My thoughts:
- The picture is not wrong
- It needs more detail:
- Codes from codings systems are used in structures
- Ontologies are the ‘best’ coding systems, derived classifications are
‘good’ as well
- In structures codes are used in two ways: to give meaning to nodes in
the structure, as
And to give meaning to the data fields in the structure.
-Since both codes and structures can give (i) meaning to concepts
problems can occir (the Boundary Problem)
Additional rules how to use the structure and codes used are needed:
Rule 1: Only basic (primitive) codes from a coding systems are allowed.
e.g. Code allowed for: 'Mamma tumor' but not a code for 'Mamma tumor
not found’
Perhaps more rules are needed.
In CIMI/HL7 there was/is and agreement to use LOINC codes to express
the question and SNOMED to be used to provide the answer.
Gerard Freriks
+31 620 34 70 88
+31 182 22 59 46
[email protected]
Kattensingel 20
2801 CA Gouda
the Netherlands
> On 10 Oct 2019, at 11:29, Vebjørn Arntzen via openEHR-clinical
> <[email protected]> wrote:
>
> d. Although measures have been taken to implement international standards
> such as the FHIR, for many years there will be a need to adhere to these
> national information models. There is a trend towards increased international
> standardization of information models and the use of terminologies as
> information carriers. Important examples of frameworks that can be used in
> Norway include Digital Imaging and Communication in Medicine (DICOM) (21),
> Cross Enterprise Document Sharing (XDS) developed by Integrating the
> Healthcare Enterprise (IHE), Fast Healthcare Interoperability Resources
> (FHIR) developed by the organization Health Level Seven (HL7) and archetypes
> developed by OpenEHR. The frameworks have different methods for terminology
> binding, but what they have in common is that they look at the use of
> standardized terminologies and the utilization of mutual experiences where
> appropriate. This is a natural development of an ecosystem of information
> exchange within health, driven by an international environment. A whole that
> contains both coding systems, terminologies and information models is an
> international trend. For example, IHE will use information models from HL7.
> HL7 uses, among other things, SNOMED CT as proposed coding in its FHIR
> information models and DICOM uses SNOMED CT directly which encodes several
> places in its frameworks. Common to the organizations that drive the
> development going forward is broad international participation, anchoring in
> academia and with suppliers and / or authorities. There is an issue related
> to the use of SNOMED CT as a bound terminology as it is licensed, and use
> will therefore be tied to membership or require payment. SNOMED International
> has previously allowed DICOM to use terms as part of a published standard. In
> 2019, a larger amount of terms were released for use in the International
> Patient Summary (discussed later). This is done to make it easier to use
> SNOMED CT, even where there is a need for restrictive binding to terminology
> in an information model.
>
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