Hi Mikael, You are right, there is no controversy on that... and no controversy at all.
Regards, Philippe Mikael Nystr?m a ?crit : > 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: owner-openehr-technical at openehr.org >[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 >>> >>> >>> >>> >>> >>> >>> >> >> >> >> >> >> > > > > > >
