Dear all, Recently an article by Bernd Blobel was published in the Dutch HL7 magazine (Dec 07 issue) in which he compares the different EHR models: openEHR, HL7v3, EN/ISO 13606 and CCR. Robert Stegwee, the chair of HL7.nl, kindly translates this article in Dutch, which unfortunately makes it unsuitable for distribution outside the Netherlands
I?ve tried to ask Bernd Blobel to share the original text of this article (which is hopefully in English), so that the openEHR community also can take notice of it. I haven?t received an answer yet. I won?t translate the whole article back to English (and I still hope that Dr. Blobel will share the original article), but for the sake of discussion I would like already to point out a few things that ?triggered? me. From what I understand Blobel claims that all the paradigms for an advanced EHR architecture were, already back in the nineties, defined in the context of the Generic Component Model (GCM) (no reference provided). In the article he states that the GCM provides a service oriented, model driven system architecture for the development of a sustainable and semantic interoperable EHR systems. The GCM provides a multi-model approach for EHR architectures, system development and implementations by the simplification of the system description by means of: - transparent domain management, - the composition and decomposition of the system components - the views from the different angles on the system (amongst which thorough modelling of business models As a result the GCM provides reference architecture for analysing, designing en implementation of EHR architectures, as well as a tool for the development of migration strategies (Educational challenges of health information systems? interoperability. B. Blobel, Methods Inf Med 2007; 46 p.52-56) Although I can?t assess the article fully on it?s merits, the idea of a theoretical ?meta? reference architecture for the future which can be used for the purposes above seems appealing, both for further improvement of the openEHR architecture as well as for the future harmonisation of HL7 en openEHR in a common (EN/ISO 13606 derived?) internationally accepted EHR standard. So my first question is: Is the GCM to be seen as a theoretical ?meta? reference architecture, which can be used as a guideline for future developments? If the answer is no, why not? Further in the article Blobel compares GEHR against the GCM. Although the header of this section mentions the openEHR foundation, he consistently talks about GEHR and the GEHR project (http:www.gehr.org). The URL for GEHR links to a site, which has to do with different aspects of healthcare than we?re generally talking aboutJ). Also when Blobel talks about ADL he refers to a URL that doesn?t exist anymore (http://www.deepthought.com.au/) and most certainly it wouldn?t have linked to the latest version of the ADL So my second question is: is Blobel, when making his comparison, referring to the latest versions of the reference architecture and ADL as recently developed within the openEHR community? Blobel?s conclusion of comparing GEHR to the GCM, is that GEHR limits itself to the structural aspects of the knowledge components and doesn?t comprise behavioural aspects. Also it isn?t possible, due to the lack of specified rules, to aggregate archetypes. Instead they have to be replaced by more complex archetypes. More generally the GEHR approach has some essential shortcomings at the mathematical, system theoretical and informatics levels. These shortcomings have to be addressed in the future. In the discussion en conclusion section Blobel adds to this: that within the EN/ISO 13606 approach, although almost complete as far as semantic interoperability concerns, a lot of shortcomings and inconsistencies have to be solved. As example: the issue of structural composition and decomposition, as well as the modelling of business processes is not solved well. Personally I think that such statements should be underpinned with arguments/ scientific proof and/or examples or at least a reference to a properly peer reviewed article that does so. I would like to invite Blobel (and others if they feel obliged to) to provide these scientifically valid facts to underpin these statement, so we can have a proper discussion. This type of ?review? statements creates confusion, which hinders any serious discussion about future developments and harmonisation. It also undermines the (in my opinion) otherwise good intention of the article as a whole. My third and last question to the community is: are these conclusions (if applicable to the current version of openEHR) valid and if yes how can we address those issues? Cheers, Stef -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.openehr.org/mailman/private/openehr-technical_lists.openehr.org/attachments/20080118/e571e0f4/attachment.html>
