I agree with Alan. In OpenEHR-Gen, we have modeled almost all the classes 
between Folder and Datatypes (Folder, Composition, Section, Entry, Item, 
DvText, etc) and represented all those concepts in our DB schema. Here you can 
find our data model: 
http://code.google.com/p/open-ehr-gen-framework/downloads/detail?name=model.png

I think my friend Alan refer to our implementation of the OpenEHR-Gen 
Framework, that automaticaly generates the DB Schema from the Reference Model 
classes we programed in Grails Framework (http://www.grails.org/). Grails have 
a great ORM tool (Object-Relational Mapping, this is diferent to the ORM 
mentioned by Alan).
Through this experience, we have seen that this complex structured model have 
some shortcomings on performance, but it do not take hours or minutes to 
complete tasks like data binding and saving or data querying, and this can be 
boosted by good servers, fast disks and a good DBMS.

What we are doing now is redesigning the data model, dividing the classes in 
two groups, one groups just for structure classes, and the second group for 
content classes. The first group have the classes that are part of the 
structure but don't have clinical content, like Section or Cluster. The second 
group have the clinical/demographic content like Element or Composition. Then 
can infer the "structure classes" from an archetype, we may not include them 
into the persistent model, so we'll model only the content classes, and add 
some metainfo to help reconstruct the complete RM structure as if it has been 
persisted on the database.

So, in the persistent layer we'll have: archetypes, a reduced persistent RM, 
and metadata.

This will be the next step in our open source project.

Hope that helps.

-- 
Kind regards,
Ing. Pablo Pazos Guti?rrez
LinkedIn: http://uy.linkedin.com/in/pablopazosgutierrez
Blog: http://informatica-medica.blogspot.com/
Twitter: http://twitter.com/ppazos



From: alandma...@gmail.com
To: openehr-technical at openehr.org
Subject: RE: Dual Model EHR implementation
Date: Fri, 3 Jun 2011 11:24:04 -0300



Hi all.  IMHO the best approach (or at least what I have done and feel is 
reasonable) is to take only some of the classes in the reference model and 
represent them in the database. I have seen some implementations which adopt an 
automatic code generation approach, direct from the reference model. But that 
builds certain structures into the database which are unnecessary and/or may 
hinder performance. When analyzing the openEHR it seems to me it was not 
conceived with its database implementation in mind (which is an absolutely 
reasonable approach). The way information is persisted, I guess, is left to 
implementators and I believe that is probably Alberto?s issue.  To solve the 
multiple database problem, the structure openEHR database structure could be 
designed using ORM tools such as that in http://www.ormfoundation.org (again, 
that is what I have used). I agree that archetypes should pose no performance 
problem at the database level if care is exercised no to try to represent them 
in the database. In the final analysis, it seems to me that that is what 
openEHR is all about: separating (represented, archetyped) knowledge from the 
(storage) structure  From: openehr-technical-bounces at openehr.org 
[mailto:openehr-technical-bounces at openehr.org] On Behalf Of Alberto Moreno 
Conde
Sent: Friday, June 03, 2011 9:28 AM
To: For openEHR technical discussions
Subject: Dual Model EHR implementation Dear all,

Within the Virgen del Rocio University Hospital we are analysing how to 
implement a EHR based on Dual Model Approach.  When we analysed direct 
implementation a database based on of either OpenEHR Reference Model  or ISO 
13606, we have detected that it could have slow performance . Given that we are 
concerned about this problem, we would like to know possible strategies have 
been identified by implementers in order to fasten the performance of storage 
and query.

Also the granularity level is one open issue that impacts on the performance, I 
would like to know if the level of granularity of the archetypes contained 
within the OpenEHR CKM is able to satisfy the requirements of  an EHR with more 
than 1 million records.

Kind Regards 

AlbertoAlberto Moreno CondeGIT-Grupo de Innovaci?n Tecnol?gica
Hospital Universitario Virgen del Roc?o
Edif. Centro de Documentaci?n Cl?nica Avanzada
Av. Manuel Siurot, s/n.
C.P.: 41013    SEVILLA
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