Since I have argued that HL7 is using recognized modeling proactices -
perhaps that may be the start.  Critical is what are the recognized
modeling practices and recognized by whom.  Why do you think HL7 has not
listened?

W. Ed Hammond, Ph.D.
Director, Duke Center for Health Informatics


                                                                           
             Thomas Beale                                                  
             <thomas.beale at oce                                             
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             11/25/2010 11:13                                              
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Ed,

I am not engaging in HL7-bashing. I am critiquing specific aspects of HL7v3
that don't work well and cause widespread problems. Anyone should
presumably be allowed to do that, otherwise how do we make progress? I
would argue that critiques of this sort do help - we received lots of
objections about openEHR from all kinds of places over the years and it
helps.

The negatives of HL7v3 need to be exposed and explained, because they are
getting in the way of interoperability and progress. HL7v2 is used
extremely widely. HL7v3 is not, and there are reasons for that. I am trying
to explain them, because ISO 21090 suffers from the same problems, and is
about to create the same problems as the RIM: a very complex standard that
is hard to use, has to be 'profiled' for use, and will be profiled in
numerous different ways, largely preventing the interoperability (and in
many cases, even implementability) it should have enabled.

I think this is important. It is not about any perfect standard; any
standard that at least followed basic modelling good practice is worth
contemplating and working together on. But standards that don't follow
basic, accepted modelling principles will just cause problems. There can be
no common pathway when one of the modelling approaches is this subtractive
modelling approach of HL7, it is only possible when all the candidates are
at least doing proper modelling. Then we can talk about which one to agree
on.

My only interests are in doing the engineering we need to do in this
sector. If I sound biased, it is because I do not see HL7 helping, and
worse, it is not listening, not even about basic modelling practices. So
the sector continues to suffer and make limited progress. I wish HL7 would
adopt recognised modelling practices, because then we could make very fast
progress.

- thomas




On 25/11/2010 15:22, William E Hammond wrote:
      I have to admit that I am tired of the HL7 bashing, most specifically
      by
      Thomas.  In my opinion, it serves no purpose.  I would hope Thomas
      would
      spend his energy in a positive direction, not by bashing HL&.
      Further,
      quoting a blog from someone who has problems with HL7 does not make
      his
      case nor help the situation.  Regardless of what Thomas says, HL7 is
      used
      by thousands of people.  About 90% of the hospitals in the US use v2.
      Further, the UK, Canada and Australia use v2.  One reason that v3 is
      not
      adopted  in the US is the success of v2.

      I think archetypes and/or DCM are important.  Rather than working
      toward a
      common pathway to mutually promote both HL& and openEHR, we have
      spent a
      lot of energy of the negatives of HL7.  n
      If I became the one source of standards, I think I could make the
      perfect
      standard.  Of course, no one else would think so.  As openEHR expands
      it
      use, it will get (and has gotten) pusgback from persons who think it
      does
      do what they want it to do.  Then openEHR can say tough luck or they
      can
      change to accommodate.  Now you are in the world of HL7.

      What I have argued for a long time is that we, all of use in the
      standards
      arena, are an invisible minority.  When it is convenient and in the
      best
      interest of governments or large companies, they will make their own
      standards.  I would like to see us follow some of the good advice in
      this
      discussion and move forward - quickly and competently.

      So I'd love to see an e-mail that simply does not serve to bash HL7.
      We
      need to undersatnd the differences and why, but we also need to
      understand
      what we have in common.

      I believe that Graham Grieve is the most organizally unbiased person
      I
      know.  He is biased by what he thinks is correct.  I think he make an
      honest attempt to deal with some of the issues relating to data
      elements
      and reach a compromise between openEHr and HL7 data elements.
      Unfortunately, it seems that even this approach has not led to
      success.

      I have kept the e-mail thread, and would like to make some sense of
      it.
      That trail also is important because it exposes the various
      philosophies
      and differences.  I may ask for permission from the participants of
      the
      discussion to share their comments with a broader audience. The
      purpose of
      the article would be to understand where we are and wht we differ and
      perhaps enable a solution.

      W. Ed Hammond, Ph.D.
      Director, Duke Center for Health Informatics



                   Thomas Beale

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                   11/25/2010 05:07

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      Some of the things I mentioned in the last post on good modelling
      practice, and the problems in HL7 due to not using them are mentioned
      here in by Bill Hogan MD, who is Director of Medical
      Vocabulary/Ontology
      Services, Pittsburgh Medical Centre. See
      
http://hl7-watch.blogspot.com/2010/11/demographics-hl7-vs-reality-part-1.html



      - thomas beale

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--
                                                                         
 (Embedded image moved   Thomas Beale                                    
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 Ocean Informatics                                                       
                         Chair Architectural Review Board, openEHR       
                         Foundation                                      
                         Honorary Research Fellow, University College    
                         London                                          
                         Chartered IT Professional Fellow, BCS, British  
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