There are many things that can be improved in openEHR, no doubt about
it. Some comments. First of all, HL7 charges membership fees, meeting
attendance fees and purchase fees for the standards; a small company can
easily spend $10,000 - $20,000 per annum just on the cash outlay. Larger
companies routinely spend $100k per annum when you take into account
meeting attendance expenses and opportunity costs. These fees, plus
donations by some large companies, fund HL7 marketing efforts. Such an
operation does not come for free.
If we are to have regional communities, an affiliate model of some kind
makes sense. However there is no getting away from some prerequisites:
* someone has to pay for the human resource at both local and
central levels; 100% volunteer work is just too unreliable
* there has to be a way to get all the affiliates established in the
first place, which really means creating an association in each
country that subscribes to the same common cause - i.e. getting a
lot of countries to agree on a common thing. History tells us this
is VERY HARD.
* the 'common cause' almost certainly has to have some official
standards status, or regional affiliates might get lots of
interested individuals, but will fail to get MoH/DoH involvement,
and hence fail to influence national programmes, and and probably
also vendors
In sum: the organisation needs a distributed organisational governance
structure, and it needs sufficient legitimacy for funding to be provided.
Now, the world currently already includes ISO, CEN, HL7, IHE, IHTSDO,
OMG, and dozens of other standards bodies, which have a) some governance
structure and b) sufficient perceived legitimacy to get some funding.
However, there is great fatigue on the user side: most of these
organisations compete, don't cooperate properly, don't formally or
empirically validate their deliverables, and are not strongly driven by
their main stakeholders. For this reason, openEHR has stayed away from
creating yet another organisation, overlaid on this crowded scene.
In e-health, the exception to the above is IHTSDO, a relative newcomer
to the scene, and while not perfect, it is significantly better in all
of these areas. It has:
* a pretty good governance model, including an explicit member
country and affiliate model
* direct board membership by key stakeholders of its deliverable,
i.e. national e-health programmes
* formally defined and relatively well managed specification,
software, and terminology deliverables (none of which are anything
like perfect today, but the point is that a reasonable process is
in place)
For this reason, the openEHR Foundation and IHTSDO have been in talks to
determine what kind of cooperation could occur in the future, which
would a) allow openEHR to work within or alongside the IHTSDO global
organisational structure and b) enable IHTSDO to take better advantage
of the openEHR knowledge engineering technology, in particular
terminology integration.
These discussions have not yet completed, but some kind of announcement
could be expected in the near future. If some better organisational and
funding structure can be created, aligned with an accepted standards
body, then I think the whole thing will accelerate very fast.
- thomas beale
On 02/11/2010 16:29, pablo pazos wrote:
> Hi Seref and Shinji,
>
> I share your opinions. Once in a while, we need discussions like this,
> since we have to lead ourselves somewhere and combine efforts if we
> want to support the difussion and adopton of the standard.
>
> The domain is complex, the problem is complex, the solution must be
> complex, but if we add the complexity of the standard to the
> complexity of understanding another language (the specs are english
> only), we have a serious problems for a worldwide adoption. I share
> Shinji's vision, we must support and encourage regional OpenEHR
> communities, specs translation, and "open source multilingual
> up-to-date tools" (most tools available are: or not multiligual or the
> translations are horrible, or not open source, or not updated recently).
>
> I think regional communities can create courses, resources, materials,
> etc... and share them with other communities, throught OpenEHR
> foundation. Guidelines to do this must be set from the OpenEHR
> Foundation Boards (I think they are there to lead the community, to
> encourage the spread and adoption of the standard, I can't remember
> the last time I saw an email of the OpenEHR Boards in the mailling
> lists). Within those guidelines, we can be coordinated, and maybe set
> year-based goals. And once a year or two we can make some event to
> share our experiences and progress from our local communities (can be
> local or regional events, since for most of ours it's hard to travel
> so far).
>
> These ideas are not new, just look at the HL7 coutry based structure.
>
>
> I know this words may sound hard to someone, I just want to support
> the success of the standard, but I think if we keep doing things the
> same way, we'll end with a high quality standard with no one to
> implement it.
> *
> *
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