Hi David,

Thanks for the reply.  

I 'think' it was the economist Milton Friedman that said the quote about
tides and boats????

I will certainly report to the Foundation & community on the results of
this conference. OpenMRS has a very high profile now and the team has
been very giving of their time. It is great to have the opportunity to
work with them.

We have been VERY fortunate to have the support of UCL over the years.
But, I am very happy to hear that the Board is looking at long term
solutions in maintaining the Foundation.  Part of my point is that it is
incumbent upon us all to participate at some level in that
sustainability.  

You are correct that this isn't the correct mailing list for this
discussion.  However, there is no mailing list for discussing the
Foundation or for publicity or even for education.  I thought about
using the Wiki. But really, unless you make a compelling case in an
email people aren't going to click through to the Wiki page anyway. So,
I plead guilty to list abuse! ;-)

Stef Verlinden had some great comments (on the Implementers list).  One
in particular is about providing presentations that others can deliver
when the find themselves in a venue/meeting where openEHR would be an
appropriate topic.  In the past, Tom Beale has allowed me to use some of
his graphics etc. that were likely created under the auspices of Ocean
Informatics. I think that we should have at least some basic
presentations (with notes) that everyone can use that have explicit open
license's. I will donate to that effort.  

Shall I copy/reformat this for the wiki?

