Hi Grahame, > well, not so fast. If you are exchanging pdf documents, you need some > rules > about how they are exchanged, and when, and then what happens as a > consequence. > These can be rather informal, but nevertheless, they must exist. And once > they > do, aren't you on the way to have an EHR reference model?
You are right, there must be some kind of rules when PDFs are exchanged to ensure that they are human readable and can be trusted by the receiver (I also absolutely agree with Stef here), so for example the natural language used must be agreed in advance and the meaning of uncommon medical notions should also be agreed (although this point probably already goes in the direction of semantic interoperability). Anyway, with the notion "standardized EHR reference model" as used within ISO 20514, I rather associate in my head a model such as the openEHR reference model or EN/ISO 13606-1. Strangely the term "standardized EHR reference model" is not itself defined within ISO 20514, but there is a reference to the notion "EHR architecture", which is defined in 20514 as "the generic structural components from which all EHRs are built, defined in terms of an information model". So, it probably depends on how one interprets the notion "standardized EHR reference model" => if it is interpreted as "some kind of - maybe also informal - rules between sender and receiver" than I think it is required for functional interoperability. If it is interpreted as a model such as the openEHR reference model or EN/ISO 13606-1, then I would say it supports a "higher level of functional interoperability" but is not actually required for achieving basic functional interop. > Then there's the question of interoperability. Generally what you describe > is *integration* not interoperability. Picking these two apart is a fun > game, > but generally inteoperability is more about plug-n-play where as > integration > is about two systems made to work together. As you move your example from > two > to many systems, you'll be increasingly moving towards a standardised EHR > reference model. In my question I actually referred to the definition of "functional interoperability" as is given in ISO 20514. Cheers, Georg
