Regarding Cluster, there is a code to tell if a cluster is a table or a list, so the computer always knows which one was chosen
2010/11/9 Hugh Leslie <hugh.leslie at oceaninformatics.com>: > Hi Andrew > > I'm happy to continue to have this discussion with you.? I still am not sure > whether your objection to openEHR is about the fact that the foundation is > not an SDO, or that you think that there is some semantic model in there > that you don't like.? If openEHR were part of an SDO would it make your > objections go away? > > As we have discussed before, the changes to openEHR from when it was pretty > congruent with the current 13606 standard have not been about adding in > someone's personal idea of how a health record should be modeled, but about > making it as easy as possible to have one way of modeling things that we > shouldn't have to think about. > > A simple example that I have raised with you before - in openEHR there are > defined ways of representing things like lists, tables and trees.? In 13606, > there is only the cluster ie a tree structure.? While this is simple, it > means that if I want to represent a table in a 13606 archetype, I need to > make a decision about whether it is represented as a ROW, COLUMN cluster or > a COLUMN, ROW cluster and every archetype may have a different decision > made.? How does a computer know which way the decision was made?? Yes, I > know that last time I suggested this, you said well it could be just written > down somewhere but obviously that might mean that most of the time it will > be one way and then some of the time it will be another way and is probably > worse!? I can't really believe that you think documenting this is better for > computability than making it explicit. > > This same approach extends to the entry types that you don't like.? The only > reason these are there are because of explicit, researched reasons to make > it easy to develop computable expressions.? Tom has given the examples of > the observation class allowing you to easily? represent data values and > patient state within a time series like apgar or 24 hour blood pressure or > postural drop which is also a blood pressure series.? Indeed, using a > generic entry model it is possible to define a model to represent these, > however the issue is that there are thousands of ways of representing the > same thing.? The openEHR reference model makes the way of representing these > things EXPLICIT so that modelers don't have to keep reinventing things over > and over and so that computers can rely on data being represented in the > same way. > > There is nothing in the openEHR reference model that is there to represent > some kind of Health semantic model.? In fact the model is incredibly generic > and is being used exactly as it is in other domains like finance.? The > difference between CEN 13606 and openEHR is not some 'openEHR game', its a > pragmatic, engineered attempt to make clinical data more computable. > > And no one is trying to make everyone accept openEHR as the only standard in > town...? we think its good and it works in real world situations and we are > happy to defend its value.? :) > > regards Hugh > > > > > On 8/11/2010 10:05 PM, Andrew McIntyre wrote: > > Hello Hugh, > > As someone who believes in a level playing field I think an international > standard, even if a little flawed is better than waiting forever for > perfection which will never come. I would extend this ISO 13606-2 to enable > sharable archetypes as well. > > At least then we have a situation where everyone has a common point of > reference. I guess everyone is also a little unhappy, but that is better > than the current situation. I think the standards are virtual in any system, > with adapters to the actual implementations, and to expect anything else is > dreaming of a mono culture, usually your own variety of mono culture of > course. > > There are great ideas to be reused from all players, but to expect the world > to accept openEHR as the only standard is unreasonable. We have actually > done a lot of work to enable the use of archetypes in HL7 V2, not because we > thing V2 is the best and most efficient mechanism, but because its a > standard and it has widespread usage and we gain a backward compatible > encoding, which means we can actually use it. (And the data model is > actually transformable into another encoding if desired) > > Similarly we adapt HL7V2 data for use in the Virtual Medical Record (VMR) > and use ISO data types there, not because they are a seamless match for > HL7V2, but because the ISO data types are a standard and we would otherwise > have to ballot a whole new standard. Its planned to constrain out many, or > most of the esoteric base class methods in the ISO data types for the VMR, > but they are still a compliant subset. > > If the openEHR CKM produced ISO archetypes then it would be a lot more > acceptable to many people, as it is standards based. Currently you have to > buy into the whole game of openEHR, which is I think a problem for many. Its > not a criticism of openEHR, but a desire for a neutral agnostic model. You > may defend the Evaluation class to the hilt, but there is no reason that > every other model has to and this is the problem. We need to accept some > level of imperfect abstraction to enable inter-operability, where everyone > has to provide glue to make it concrete. Its then less than optimal for > everyone, which is I guess what "compromise" and "consensus" is all about. I > still think it provides several orders of magnitude of functionality, over > the current reality. Otherwise we are doomed to the "My Model is better than > yours" war until the last man is standing. > > I also lament the lack of real technical input into the standards, but > that's the reality, I am sure in retrospect many "standards" eg http, smtp, > html could have been designed much better, but inter-operability and > pragmatism has trumped perfection and we all live with an imperfect world. > That's why I think we should give the ISO Data types a go. > > Andrew McIntyre > Medical-Objects > > Monday, November 8, 2010, 10:59:45 AM, you wrote: > > ________________________________________________ > > Dr Hugh Leslie MBBS, Dip. Obs. RACOG, FRACGP, FACHI > Clinical Director > Ocean Informatics Pty Ltd > M: +61 404 033 767???E: hugh.leslie at oceaninformatics.com ?W: > www.oceaninformatics.com > _______________________________________________ > openEHR-technical mailing list > openEHR-technical at openehr.org > http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-technical > >
