Philippe, Thank you for the comments. I believe that we will have "islands" of health information for a very long time... for many reasons, some of which are not technically sound, but more the result of convention. On the other hand, the "islands" do facilitate an inherent security and fault-tolerance. "Bombing" one island would never destroy the greater system.
We just need to ensure that each island is able to connect periodically to a global repository-network... for updating/refreshing... and that we have robust access control and ways to determine how reliable the data is. Christopher J. Feahr, O.D. Optiserv Consulting (Vision Industry) Office: (707) 579-4984 Cell: (707) 529-2268 http://Optiserv.com http://VisionDataStandard.org ----- Original Message ----- From: "Philippe AMELINE" <philippe.amel...@nautilus-info.com> To: <openehr-technical at openehr.org> Sent: Monday, August 04, 2003 1:42 AM Subject: Re: certification and verification of OpenEHR > Hi, > > >>Constraining every enterprise system to the same physical > >>record architecture is always denied as an ultimate objective of > >>"EHR"... although that *would* be a path to a fairly high level of > >>user-system interoperability... it's just that no one would agree to do > >>it. > >I see the state of thinking as follows: > >- existing providers, including hospitals, labs, GPs, will in many cases > >keep their existing EMR systems (all different etc) > >- the shared-care health record is likely to be installed as a new system > >on a regional or even national basis in some places. > >- what is standardised is the shared-care EHR and its interfaces. EMR > >systems have to send some percentage of their innformation to the EHR > >- most likely, GPs will start using the EHR directly > >- providers that decide to adopt the same technology as the shared care > >EHR will obviously have an easier time of shipping information in and out > > There is certainly a feeling in the air that each place of care can't > remain a "care island" in the ocean. > We probably can talk a very long time about models, architectures, > standards... in order to allow various form of communication. > > As someone that as been working on very practical solutions in that field > for some years, I can introduce (very) shortly two major concepts : > > - Be usefull > > It certainly seems to be a dumb advice ; of course no one will ever build a > useless system ;o) > However, since we are talking about communication, the system must be > usefull for each and every party. So, if you want to adress the continuity > of care issue, the system must be usefull for the patient, the GP, the > hospital practitionner and so on. > I mean they must use it, and not only benefit from it ; so I mean the > patient must use it and not only be the "center of it". > > - Subsidiarity > > It is a complex word, but the meaning is simple : let the wider system > concentrate ONLY on functions that narrower systems can't offer. > For us it means two orthogonal considerations : a genuine "functionnal > axis" (put the proper functionnalities on the proper system), and a "data > storage axis" (store the proper data on the proper systems). > > Best regards, > > Philippe > > - > If you have any questions about using this list, > please send a message to d.lloyd at openehr.org - If you have any questions about using this list, please send a message to d.lloyd at openehr.org
