On 06/11/2010 15:29, David wrote:
> Thomas,
>
> I've been retired for some time now but have kept a quiet watch over
> things that have been happening in the world of heath data
> standardisation. I stay quiet because I do not wish to intrude into
> arguments that people in the real world are having.
>
> However, Thomas, I think that what these "Guidelines" from NCI CBIIT
> suggest is exactly what most IT people working on large health IT
> projects (or any type of IT project for that matter) think - ITS
> EASIER AND CHEAPER TO DO IT OUR WAY (rather than trying to use
> standards) IN ORDER TO GET OUR INTERNAL SYSTEMS UP AND RUNNING. This
> is a narrow and somewhat selfish approach (some would say justifiable
> in $ terms) but it achieves internal agendas. I have had some
> experience with this sort of thinking having worked for the Australian
> Institute of Health and Welfare and its providers.
>
> I think that these "Guidelines" include any untested standard which,
> unfortunately, includes openEHR. It's called throwing the baby out
> with the bath water.
I agree: the same response might be possible with another standard. My
question is about the complexity level of the standard in question. In
other words, is it possible to imagine that the NCI's response to a
different kind of data types standard might have been something like:
* the standard appears to be concise and lightweight
* it will work well with a) other standards that we use b) our
existing modelling frameworks
* it will cost something to implement but not too much
* our ability to verify the standard from available implementations
makes it low-risk
* our ability to re-use available open source implementation in
various languages makes it easy to guarantee its being deployed
uniformly across the enterprise
* it may in fact save us work in the long run, by providing an
internal standard toward which to migrate data types that we
already use.
If it is not impossible to imagine the above response, then we have to
ask: why are the SDOs not instead making concise, lightweight, validated
and implemented standards?
>
> If the NCI CBIIT go for an "orthodox" solution rather than a
> "standards" oriented solution, then you are still no closer to
> implementing yours or anyone else's standards! And what are the
> chances that, even if they went with a "standards" approach, they
> would choose to go with any "standard" that is somewhat untested in
> such a large system?
exactly my point ;-)
>
> From what I've seen, it seems to me that openEHR would work well on
> most levels of health requirements, however, if at least one of the
> big guys (IT, government, health orgs etc) doesn't get behind it
> because of their vested interests or inertia, you are going to be
> pushing it up hill. I think that a relationship with IHTSDO could be
> an important one as long as you don't get subsumed into their agenda
> rather than pursuing your own.
well, let's say, a significantly augmented agenda needs to be considered...
- thomas *
*
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