Hi Tim, Thanks for your posts and never-ending enthusiasm. I have responded inline re your comments on archetype collaboration wrt CKM.
Regards Heather Tim Cook wrote: > Hi All, > > [This posting is related to Tony Shannon's great email regarding the > future of openEHR in 2009. I think some of it relates to the technical > list members as well so I have CC'd them.] > > Not wanting to hi-jack Tony's thread I started this one where I hope I > have a few positive and possibly helpful suggestions. Some of them may > need funding to help protect some people's time and others are virtually > cost free. > > I do have one negative comment and I'll get that out of the way first. > As I have indicated, I believe that I will have more success working on > some of the fringe areas of healthcare with openEHR. Therefore I tend > to talk to providers that are not in the main; primary care/family > medicine/general practice areas. I have been told by more than one of > these folks that they didn't feel very welcome to participate on this > (Clinical) list on issues that concerned their areas. Whether it was > lack of feedback on questions or actual comments about currently > focusing on archetypes for more general medicine. A bit more > consciousness about welcoming new people might be in order. :-) > > Now for a few positive suggestions for the group and for individuals. > Some of you may already be doing some of these things but in my > experience in building open source teams they have helped me. > > 1. There are more than 450 members registered on this (Clinical) list. > With a few more than that on the technical list. Many are duplicates > (like myself). I would guess that at least 75% of the Clinical list > members have downloaded and tinkered with one of the archetype editors. > Probably created a few and then said; Now what? > This is absolutely a major issue - and one of the key motivators for CKM. For those not up to speed on the acronyms - Clinical Knowledge Manager - found at www.openehr.org/knowledge. Further description can be found at http://www.openehr.org/wiki/display/healthmod/Clinical+Knowledge+Manager In the first instance this is an archetype repository - with a significant number of 'reasonably sound' archetypes uploaded in draft status. (Reasonably sound as we know that people are starting to use these archetypes in their draft form, pre-publication). The scope of CKM will expand further to embrace other knowledge artefacts. The CKM development to date has focused on 3 main functions: * asset management so that we know exactly what archetype is what, and can track all changes - revisions and versioning etc. * supporting the archetype publication lifecycle. It is true that we have just one archetype that has gone through the formal team/peer review process to be formally published (a temperature observation) and there are 4 well into the review process and another about to kick off. Publication occurs at the completion of content agreement. Archetype publication hasn't ended up being as rapid a process as I would have liked - there have been issues with limited numbers of reviewers, software refinement, etc. We have made significant process in refining and streamlining the usability and team review collaboration and we have had a group of about 35 clinicians from around the world participating actively to date. We actually can't review much faster or I fear that we will 'wear out the goodwill' of those currently involved - so while still in this beta phase, recruitment has largely been word of mouth, and now a few more are engaging through these lists this dynamic is likely to change. * Next steps (in various stages of development) include: * Review for archetype translations * Review for terminology binding * CKM instances in other languages. * Creation of a template library * Creation of a terminology subset library * Creation of an archetype 'nursery' or 'sandpit' - a collaborative space in which interested clinicians/modellers can connect with each other, share ideas and resources, and develop archetypes up to the point where they can be transferred as drafts to CKM itself. > No software to use them on (hopefully OSHIP will soon help with that) no > place for peer review and feedback. I suggest a section on the SVN > server labeled 'community' with the correct folder structure underneath > like the other areas. A group of the experts should receive an email > each time a commit is made to this section. One of the experts then > provides some kind of feed back on that commit. Maybe some of them are > good enough to be moved into the CKM for consideration? Maybe the > experts can provide enough feedback that these early community > committers get better. Totally agree that this functionality and space is required. This is the purpose of the planned 'sandpit' within CKM - catering for everything from the registering the archetype concept, documentation and references, connecting interested clinicians through to supporting the building of the first drafts. Early