The current goal of the CCR is only to provide a nonpersistent record for the patient to transpost or send from physician to another for a single care encounter. I see that being rapidly extended into using it to create personal records for patients, etc.
There are going to be problems mapping data from VistA to it. One example is that there are family and social history sections in the CCR that are not broken out in VistA. This is not meant to be the model for the EHR of the future, at least not at this point. I see it as the first iteration of this, of course. There is versioning built in. On Tuesday 14 June 2005 01:19 am, Ken Stone wrote: > It absolutely makes sense to have a 'vanilla' EHR record format that > every conforming program would have the burden of being required to be > able to export data to/import data from, but with the understanding > that the simplified version of reality represented in that vanilla > record format might not be the most accurate or nuanced representation > possible. But after picking the low-hanging fruit that it's easy to > gain consensus on, metadata (ideally with human readable documentation > of the underlying semantics, as understood by that implementation of > that program) seems like the only completely flexible way to go. By > permitting each program it's own personalizable "scratch space" within > the confines of a standardized EHR record, every program could at > minimum use the standard as a backup method and/or means of > transferring all of it's EHR data to an identical copy of itself. > From there, refinements to the common 'consensus' model and a > relatively large amount of interoperability should be only a short > step away. > > -K > > On 6/14/05, Gregory Woodhouse <[EMAIL PROTECTED]> wrote: > > I've talked to Nancy about the need for modularity and extensibility > > for precisely the same reasons. I don't think I've ever seen two > > products with non-trivial data dictionaries map cleanly to one > > another on a semantic level. Even when the mappings look like they > > make sense, there are always surprises once actually try to get the > > two systems working together. Some people think metadata is the > > answer here, and some think the answer is to have more carefully > > specified ontologies. I'm not really convinced in either case. > > === > > Gregory Woodhouse > > [EMAIL PROTECTED] > > > > "Before one gets the right answer, one must ask the right question." > > -- S. Barry Cooper > > > > On Jun 13, 2005, at 8:54 PM, Ken Stone wrote: > > > On 6/13/05, Nancy Anthracite <[EMAIL PROTECTED]> wrote: > > >> Ken, there are a few of us looking at what can be done about > > >> creating the CCR > > >> from VistA data which is of particular interest because the roll- > > >> out of > > >> VistA-Office EHR and the release of the CCR are likely to occur at > > >> the same > > >> time, so that functionality within VistA-Office will be needed > > >> quickly. > > >> > > >> Have you taken a look at the online demo of CPRS at www.va.gov/ > > >> vista? It > > >> would be interesting to hear from you what you think is so bad > > >> about it after > > >> you have "used" it a bit. > > > > > > Nancy (Anthracite? Cool name!), > > > > > > The thing that got me geared up (if you want to call it that) about > > > CCR was simultaneously learning of its pending existence and also > > > getting the impression that it is meant to serve as a > > > lowest-common-denominator standard for EHR data exchange. Which is > > > fine, except that not all EHRs will (or should be) > > > lowest-common-denominator software. > > > > > > Obviously standardization is good, to the extent that standardization > > > can reasonably take place. But there are likely to be a lot of > > > interesting bits of data that physicians will be wanting to keep track > > > of someday, many of them not yet even known or invented yet, which is > > > presumably why everybody in the past wanted to "go play king of the > > > hill in their separate pigeonholes." As future generations of EHRs > > > get developed and refined, it would be nice if the old standard for > > > EHR portability could keep up, and do so in a way that would allow > > > intelligent programs to adequately encode and (if appropriately > > > programmed/kept up to date) decode every last possible bit of > > > information that's meant to be in an EHR. By the fact that people > > > around here are talking about using XML to encode EHR data, it seems > > > clear that a number of other people are already well-aware of both the > > > problem and the general approach that I would have proposed to solve > > > it. > > > > > > The only thing I've got to add (or rather, ask) is: does the proposed > > > CCR standard currently contain standardized fields to allow (a) easy > > > automatic recognition of the encoding software product (and version), > > > and (b) easy automatic recognition of the CCR version itself (assuming > > > possible future refinements of the CCR standard)? If so, then I think > > > there are sufficient escape hatches built in such that the advocates > > > of "just go ahead and release the standard already" could be forgiven > > > their impatience. > > > > > > -K > > > > > > (p.s. As to looking at CPRS--maybe after exams. Not right now...) > > > > > > > > > ------------------------------------------------------- > > > This SF.Net email is sponsored by: NEC IT Guy Games. How far can > > > you shotput > > > a projector? How fast can you ride your desk chair down the office > > > luge track? > > > If you want to score the big prize, get to know the little guy. > > > Play to win an NEC 61" plasma display: http://www.necitguy.com/?r > > > _______________________________________________ > > > Hardhats-members mailing list > > > Hardhats-members@lists.sourceforge.net > > > https://lists.sourceforge.net/lists/listinfo/hardhats-members > > > > ------------------------------------------------------- > > This SF.Net email is sponsored by: NEC IT Guy Games. How far can you > > shotput a projector? How fast can you ride your desk chair down the > > office luge track? If you want to score the big prize, get to know the > > little guy. > > Play to win an NEC 61" plasma display: http://www.necitguy.com/?r=20 > > _______________________________________________ > > Hardhats-members mailing list > > Hardhats-members@lists.sourceforge.net > > https://lists.sourceforge.net/lists/listinfo/hardhats-members > > ------------------------------------------------------- > This SF.Net email is sponsored by: NEC IT Guy Games. How far can you > shotput a projector? How fast can you ride your desk chair down the office > luge track? If you want to score the big prize, get to know the little guy. > Play to win an NEC 61" plasma display: http://www.necitguy.com/?r > _______________________________________________ > Hardhats-members mailing list > Hardhats-members@lists.sourceforge.net > https://lists.sourceforge.net/lists/listinfo/hardhats-members -- Nancy Anthracite ------------------------------------------------------- This SF.Net email is sponsored by: NEC IT Guy Games. How far can you shotput a projector? How fast can you ride your desk chair down the office luge track? If you want to score the big prize, get to know the little guy. Play to win an NEC 61" plasma display: http://www.necitguy.com/?r=20 _______________________________________________ Hardhats-members mailing list Hardhats-members@lists.sourceforge.net https://lists.sourceforge.net/lists/listinfo/hardhats-members
