On 10/02/2010 12:00, Andrew McIntyre wrote: > > I think a DCM format should exclude the administrative attributes, > such as Author and Observation Time
Andrew, I could agree in principle, but how could Observation time be an 'adiministrative' attribute? > and leave those to the Information > model. Drawing that line is potentially tricky, but needs to be done > in order to allow each Information model to do it the way it wants to. > Things like order numbers and links to orders should also stay out of > the DCM model. > > In the end we want the pure clinical hierarchical structure that does > not conflict with the information model and ideally does not conflict > with the Terminology Model. > is DCM now trying to be totally model-agnostic? > The line between the DCM and terminology is also hard to draw as it > varies depending on the ability of the terminology. eg SNOMED-CT is > quite rich wrt its models and ICD-X is quite poor. well... sometimes. Have a look here for SNomed's context model - it is in poor shape... http://www.openehr.org/wiki/display/term/Information+Model+-+Terminology+Equivalence > A DCM optimised for > SNOMED-CT will be inadequate if the only coding system is ICD-10. I > guess including SNOMED-CT context structures with the option to use > them for ICD-10 and move them to the terminology for SNOMED-CT is one > possibility? 2 similar DCMs (?archetypes) with stated terminology > affinity would be another. > many countries are using things like ICD9 or 10, ICPC+, vocabularies for nursing, procedures, devices, prostheses and drugs. Snomed actually doesn't figure that highly in the list of currently used terminologies - i.e. actually in production. Re-imbursement-related terminologies and vocabularies are far more important right now. So optimising DCM (whatever DCM now is) for Snomed would be quite wrong-headed, unless DCM is also destined for 'in 5y+' time. > I appreciate this is an openEHR list, and maybe this discussion should > be transferred to a DCM list, but I don't think there are enough > resources to model every clinical concept in every information model > and there is enormous value in a neutral DCM format. The archetype > concept is a good way to achieve this, but perhaps a generic "DCM only" > Reference Model that does not try and be a EHR model would help? > > I am still interested to see what the concrete objections to the openEHR reference model classes as the basis forDCM archetypes are. - thomas beale * * -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.openehr.org/mailman/private/openehr-technical_lists.openehr.org/attachments/20100210/09bc7984/attachment.html>