days of this development, but clearly needed - and supporting contributions of clinicians with all levels of technical skills. This cannot be a 'technical' space or significant numbers of clinicians will not be able to cross this barrier and engage. > It is clearly true that Sam, Heather, the NHS > group and a handful of others cannot possibly build all the archetypes > needed. Absolutely - all volunteers gratefully accepted. It has been interesting to see clinicians I know who have absolutely minimal computer skills, and absolutely no theoretical knowledge of archetypes, engage in the clinical review process within CKM. As practicing clinicians they have been able to make significant contributions to the clinical correctness of the archetypes - clinical concepts, data elements, definitions, max and min constraints etc - very exciting. And as their understanding grows, they will be able to contribute more to the design of the archetypes. CKM as a tool will enable us to take the models to the clinicians in order to get them clinically correct - make the clinical content approachable and understandable by non-technical domain experts, and provide the means to give feedback; then engage informaticians, terminologists and engineers to make sure that we have the technical and terminology aspects correct as well. But the traditional method of making the clinicians become technically competent in order to contribute at all has to change. > Sure, you'll get a lot of junk archetypes to sort through in > the beginning. You'll also need to spend more time in education but > there are a lot of resources on the website and wiki that you can point > to. But people like to participate in something meaningful. If they > enjoy it, they'll tell a friend. It shouldn't be too difficult to setup > a web page to show people when to get an SVN client along with a name > and email registration space where they can be sent a SVN password > automatically. Open this are up to the world. Absolutely. //Tim O'Reilly said in 2006, "/Web 2.0 is the business revolution in the computer industry caused by the move to the internet as platform, and an attempt to understand the rules for success on that new platform. Chief among those rules is this: Build applications that harness network effects to get better the more people use them. (This is what I've elsewhere called "harnessing collective intelligence.") /I'd like to see CKM get better as more people get involved and contribute. Harnessing collective intelligence - that is exactly what we need to do. Facebook for clinical modelling - now there's a thought! / / // > If it gets completely > out of control then change the rules or shut it down. Right now there > is no way to encourage "the crowd" to participate and share their > wisdom. > > 2. When you go to meetings and conferences. Do not hang out with > openEHR people. Meet new professionals and have a 15-30 sec comment > about how we are turning over the data design of healthcare applications > to the healthcare providers. Give them the URLs to get an editor and to > the community SVN website along with the mailing list info. Do not try > to explain openEHR or even archetypes to them at that point. Even if > they ask; give them a little more info and encourage them to join the > community. Leave them wanting to learn more. > > 3. Post comments on blog articles and healthcare related sites/online > magazines. Try one of these: http://www.hitsphere.com/ > > 4. Prepare a guest blog entry. In fact two of those on the above site > have asked me and are waiting for me to prepare guest postings on > openEHR for their sites. Most of these guys WELCOME contributed content > that is of interest to their readers. > > 5. When you see stuff that is blatantly bull$$%$%^ on blogs and online > magazines, do not hesitate to say so. If you really believe in what you > are saying and doing then let people know. Certainly people like David > Kibbe have no problem with saying that CCR is the greatest thing to > happen to healthcare while at the same time thinking that openEHR is an > open source EMR project. Don't be afraid to put your ideas and > convictions out there. It usually only takes a few minutes. If we > spend all of our time discussing openEHR related matters on these lists > then we are only "preaching to the choir" and not recruiting new people > with new ideas. > > > Well, that's my top five. I hope they help promote and expand the > community. > > Cheers, > Tim > > > > ------------------------------------------------------------------------ > > ------------------------------------------------------------------------ > > _______________________________________________ > openEHR-clinical mailing list > openEHR-clinical at openehr.org > http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-clinical -- *Dr Heather Leslie* MBBS FRACGP FACHI Director of Clinical Modelling *Ocean Informatics <http://www.oceaninformatics.com/>* Phone (Aust) +61 (0)418 966 670 Phone (UK) +44 (0)77 2206 4546 Skype - heatherleslie
