Like Koray, I too would like to know

" . . if someone did or knows of any such study which applies formal 
validation methods? . . "

Regards
Gordon

Gordon Tomes | Acute Care Division | Department of Health and Ageing (MDP 
63) | PO Box 9848, Canberra ACT 2601 |  Ph 02 6289 5081 |  Fax 02 6289 
7630 |




Sam Heard <sam.heard at oceaninformatics.com> 
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07/02/2008 07:28 AM
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Re: Formal methods for Evaluation of Interoperability & Maintainability? 
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Hi Koray

I think we will have to come up with some metrics that are relevant as it 
has not been done before in the domain space. Clearly modelling at two 
levels is a common approach - relational databases model the idea of 
tables with rows and columns, linking keys, data types and indexes. The 
domain information is expressed in terms of these rows and columns. Many 
systems driven on metadata do the same thing. What is new about openEHR is 
a generic approach to allow any  base model to be constrained through the 
use of ADL. The result is that the base model can reflect the general 
business rules and the  fixed information constructs - the archetypes the 
domain knowledge and how it is represented in terms of the base model. The 
approach relies only on getting sufficient expressivity at the base level 
to make the split efficient and safe.

The comparison in health care at present is with HL7 version 3. This has a 
base model (RIM) from which a new model, an RMIM, is constructed (level 
2). The difference is that RMIMs are constructed with alterations to the 
RIM classes (which are renamed). So we now have a new class based on a 
pattern. The semantics of the RMIM is a mixture of RIM and RMIM and 
difficult to untangle. CDA is using templates in the same way as openEHR 
uses archetypes - to express some domain content. As CDA is already 
committed to XML, the means of further constraint is limited - hence the 
use of schematron and other devices.

I guess the first metric that we could consider is the speed at which 
domain concepts can be modelled and the level of human intervention for 
documentation and maintenance. The UK NHS, which has the most experience 
of both, has found openEHR far more efficient to use than MIF template 
constraints on HL7 CDA. Vendors are cautious and have little experience of 
openEHR directly as yet.

Clearly archetypes are of great use in systems that use the openEHR 
Framework and allow use of operability constraints out of the box. What 
about other vendor systems? Well, Ocean tools are being used to produce 
inputs for vendors which are formal specifications of data to be stored 
and communicated. The ability to reuse these artefacts for many purposes - 
queries, transformations, display and data entry provides another metric 
that is of use.

We will need some large systems built on openEHR and traditional 
approaches to compare in the future. For the moment, just having clinical 
specifications that are computable is the main influence on choosing 
openEHR - or starting from scratch as new vendors see the benefits (or 
not).

Cheers, Sam

 

Koray Atalag wrote: 
Hi,

I want to learn how we can formally/objectively prove that Archetype 
based dual level development formalism alleviates problems of 
interoperability and maintainability. I was wondering if someone did or 
know of any such study which applies formal validation methods?

Best regards,

Koray Atalag, MD, Ph.D.

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-- 

Dr Sam Heard
Chief Executive Officer
Ocean Informatics
Director, openEHR Foundation
Senior Visiting Research Fellow, University College London
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