I agree with Thomas and Graham that the initial argument really hinges on whether the most minimum communication of an email with attached clinical pdf, by being human interpretible meets the definition of 'functional interoperabilliy.
I would say no, simply because it then makes no distinction between simple communication (which can be extremely helpful) and 'functional interoperability' which I believe carries some notion of computability, helping place the document or information therein, more precisely within the recipient system, but falling short of the precise computability suggested by 'semantic interoperability'. Semantic interoperability is hard to achieve because it requires both technical consensus and human, clinical agreement. I am starting to think that one of the values of archetypes is that they provide a natural levle of granualarity within the record that immediatley supports funtional interoperability, whilst allowing for the organic development of semantic interoperability. As an example, within the NHS, there is a workstream devoted to interoperability between the heath and social care services. Because of the lack of consensus around the data items to be included, it has been decided initially to use a CDA wrapper with some broad 'functional' headings e.g Past Medical History, Mobility Assessment, Continence Assessment. These accord very nicely to probable or actual archetypes which immediately support a level of functional interoperability.The maximal dataset approach allows each archetype to contain mutliple varieties of e.g. mobility assessment and backed by the reference model, enables minimal 'functional' representations of these in non-native systems. Semantic interoperability will only come about when 2 or more agencies agree to share a particular variety of mobility assessment, via further template level constraint, adjusting their internal processes to match but this is a social/organisational commitment, requiring no change in the technical representation on the archetype. Ian Dr Ian McNicoll office / fax +44(0)141 560 4657 mobile +44 (0)775 209 7859 skype ianmcnicoll Consultant - Ocean Informatics ian.mcnicoll at oceaninformatics.com Consultant - IRIS GP Accounts Member of BCS Primary Health Care Specialist Group ? www.phcsg.org 2008/6/25 Thomas Beale <thomas.beale at oceaninformatics.com>: > Georg Duftschmid wrote: > > > 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. > > > well, as Grahame implied in his response, you can get into a long > definitional discussion on such points. For my part, I am interested in what > we want to achieve and what is needed to do it. Some of the key requirements > in my view are: > > computable data > adaptable (future-proof) systems > content defined by domain experts > longitudinally queryable record (requires integrating data from multiple > sources) > > from this point of view, 'functional interoperability' is not much. Not that > it is not useful, but we need to be aiming far higher if we want > personalised (i.e. preventative), more cost-efficient and safer health care. > > - thomas > > > _______________________________________________ > openEHR-technical mailing list > openEHR-technical at openehr.org > http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-technical > >
