 http://informatics.mayo.edu/wiki/index.php/ISO_Datatypes

 user name: wiki

 password: wikiwiki


 It will be helpful to make your views known on this list.

 Cheers, Sam
 -- 
 Dr. Sam Heard
 MBBS, FRACGP, MRCGP, DRCOG, FACHI

 CEO and Clinical Director
 Ocean Informatics Pty. Ltd.
 Adjunct Professor, Health Informatics, Central Queensland University
 Senior Visiting Research Fellow, CHIME, University College London
 Chair, Standards Australia, EHR Working Group (IT14-9-2)
 Ph: +61 (0)4 1783 8808
 Fx: +61 (0)8 8948 0215

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CEN meeting and data types

2007-02-22 Thread Grahame Grieve
hey Sam

I'll bite ;-)

  but the openEHR data types are ready for
  archetypes and the cluster element (leaf node) architecture.

it you want, we can go round and round on semantic issues. Always
a pleasure ;-). But is there anything specific that makes
you think that it would be inappropriate or unwise to use the
iso datatypes in the document with 13606? (so not including
general issues)

Grahame

Sam Heard wrote:
 Dear All
 
 I have been at the CEN working group meetings representing Standards 
 Australia. 
 It is clear to me that CEN needs to take on the openEHR data types in order 
 to 
 progress quickly. The ISO data types are likely to be appropriate for the HL7 
 environment and will map to openEHR - but the openEHR data types are ready 
 for 
 archetypes and the cluster element (leaf node) architecture.
 
 You can have a look at the ISO data type proposal likely to come through HL7 
 soon at:
 
 http://informatics.mayo.edu/wiki/index.php/ISO_Datatypes
 
 user name: wiki
 
 password: wikiwiki
 
 
 It will be helpful to make your views known on this list.
 
 Cheers, Sam
 -- o
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CEN meeting and data types

2007-02-22 Thread Thomas Beale
Grahame Grieve wrote:
 hey Sam

 I'll bite ;-)

   but the openEHR data types are ready for
   archetypes and the cluster element (leaf node) architecture.

 it you want, we can go round and round on semantic issues. Always
 a pleasure ;-). But is there anything specific that makes
 you think that it would be inappropriate or unwise to use the
 iso datatypes in the document with 13606? (so not including
 general issues)

   
I guess it depends on what CEN wants to achieve, and also what the 
implementation state and intention of the ISO types is. Possibilities I see:

* Let's say that the ISO types provide a set of types whose purpose
  is to facilitate data type conversion between HL7  HL7-like (e.g.
  various flavours of v2, v3 etc), openEHR, others (UN-cefact? ASTM?
  etc). Then the kind of implementations will be limited to XML
  conversion.
* On the other hand, if they were used as real data types, say in
  CEN, then there is now the job of implementing them in all the
  major technologies and testing them. Plus they need to be checked
  for use with archetypes.
* If CEN used the openEHR data types, they get something implemented
  in Java, C#, Eiffel, XSD (others?), that are heavily debugged and
  in production use now, and for which the constraint semantics and
  syntax are already known and tested in ADL. This includes
  constraint types for String (C_STRING), Integer (C_INTEGER),
  Date (C_DATE)..plus specialist constrainer types for
  DV_ORDINAL (C_DV_ORDINAL), DV_QUANITTY (C_DV_QUANTTY) and
  CODE_PHRASE (C_CODE_PHRASE). These have all been tested and are
  known to work, and numerous archetypes have used them. Also, the
  openEHR data types are founded on existing standard data types
  (ISO11404), and assume the standard semantics for all the usual
  built-in things (String, Integer, Boolean, Array, List,...)
  plus the ISO8601 date/time types (Date, Time, etc)

Now, since CEN is an archetype-enabled standard, it might make sense to 
use data types that are known to work in software and known to work for 
archetypes.

So one question is: what is the intended use of the new ISO date types 
(conversion, or to be the 'real thing')? Secondly, how will CEN EN13606 
be validated with a new set of data types?

- thomas beale



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CEN meeting and data types

2007-02-22 Thread Gerard Freriks
Thomas,

I agree with you that in the case CEN (13606) adopts the OpenEHR data  
types they know that it is proven technology.
Just now, when any moment CEN/tc251 EN13606 will get published, we  
dearly need proven data types to implement it.

In the case that CEN will make the choice for OpenEHR, my remaining  
questions are:
What harm is done?
How can CEN/tc251 EN13606 be aligned, some years from now, with the  
forthcoming ISO data type standard?
Can it be aligned? Or can't it?

Gerard


--  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





On 22-feb-2007, at 11:27, Thomas Beale wrote:

 Grahame Grieve wrote:
 hey Sam

 I'll bite ;-)

 but the openEHR data types are ready for
 archetypes and the cluster element (leaf node) architecture.

 it you want, we can go round and round on semantic issues. Always
 a pleasure ;-). But is there anything specific that makes
 you think that it would be inappropriate or unwise to use the
 iso datatypes in the document with 13606? (so not including
 general issues)


 I guess it depends on what CEN wants to achieve, and also what the
 implementation state and intention of the ISO types is.  
 Possibilities I see:

 * Let's say that the ISO types provide a set of types whose  
 purpose
   is to facilitate data type conversion between HL7  HL7-like  
 (e.g.
   various flavours of v2, v3 etc), openEHR, others (UN-cefact?  
 ASTM?
   etc). Then the kind of implementations will be limited to XML
   conversion.
 * On the other hand, if they were used as real data types,  
 say in
   CEN, then there is now the job of implementing them in all the
   major technologies and testing them. Plus they need to be  
 checked
   for use with archetypes.
 * If CEN used the openEHR data types, they get something  
 implemented
   in Java, C#, Eiffel, XSD (others?), that are heavily debugged  
 and
   in production use now, and for which the constraint semantics  
 and
   syntax are already known and tested in ADL. This includes
   constraint types for String (C_STRING), Integer (C_INTEGER),
   Date (C_DATE)..plus specialist constrainer types for
   DV_ORDINAL (C_DV_ORDINAL), DV_QUANITTY (C_DV_QUANTTY) and
   CODE_PHRASE (C_CODE_PHRASE). These have all been tested and are
   known to work, and numerous archetypes have used them. Also, the
   openEHR data types are founded on existing standard data types
   (ISO11404), and assume the standard semantics for all the usual
   built-in things (String, Integer, Boolean, Array, List,...)
   plus the ISO8601 date/time types (Date, Time, etc)

 Now, since CEN is an archetype-enabled standard, it might make  
 sense to
 use data types that are known to work in software and known to work  
 for
 archetypes.

 So one question is: what is the intended use of the new ISO date types
 (conversion, or to be the 'real thing')? Secondly, how will CEN  
 EN13606
 be validated with a new set of data types?

 - thomas beale



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CEN meeting and data types

2007-02-21 Thread Sam Heard
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