Hi Thomas,
I didn't mean that we have to follow the HL7 structure and ways of funding.
They have good and bad things, as you point. One of the good things is that a
set of small regional communities are stronger than a huge central community,
because they have common interests, common language, common culture, etc. For
example I spend more than 15 mins on writing emails to the lists because of the
language, when I spend 3 mins writing to lists in spanish. Reading the english
only specs is another thing that discourages people with no formation in the
language.
But a central community is needed to build guidelines and coordinates the
global view, plans and concrete objectives for OpenEHR as a whole. This is a
work for the boards, but now I can't see any interest from them (of course,
individuals like you are always here, but the boards had no presence here, and
we need leadership and vision).
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.
I don't think that a paid membership to local communities will work, as you
point, is not the best way to build a community, it's just a way to get enought
money to do things. I rather prefer an open model, where people just pay for a
service, like courses. There are two types of communities, discution
communities and action communities. The first are made of people with a common
interest, link "cars" or "travel", you don't have to pay someone for something
they want to talk and discuss. We have to encourage people to have interest in
OpenEHR. The second, are communities of people that have common problems and
try to solve them. We need this type of community to really do things, but we
need to start with a common interest.
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.
Again, I think we can build some money to improve the tools, like making
courses, events (like the IHE Connectathon), selling books, t-shirts, coffe
cups, etc (donations are always welcome). I'm against a paid membership, it
closes a community that claims to be open, this is not a gym :D
Just an idea: I think the Service Model is very green yet, but when it go a
little more mature, we can make automated tests to test the implementations,
and they can have an OpenEHR certificate that the software meets the
specification (a paid certificate).
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.
That will be great, more tooling and terminology integration are two things to
improve in OpenEHR, it's a good oportunity to do so.
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
Kind regards,
Pablo Pazos.
http://informatica-medica.blogspot.com/
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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