Hi Tom, Some agreement seems to appear after all :) Just to cover the points I've picked up: there are different views about what is offered by different realms, and the extend to which integration of these realms is possible. It is great to see these options expressed. In addition to absolutely valuable feedback, I can almost see a common interest to further test the usability of existing research in different realms in a more or less well defined scope. Charlie puts this into context of LRA related work, I have targeting HL7 related tasks (mostly as an academic exercise), and Tom suggests narrowing the scope, which may or may not be realized in the context of my or Charlie's efforts. I have an embarrassingly simple expectation for an outcome of the semantic interoperability work that has taken place so far: I want to be able to use medical data in two different systems in a very basic way, that's all. I'll try to make this happen in the smallest, controllable scope I can get my hands on, but I'd like to thank to all contributors of this thread, for it has given me a nice overview of the state of the art and the craft.
Kind regards Seref On Thu, Apr 23, 2009 at 1:15 PM, Thomas Beale < thomas.beale at oceaninformatics.com> wrote: > b.cohen wrote: > > Two issues are being conflated herre. > 1. Standards > The sole purpose of a standard is to guarantee interoperability but, to > achieve > this, the standard itself must satisfy certain criteria. These criteria are > well illustrated by documents such as the old Whitworth standard for nuts and > bolts. This defines the way in which the dimensions of nuts (diameter, threads > per inch, etc.) and those of bolts must be > specified, this definition being both: > a) formal enough for the manufacturer to be able to prove that his products > satisfy their specifications and > b) necessary and sufficient to guarantee to the purchaser of a nut or bolt > that > it will fit the bolt or nut she already has. > Unfortunately, few, if any, of the 'standards' in Healthcare meet these > criteria. > > > > Agree with the above. However, something funny happens with 'standards' in > the e-health area - people and even governments assume they are a design for > systems (not nessecarily software on a box, but holistic process and > information frameworks), and can be used as the intellectual basis for > building things. This is almost always a mistake, but the problem is > compounded by the fact that some standards seem to be trying to be design > paradigms, and it is not clear whether they are a fully specified design for > a type of system, or a fully specified standard for interoperability between > types of system - often they seem to fail on both counts due to lack of > clarity of purpose. > > 2. Language > ... > since there can be no universal ontology, and the composition of disparate > ontologies is not computationally feasible, only those communities who can > identify with a common ontology can benefit, and as this identification is > always merely temporary, later dissatisfaction with its implications is > inevitable. > I hope this is not seen as too pessimistic. There are effective ways of > dealing > with these problems but only if we learn how to include the subject, and the > subject's models, in our models. The 'objective' forms of analysis that have > been so successful in engineering simply will not suffice. > > > > *I think the above is correct and is a call to a) narrow the scope of any > particular standard to something where agreeing on a common ontology is > feasible and b) actually doing the work to develop the ontology for each > such standard. > > In terms of scope, we need to think of 'EHR' or 'health information > recording' as something like our scope (i.e. not get deluded that our scope > is 'medicine'). Then we (all) need to do a lot more work on the ontology > part. One meagre part is offered in the openEHR Entry model (see our paper > at > http://www.openehr.org/publications/health_ict/MedInfo2007-BealeHeard.pdf), > but there is of course more coverage required (e.g. documenting clinical > events), and improvements to be made to our first effort - or maybe there is > a complete re-formulation waiting around the corner. Some ideas in this area > are posted on the wiki page at > http://www.openehr.org/wiki/display/ontol/Ontologies+Home > > - thomas beale > > * > > _______________________________________________ > openEHR-technical mailing list > openEHR-technical at openehr.org > http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-technical > > -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.openehr.org/mailman/private/openehr-technical_lists.openehr.org/attachments/20090423/59269498/attachment.html>
