Greg:
One tangible way to get at what I view is global that is one of my foci is
to look at the Lab Module of VistA and its current features as well as
mechanisms for requesting lab services as part of a treatment plan and
then posting the requested measurements into the EHR. Issues of
Point-of-care-testing are involved and these may be different in different
care settings (e.g. family practice setting verssu large clinic or even
hospital resident settings). The current module is being re-engineered
within the VA which now has a host of differnt care settings than it had
when the module was originated. At the Fall VCM I would like to invite the
the Lab Module Project Manager to deal with the broader issues that VA
leaders have published this year in their book: "Person-Centered Health
Records: Towards HealthePeople" where they allude to how the new
HealtheVet will be the model for the general architecture HealthePeople
but a whole range of Conceptual Content model and business process issues
that attend the IOM 2003 report about the Five Key Competencies in
healthcare. The formation of the HITSP begs a number of these issues just
with respect to the clinical laborarory. If an initial vigorous discussion
about the clin lab issues at the Fall VCM could be carried out, it would
complement the hopefully by then released VOE which would exhibit most of
the current VA VistA capabilities. Perhaps we could get the IHS folks to
compare/contrast their version of the lab module and discuss identified
needed but not yet present capabilities as one facet of the Requirements
Engineering Process (which is flexible and not a catechism).
Thats is appreciating the present relationship bewteen implemented Technical
Platform and beginning to formulate ideas about a new
(technology-independent) design to meet the glimpses of the new
requirements even before design processes have begun. Later, discussions
could focus on the the appropriate implementing technology (which is
where M stds might come in). That a glimpse of Enterprise View, Life Cycle
Principles (other facets can be revealed by use of Zachman Framework
activities as one method). The process will require both clinical
laboratorians AND information engineering disciplines. Hopefully, the VCM
form for the VA lab module team would be as useful to them as to the VistA
Community. We have to recognize the value of such an exchange before it is
appropriate to even ask the the team to attend.
I thats my example as an answer.
On Tue, 13 Sep 2005, Gregory Woodhouse wrote:
Maybe a good way to approach the subject is with a (not so) hypothetical
question: Imagine two communities, each with its own set of interests (say,
CPOE and practice management) and each using its own basic technology (say
MUMPS/Fileman in one case, and Java/MySQL in the other), and platform (say
Linux on a Pentium or Solaris on an UltraSPARC). What will it take for them
to successfully coordinate their efforts? How about develop product that can
be used side by side in the same practice?
===
Gregory Woodhouse
[EMAIL PROTECTED]
"The whole of science is nothing more than a refinement
of everyday thinking." -- Albert Einstein
On Sep 13, 2005, at 11:18 AM, A. Forrey wrote:
Greg;
Not to quarrel with what youve said but my point is (and has been) that
that Common conventions (standards) are needed at all levels and if they
are relavant and are to be referenced then the they need to exist and be
current. We need standards about all of these compoents of a health
information architecture. M is a key infrastructure convention for Vista
and it needs to be kept current if its is to be referenced. There are many
other standards that complement M, including those for conceptual contant
(e.g. termiunilogy, models, etc). Elements of the VistA Community need to
be active in these efforts which include messaging, technical
infrastructure etc. The notice about the ONCHIT effort is just a reminder
about the scope of waht will be needed to keep VistA current and relevant.
To the extent that we can benefit from what the VA, IHS and DoD are doing,
fine, but if they are not doing what will be needed for the general
constituents of VistA then we need to work at that. The MDC is just one
building block that has been neglected, I am sure that there are others but
all will be needed. We just need to talk about who is doing what and keep
working.
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