In een bericht met de datum 5-10-2003 22:37:25 West-Europa (zomertijd), schrijft sam.heard at bigpond.com:
Dear Sam, I agree, but perhaps your points need to be sharpened a little to distinghuish form one term and a terminology system. See my comments. > Dear All > > This area is difficult and we must learn as we go. There are a few > conclusions I have come to from an EHR system point of view.. > > 1. The data structures and term sets that are required for clinical care and > communication must be able to be instituted both prior to and after the > standardisation processes have been published. Yes, this will always be true, since the archetype should allow for new research results to be added, independend from where the standardisation process is. E.g. if a new scale for prediction of rehabilitation of stroke patients comes up after the standardisation process around archetypes / templates / models is finished, such a new archetype to represent this scale must be possible. > > 2. Special requirements that are not contrary to agreed standards should be > able to be implemented without difficulty - this is the norm rather than the > exception. > See 1. If new instruments for clinical practice require additional characteristics, these must fit into slots of the archetype. This would imply that the archetype materials allow for such additions with a predefined 'free text'/ 'free format' section to do this. > 3. Where terminologies required in archetypes are small and generally > agreed, these should be primarily expressed in the archetype itself - not to > do so is to add to the unrealistic demands on external terminologies. > I agree, the goal is to develop a archetype and to use base material from external terminologies where relevant, feasible and possible. > 4. Translations will be safest inside archetypes where the meaning is > clear - the context is highly specified. This is a reason to extend the role > of internal terminologies of archetypes. > This is no different (procedure like) as within HL7 RIM the internal and external vocabularies are specified. See HL7 materials for the different portions. > So, the new statements I would make are: > > 1. Archetypes should have no language or terminology primacy - and these > should be able to be added post-hoc. > Except for the archetype meta language and vocab itself. These should be explained / defined explicitly. There will be a primacy for the actual wording / terms used to describe the clinical content and context for this particular archetype. However, using particular words in the archetype should not a priori be based on one terminological system. Post hoc linkage from the actual wording in the archetype to terminological systems should be allowed. Perhaps, therefore it is better to reword this statement as 1. Archetypes should have no primacy for a language or terminology system or vocabulary - and these should be able to be added post-hoc. > 2. Terminologies internal to the archetype will always be safer to translate > and provide synonyms and specialisations. > OK, but again see the suggestion to explicitly define internal and external terminologies within the archetype stuff. > Despite the feeling of some in the business, this does not really diminish > the need for external terminologies. I am also aware that the comprehensive > approach of Philippe and the Odyssey Project and the text processing of > Peter Elkin. I believe these efforts will remain as relevant, but more > focussed within an archetype driven information model. > > Cheers, Sam Heard Thanks, William Goossen -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.openehr.org/mailman/private/openehr-technical_lists.openehr.org/attachments/20031006/c65099e0/attachment.html>
