Hi Thomas,

> no reference model = no computability, including queryability. To 
> overcome that, if you use PDFs, plain text etc, you need structured 
> meta-data. As soon as you need that (e.g. like IHE) you need a model of 
> it. As soon as it tries to be more sophisticated, the model becomes more 
> complex. If we want queryable, computable data (e.g. for decision 
> support, research), you have to have models. Otherwise the software 
> doesn't know what the data mean.

If I understand you right, you argue that a reference model is required if 
SEMANTIC interoperability (you refer to software that must know what the data 
mean) has to be achieved. I would fully agree here.

What makes me wonder about the statement in ISO 20514 is that they consider an 
EHR reference model as required for FUNCTIONAL interoperability 
=> "In order to achieve semantic interoperability of EHR information, there are 
four prerequisites, with the first two of these also being required for 
functional interoperability: 
a) a standardised EHR reference model, i.e. the EHR information architecture, 
between the sender (or sharer) and receiver of the information,
b) ..."

They further define functional interoperability in ISO 20514 as "the ability of 
two or more systems to exchange information (so that it is human readable by 
the receiver)".
I would think that human readability and thus functional interoperability can 
also be achieved without a standardised EHR reference model.

Cheers, Georg
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