I like your reply. I am willing to commit to putting energy behind merging
al standards groups, probably under ISO.
W. Ed Hammond, Ph.D.
Director, Duke Center for Health Informatics
Thomas Beale
<thomas.beale at oce
aninformatics.com To
> openehr-technical at openehr.org
Sent by: cc
openehr-technical
-bounces at chime.uc Subject
l.ac.uk Re: Interoperability with HL7
02/01/2010 12:02
PM
Please respond to
For openEHR
technical
discussions
<openehr-technica
l at chime.ucl.ac.uk
>
regarding any war - me neither ;-) Ed, I hope you see that it is reasonable
to respond in some way to disinformation like 'only use openEHR if you are
trying to talk to openEHR systems' - on an openEHR list! Nearly the only
problem of interest in openEHR is adding semantics to existing
environments. It is obvious by inspection that openEHR would not need to
exist in its current form in order to talk to itself.
There are theoretical difficulties with HL7v3 messaging & RIM, I don't
think there is any way around that, and they do manifest in practical ways;
there are also difficulties with CDA. But above all, I still (really,
honestly, sincerely) want an answer from HL7 to the question:
how can I define a piece of domain content (microbiology result,
Apgar result, ENT exam, etc) once and re-use it in multiple concrete
technologies such as a) XSD, various GUI forms development, various
programming languages, and b) for various different purposes, e.g.
EHR persistence, messages, screen forms, and especially for creating
portable queries from.
As far as I know I can't really. I can make an RMIM, or a CDA template, but
I can't really use these together without treating them like different data
schemas. And I can't directly re-use either for EHR persistence, querying,
reporting or screen display or data capture. I am not saying that openEHR
has got every last detail on this solved, but it does have large chunks
demonstrable, including fully generated message schemas, programming
objects, querying and reporting. The formal infrastructure is proving to be
very solid and extensible - and yet it retains simple features like only
one XSD for all openEHR data (well it is literally a collection of 6 or 8
component XSDs but you know what I mean). Within the openEHR framework we
can generate the equivalent of any HL7 message or CDA - via a tool chain
using archetypes, templates and terminology. And we can query the date with
archetype-based queries.
On the other hand, HL7 has a big community, much better marketing, and
probably a better handle on use cases. To me the question about joining
forces (which is what we in health informatics owe the world at large, I
think) is how it can be done: it must have technical things like:
a solid, open formal platform framework
a clear, useful reference model
a single source domain modelling approach
a solid querying methodology
an integrated set of service definitions
a clean way of integrating with any terminology
It must also have the qualities of a community:
a recognised meeting place and culture
agile but defensible governance
buy-in from industry
an on-the-ground network of affiliates
a wide-ranging handle on the requirements of the domain
I would say openEHR's strengths are in the first list, and HL7's largely in
the second - I am the first to recognise the community-related weaknesses
of openEHR. What the world really wants here is a) ONE technical framework
and b) ONE open community and governance framework. It could be possible,
at the price of some dented egos. History says it will remain a dream. What
would it take to overcome that? (Proper funding might be one answer)
- thomas beale
On 01/02/2010 15:51, William E Hammond wrote:
Not trying to start a war, but I am disappointed at the continued
dialog
that is negative toward HL7. If, in fact, openEHR has solved all of
the
problems of interoperability and is being picked up around the world,
I,
and I think, many of my HL7 colleagues will be delighted. Very few
of the
members of HL7 make money from HL7, so I think our motivations are
driven
by our companies and the market place. Solving the problems of
interoperability will certainly open the door for many more important
accomplishments. I hope archetypes are engaged by the clinical
community
and help us make a key step forward. However, there are still
hurdles to
be overcome before we have systems working together. Let's join
forcesa
and publicize successes in a demonstratable way. Whether HL7 or
openEHR, I
think one's success is the others success.
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