Thomas / Ed and all I have been lurking on this thread - and am not sure that it is really constructive to contribute, but I will try.
Changing the world in this space is difficult - indeed any wide-scale change to complex systems is hard to achieve, especially if you have a very clear view as to what the "right" future state is. Sharing and manipulating healthcare information happens in many evolving ways in different places and contexts - there is not going to be a single well engineered framework for this, any more than there is a single language uniformly engineered and tested for written and oral communication. As for written communication there will be some widely supported "lingua franca" for some purposes. What makes a good spoken language is use and usefulness, not necessarily tight semantics or clean grammar. What makes good HIT data exchange languages and syntaxes is something that we are all learning about - as we are about the best economic and social way to develop, test, improve and promote the use of such languages. I have always been somewhat surprised by the degree of similarity between openEHR and HL7v3, with their reference models, datatypes, and constrained, reusable models. Also with the fact that some people who try implementing them find them complex and brittle, and others find them useful. Also the fact that they seem to some to be controlled by a small cohort who do not seem to listen. I know that there is work going on on both organisations to understand and address these perceptions. My personal focus in HL7 for the last four years has been on improving the visibility of the work being done and the processes being followed, to make it easier to engage in a cost effective way, and to reduce duplication of effort. There is much more to be done in that regard, but I was still approached at the last HL7 WGM by a number of new and old attendees to be told that it was a remarkably good place to get work done. I know that this is a matter of perspective, and that there are folk who have found it frustrating and unproductive. I am sure that the HL7 TSC will continue to work on improving that. I personally find HL7 a pragmatic place where skilled engineers and subject matter experts address the problems that they care about and develop the specifications that they need and I see similar behaviours on this openEHR list. As for changing the world to make sharing healthcare information more effective, getting a good specification is important, but there are other factors. The supply chains and sets of collaborations that gets the right information to the patient and carer/clinician at the right time for effective management of health are very rich and varied - those of us that do think there is a valuable place for international consensus standards need to continue to work on identifying, measuring, improving and promoting that value. I am sure that the openEHR community will continue to do the same with the value of their work.. I look forwards to continuing to learn from both traditions as well as others, and do have a great deal of respect for the energy and insight that exists in the openEHR community, and am hopeful that constructive collaborations and cross-fertilisations will continue all the best Charlie On 25 November 2010 16:59, Thomas Beale <thomas.beale at oceaninformatics.com>wrote: > > I have not seen much evidence of widespread uptake of HL7v3, indeed Stan > and others have said in various places that it has been significantly lower > than expected. CDA is the one thing that is getting use. The few large > implementations have spent a MOUNTAIN of money to do what they did, and I > know for a fact that the outcomes are not seen as good value. > > See here for what appears to be a reasonable outline of the status quo - > http://www.hl7standards.com/blog/2007/10/10/preparing-for-hl7-v3/ > > I don't believe changing the RIM, 21090 and other models (apart from CDA) > would have that much negative impact on the industry as a whole, but if the > changes were radical enough, they could help a lot. > > I currently don't have time to submit endless feedback to HL7 processes, > especially when I know they will not be listened to. I can't imagine that > HL7 is going fix its basic modelling methodology, which is what it needs to > do. I have actually provided very detailed critiques in the past, and > nothing has happened (other than blocking). Today I just have to be > concerned with things that are going to be economically implementable by > normal programmers, correct and safe. I realise that openEHR still has to > solve some things to make that true (mainly to do with better and more > openly available Operational Template downstream generators), but at least > we don't (for the most part) have models that just cannot achieve > interoperability. In openEHR, every single installation of any major version > of openEHR, anywhere in the world, is 100% safe for data creation, > readability, and interoperability. It is the same schema forever, for all > clinical and demographic data, within any given major release. > > I believe that the openEHR methodology provides a pretty good framework for > a) safe data, b) interoperable data, c) data reuse, d) implementable > software, and e) being domain driven (via archetypes). I just can't use any > HL7 models to do anything useful in the EHR space. > > - thomas > > p.s. if v3 was so good and easy, I am pretty sure Stan would have > introduced it at IHC. > > > > On 25/11/2010 17:31, William E Hammond wrote: > > HL7 is following basic modeling procedures in the minds of a lot of people. > HL7 and CDISC, for example, have worked together to produce BRIDG. A large > number of international technologists have and are contributing to HL7. I > agree that RIM has problems. RIM evolved early on from data models. > Decisions were made by a number of people who at that time believed that > was the approach. Stan Huff is leading a TF to look at some of these > issues (Graham is part of that TF). WHat changes will be made? I don't > know. The problem is further complicated in that the current model has > been used in a lot of applications. Thise applications work, even though > many of us believe there is a better way. Those changes have to be made > against an implemented set. I do urge you to submit your criticisms to the > HL7 Technical Steering Committee and to John Quinn, the HL7 CTO. Or to > Stan HUff. > > * > * > > _______________________________________________ > openEHR-technical mailing list > openEHR-technical at openehr.org > http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-technical > > -- Charlie McCay, charlie at RamseySystems.co.uk Ramsey Systems Ltd, 23D Dogpole, Shrewsbury, Shropshire SY1 1ES tel +44 1743 232278 / +44 7808 570172 skype: charliemccay linkedin:charliemccay -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.openehr.org/mailman/private/openehr-technical_lists.openehr.org/attachments/20101126/c151bd31/attachment.html>
