Hi Philippe,
My answer was written from the pure computer science and engineering
perspective. I meant that openEHR have worked with the structure of the
electronic health records, but not built any medical terminology systems by
their own (as far as I know).
Regards,
Mikael Nystr?m
-----Original Message-----
From: [email protected]
[mailto:owner-openehr-technical at openehr.org] On Behalf Of Philippe AMELINE
Sent: den 9 februari 2006 15:37
To: openehr-technical at openehr.org
Subject: Re: dictionary
Hi Mikael,
I would be very sorry to have this conversation become too formal or appear
as some criticism. I am much willing to learn, and I think that, as a master
thesis supervisor, you teach Mattias not just to be happy with "established
concepts" but to have a push on it and check if it is a stone basement or
just a theater set.
My questions : "are you certain that a structure can host any terminology",
"what is the discourse complexity level you can address"
are of the "have a push on it" kind.
My feeling is that the good order to ask questions (and answer it) is :
Why do you want to communicate ?
What discourse complexity level can allow to address these needs ?
What discourse representation technology fits these "required language" ?
So, you may already have answered questions 1 and 2, and that it is possible
to answer Q3 with a discourse structure that can host any existing
terminology.
But at large, I don't agree that such a concept can address any answer to
questions 1 and 2. My personal opinion is even that, as a bottom-up
strategy, it constraints the system to a very specific range of
environments.
By the way, the term "terminology" itself would demand to be made more
accurate. It is often used to describe coding systems, classifications,
dictionaries, standardized vocabularies, ontologies...
All these components can actually appear somewhere in a discourse structure,
but at a specific place !
One can say, for example : "The patient complains from a terrible abdominal
pain 2 hours after meal. We can classify it as D01 in ICPC"
But not : "The patient complains from a terrible (D01 in ICPC) 2 hours after
meal."
This is certainly a multi-axial discussion. I hope I make my point of view
understandable.
Cheers,
Philippe
Mikael Nystr?m a ?crit :
> Hi Philippe,
>
>>From my point of view is the lack of communicable structure between
>different EHR systems the main problem openEHR?s archetypes tries to solve.
>I think this is what Mattias tries to say with his letter. In general
>medical informatics is it of cause also a large need for medical
>terminology systems of good quality, but openEHR?s archetypes don?t try
>to solve this problem by themselves. Instead you are able to link your
>archetypes to the medical terminology systems of the flavor you prefer,
>like SNOMED CT, ICD-10, ICF, ICPC, NCSP or something built by yourself.
>(At least in Sweden there exist maybe too many ?home built? medical
>terminology systems.)
>
> Regards,
> Mikael Nystr?m
> Mattias? and Johan?s master thesis supervisor
>
>
>
>-----Original Message-----
>From: owner-openehr-technical at openehr.org
>[mailto:owner-openehr-technical at openehr.org] On Behalf Of Philippe
>AMELINE
>Sent: den 9 februari 2006 12:34
>To: openehr-technical at openehr.org
>Subject: Re: dictionary
>
>Hi Mattias,
>
>The more I work on medical information systems, and the less I believe
>that the structure is more important than the terminology.
>
>To be a little bit more accurate, my opinion is that any health
>information system is there to "tell stories".
>I started in the domain 20 years ago with endoscopy reports : the story
>to tell was a 10 to 20 minutes medical act. Now, for many reasons (but
>it would be too long to explain it there), the "big thing" is
>continuity of care, and the challenge is to be able to tell someone's whole
medical journey.
>
>So, how can we tell these stories (from a 10 minutes encounter to the
>whole life and the fighting strategies to remain as healthy as possible) ?
>The answer is rather simple (at least to express) : we need to make
>"sentences". And to make sentences requires a grammar (the discourse
>structure) and a vocabulary (to populate the discourse structure).
>
>Is it possible to have a discourse structure that can "host" any
>terminology ?
>My personal answer is 'no', but maybe I try to tell more complex
>stories than you intend, or maybe you have a more powerful technological
solution.
>
>At large, I can ask you a question : do you think that you could
>communicate using the english grammar and let people choose any other
>language's vocabulary to populate it ?
>You can answer that natural language is more complex that formal
>language, but I can say that the more complex the story you intend to
>tell and the closer they need to be.
>
>Regards,
>
>Philippe
>
>
>
>>The important thing in openEHR archetypes is the structure of them. As
>>long as there is a structure that is equal for both "Weight" and
>>"Bodyweight", it shouldn't be a problem. The allowed information model
>>structures in archetypes is what really matters and the terms can
>>always be bound to external terminologies to create a mutual
>>understanding.
>>
>>Regards,
>>
>>Mattias Forss
>>
>>
>>
>>
>>
>
>
>
>
>
>
