There is an English version of the comparison. I am sure Bernd would be
happy to share. I think the article has some excellent thoughts and is not
biased toward any one approach. I don't agree with everything, but I found
the article useful.
Ed Hammond
Thomas Beale
<thomas.beale at oce
aninformatics.com To
> For openEHR technical discussions
Sent by: <openehr-technical at openehr.org>
openehr-technical cc
-bounces at openehr.
org Subject
Re: {Disarmed} Comparison of EHR
models
01/19/2008 03:23
PM
Please respond to
For openEHR
technical
discussions
<openehr-technica
l at openehr.org>
I have not managed to obtain a copy of the article in question so am going
on your summary here and a few other emails I received. Main points:
There are two main aspects to building systems: the semantic and the
engineering.
The semantic aspect is that which enables us to build the first copy
of a system that functions as we want. This contains nearly all the
hard intellectual design thinking, ontological aspects and
domain-related elements.? Higher levels of the semantic dimension
include business processes.
The engineering aspect is about how to turn a single prototype system
into a production quality system and deploy it hundreds or thousands
of times. Most of Bernd's work is in this area - the service
architecture, security, scalability and so on.
Architectural approaches which only focus on one or other of these aspects
won't produce a widely usable outcome. openEHR has mostly, historically,
focussed on the bottom level semantics, and is now focussing on the
upper-level semantic aspects and the engineering aspects (mainly service
models). See this page for a brief explanation:
http://www.openehr.org/201-OE.html
I am not sure why Bernd is saying anything about Gehr - the last time we
touched it was at least 5 years ago, and the architectures and
understanding we have of solutions for the domain are so radically improved
as to make any analysis of Gehr a waste of time. The most useful document
for Bernd to read would be the openEHR Architecture Overview - see
http://www.openehr.org/releases/1.0.1
/html/architecture/overview/Output/overviewTOC.html (PDF ->
http://www.openehr.org/releases/1.0.1/architecture/overview.pdf)
- thomas beale
Stef Verlinden wrote:
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 (MailScanner has
detected a possible fraud attempt from "http:www.gehr.org" claiming
to be 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
_______________________________________________
openEHR-technical mailing list
openEHR-technical at openehr.org
http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-technical
--
please change your address book entry for me to
Thomas.Beale at OceanInformatics.com
Thomas Beale
Chief Technology Officer Ocean Informatics
Chair Architectural Review Board, openEHR Foundation
Honorary Research Fellow, University College London
_______________________________________________
openEHR-technical mailing list
openEHR-technical at openehr.org
http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-technical
