I'm a .Net developer in the U.S. researching development of EHR. I've been
absolutely fascinated by the recent debate between advocates of HL7 and
openEHR. For me it was hugely informative and I'm glad it all happened. You
don't learn this stuff just be reading the papers from each community.
Since I'm not sufficiently acquainted with all the details of either system I
could not follow each nuance of the argument. But among the things I'm taking
away from this is that HL7 involves a complex and ever-changing schema at the
DB storage level, something that worries me. I did not hear a rebuttal of this
point from the HL7 side.
Randy Neall
Veriquant, LLC
tel 828-685-1302
fax 828-685-1957
randy.neall at veriquant.com
----- Original Message -----
From: Gerard Freriks
To: For openEHR technical discussions
Cc: grahame at jivamedical.com
Sent: Friday, September 15, 2006 16:07
Subject: Re: Antw: Re: EHRcom/openEHR the new exciting paradigm
Dear William,
Either the brave Dutch are stupid or very clever to become almost the only
nations on this earth to vote negative on:
the CEN/tc251 EN13606 EHRcom and HISA standards.
I know one thing for certain.
Based on the openEHR specification in TNO project we have one working
implementation from Sweden using Java and one from Australia using .Net.
And besides openEHR and CEN/tc251 are based on several working
implementations produced in many European projects.
Not only the theoretic foundation is in order,
the implementations are there,
and they work as claimed.
It can be proved this solutions are scalable.
I know that there are parties that started to implement HL7v3 messages on a
large scale and encountered scalability problems.
There parties are changing there point of view and are moving towards
CEN/tc251 EHR related standards.
To read recently in a HL7 e-mail list a discussion dealing with the
definitions used in HL7 with respect to several of the founding classes of the
RIM (Entity and Act) and the confusion in the documentation is a tell tale
example of only one of the serious problems in the HL7 community.
And all this after 10 years of work and the production of tons of
documentation that can not be printed.
You can reverse any statement I make.
You can decide not to believe any statement I make,
as you and several of my country fellow man did when we were discussing
EN13606 EHRcom,
lets see how history will prove who is right and who is wrong.
So we stop this debate and see how things evolve in time.
In the end what matters is, not only that the healthcare sector is able to
express what they want,
but can it Plug-and-Play be implemented without reprogramming.
And then I'm confident that openEHR and CEN/tc251 EHRcom plus HISA will
provide just this,
because it was in our requirements, also, from the start.
I agree.
There is only one patient, with one problem that needs our unified attention
and devotion.
So we have to co-operate.
But we have to continue to discuss and provide arguments and listen to the
arguments given.
Instead of attacking persons, as I have been able to observe several times it
to happen in the Netherlands.
Lets start the real debate.
Patients and healthcare providers need real solutions that empower them.
Gerard
-- <private> --
Gerard Freriks, arts
Huigsloterdijk 378
2158 LR Buitenkaag
The Netherlands
T: +31 252 544896
M: +31 653 108732
On 15-sep-2006, at 19:08, Williamtfgoossen at cs.com wrote:
This is reversable:
When the world starts to experience the multitude of difficuties with the
OpenEHR and CEN 13606 and archetype development method what will we do?
Will we start to patch up something that has intrinsic problems?
Do you remember the recent discussions on the OpenEHR list.
My conclusion was that they don't know the definitions of the major classes
of the RIM and other technicalities.
Luckily OpenEHR / 13606 is not deployed that widely, so there are not much
legacy systems to reckon with?
Or will we start from a more sound starting point. One that is an
International standard and is on its way to become an ISO standard as well?
Of course this reversion is just to point to the fact that we are
apparently back in our corners and have this dispute that is nonsence and not
contributing.
I am the last to tell that HL7 v3 is perfect, but will be one of the firsts
to tell it is working.
I am the last to believe OpenEHR / 13606 is perfect, and wait till I see it
work in real practice.
In the meantime, we have harmonized and differences (few) and commonalties
(biljons) have been determined.
In the meantime, we will start working with existing tools, set
requirements and improve the tools.
I do not care where the tools come from, I care what they can do for the
very difficult work of entering, storing and exchanging information about
patients and care in a intelligent, semantic interoperable way.
I do like HL7 v3 D-MIMs because I see several good working EHR systems
based on this. To me, beside philosophical problems (fundamental to limits in
human thinking), and technical approaches, it really does not make a
difference: make the clinical materials available electronically and make
clinicians not have to worry about the technology and transformations behind.
Any discussion in favour of one and against another approach is going back
to the trenches of WW1 where we would like to work towards the future.
William
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