Cheers,
Tim





On Fri, 2007-11-30 at 12:05 +0000, David Ingram wrote:
> Tim
> 
> I was very interested to read of your engagement with openMRS as 
> there has been contact with me about this via Don Detmer, CEO of 
> AMIA, who is a visiting professor in CHIME. What you are doing seems 
> an excellent way of broadening out the openEHR mission.
> 
> After your conference, it would be extremely helpful to hear, in some 
> detail, your assessment of the commonalities and differences, and the 
> potential and useful opportunities to develop synergy with them, from 
> the Foundation.
> 
> On the broader issues you raise, the Board has been working on a 
> number of options for supporting the consolidation and development of 
> the openEHR community, through a business case built around the 
> Foundation's mission, which emphasises clinical and health 
> engagements, rigour and openness of technical approaches, and 
> building of trust within user communities. We believe that revenue to 
> the Foundation must come through its direct connection with and 
> relevance to these three, and from activities and organisations that 
> identify with or build on its mission. As of now, having a financial 
> interest in the openEHR Foundation essentially means paying bills, 
> which have been considerable, in cost and in kind, over a long period of time.
> 
> For my part, I am very fortunate in having had the explicit support 
> of successive Presidents of UCL in holding this position, but we all 
> recognise that we have to find the right way, now, to change gear and 
> put future finances onto a proper and sustainable footing. Sam and I 
> have started some confidential high level discussions, here, about 
> this, and we have been very well received. I have worked a lot in the 
> voluntary sector and know the often quite unproductive load that can 
> be placed on Foundations that depend, for their work, on sponsorship 
> and voluntary support, alone. We should thus, we believe, explore 
> appropriate revenue streams, tied closer into the contractual domain, 
> around use and support of the openEHR IPR and trademark. Any useful 
> trademark must be asserted, supported and, if necessary, defended, 
> and that costs money; even acquiring the trademark has cost us a 
> great deal. But, that said, clearly Foundation revenue streams must 
> be framed in such a way that they are explicitly connected with 
> relevance and usefulness in pursuit of the mission of the Foundation, 
> as an open and not-for-profit enterprise. This is not an easy 
> balancing act and there are no exact parallels that I know of, though 
> many quite close analogies to learn from.
> 
> We must and are determined to take our time to get this next stage 
> right. We're in this for the long term and welcome and value all the 
> huge amount of thoughtfulness and commitment shown within the 
> community, that is helping us all move forward.
> 
> By the way this should perhaps be a post on a different list.
> 
> David
> 
> 'A rising tide floats all boats' is a new one on me; I will check its 
> provenance and certainly remember it. In the worlds I move in we 
> often seem to live in a Mr Micawber (Charles Dickens) zone between 
> 'income  = one pound, expenditure equals one pound and sixpence 
> (misery and disaster abound)' and 'income = one pound, expenditure 
> equals nineteen shillings and sixpence (joy and munificence all 
> round)'! Change management in the latter scenario seems an Human 
> Resources Department free breeze; in the former scenario a completely 
> draining HR
> dominated nightmare! So I'm all for rising tides. In England, we have 
> some tides that rise and fall 10 metres, every day, though!
> At 11:10 29/11/2007, you wrote:
> >All,
> >
> >I believe that there has been huge growth in the awareness around the
> >world of openEHR and especially archetypes over the past two years.
> >
> >The keyword in that sentence is 'awareness'. In many places there is a
> >pretty serious lack of understanding.  Tom Beale, et.al. has done a
> >wonderful job over the years of creating AND maintaining outstanding
> >documentation for the Foundation. This is a first for many open
> >source/open content projects.
> >
> >How can we the community, support the Foundation better so the
> >Foundation can support us better?
> >
> >[Caution random thoughts ahead]
> >
> >At an appropriate time, conferences are very beneficial in community and
> >awareness building. [5-6 years out for an openEHR conference?]
> >
> >Meetings at other related conferences are always good.  I understand
> >that there were a significant number at MedInfo this year [I couldn't be
> >there :-< ]. This is something that should be in the planning.  Are
> >there papers to be presented?  Where will they be submitted? BoF
> >meetings.
> >
> >How can we come together under the auspices of the Foundation to build
> >internal support and support each other? [actually I understand this is
> >already being worked on]
> >
> >I'd love to have discussion on these and other points.  Remember; "a
> >rising tide floats all boats" [I have no idea who said that but it
> >sounds cool so I repeat it often]. :-)
> >
> >A story about what (partially) prompted this email:
> >
> >I was invited to give a presentation to a Standards working group on
> >Archetypes.  Now; I am not an "Archetypes" expert by any means.  Heck,
> >I'm not even a clinician. But I do understand the Reference Model and I
> >understand two-level modeling. Besides, I've never been to Kenya
> >before. :-) So I accepted.  I was also asked to present a comparison
> >between OpenMRS "Concepts" and archetypes.  Well, I ass-u-me-d that the
> >people that had invited me saw some similarities between them and wanted
> >some clarification and a suggestion as to how the two might be used
> >together.
> >
> >After several weeks of just thinking about a presentation and asking a
> >question here and there.  I realized that the conference in next and
> >maybe I should really understand OpenMRS "Concepts".  [usually a good
> >idea at this point].  BTW: The panel we are in together was labeled
> >"Vocabulary Management".  I had sent an email a few weeks ago suggesting
> >it should be called "Knowledge Management" if we were presenting
> >"Archetypes" and "Concepts".  No answer.
> >
> >On Wednesday (yes only 5 days before traveling to the conference) I
> >started engaging the OpenMRS community with serious questions (I had
> >been lurking for weeks).  Well, one question led to two and two to four
> >(you get the idea) and pretty soon I think I shut down OpenMRS
> >development progress because everyone was busy answering my questions
> >(sorry but thanks, OpenMRS guys).
> >
> >After my re-education and a basic "aaaaaHHHHHHaaaaaa" I realized that
> >"Concepts" and "Archetypes" are not even close in similarity! Basically,
> >"Concepts" are a local vocabulary used to improve computability to
> >patient responses in a typical EAV data model.
> >
> >My point is [may be you haven't done this] that it is too easy sometimes
> >to get so close to something that you do not understand or appreciate
> >the view point of others.  I began to make assumptions.  I almost lost
> >an opportunity to present the wonderful virtues of openEHR and two-level
> >modeling because of it.
> >
> >I am looking forward to next week and I really do appreciate my hosts
> >asking me to attend.
> >
> >In preparing the media for the conference they asked for presentations
> >as well as any background documentation.  I included (with my
> >presentation) the openEHR overview, the archetype principles document
> >(after checking the license) and a couple of archetypes in ADL and HTML.
> >I believe (hope) that people that would not normally go tot he website
> >to look for these will at least browse them on the conference media.
> >
> >I also think that it is very important for us to point out that while
> >the ideal is a longitudinal, future proof health record. The openEHR
> >specifications (applications) can deliver independent clinical
> >applications that can share information.  Lets say that a health
> >authority wants to review TB registries, Malaria registries and HIV
> >registries. They can do that with the same application using the
> >specific archetypes from each area.  No other model can accomplish that.
> >
> >So, my point is ...
> >
> >we as a community need to promote and EDUCATE at every opportunity, the
> >concepts of openEHR, archetypes and the Foundation so that we can
> >encouragin funders to recognize the Foundation needs and so that the
> >Foundation can grow to support us.
> >
> >
> >DISCLAIMER:  I am not a member of the openEHR Foundation Board of
> >Directors nor do I have any financial stake in the Foundation.  I do
> >however believe that this is the best opportunity that the world has (so
> >far) to achieve longitudinal, interoperable, computable health
> >information systems.
> >
> >Your comments are encouraged,
> >
> >Tim
> >
> >
> >
> >
> >--
> >Timothy Cook, MSc
> >Health Informatics Research & Development Services
> >LinkedIn Profile:http://www.linkedin.com/in/timothywaynecook
> >
> >_______________________________________________
> >openEHR-technical mailing list
> >openEHR-technical at openehr.org
> >http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-technical
> 
> David Ingram, Professor of Health 
> Informatics,                         Tel.  020 7288 5965
> CHIME, University College 
> London,                                         Fax. 020 7288 3322
> Archway Campus, Highgate Hill, London N19 
> 3UA                     http://www.chime.ucl.ac.uk 
> 
> _______________________________________________
> openEHR-technical mailing list
> openEHR-technical at openehr.org
> http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-technical
-- 
Timothy Cook, MSc
Health Informatics Research & Development Services
LinkedIn Profile:http://www.linkedin.com/in/timothywaynecook 


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