According to HL7 RIM there are four core classes Entity, Role, Participation Act
Then one can relate healthcare domain concepts such as visit, admission, patient, health care professional, health care organization, observation, procedure based on these core classes. If there are standard, common, general, archetypes then obviously one can use them in such a way to model clinical process ! I am not sure what is the equivalent of HL7 RIM core classes in openEHR to model clinical process and how one can use archetypes in that respect. Athanassios PS: Athanassios: Why not implementing these standard archetypes with classes-objects at programming level, if we agree the names of the attributes (features) ? Thomas: Because this is exactly what we want to get away from; that is the road to disaster - it is the 1980s approach where everything in the domain becomes a class and/or a relational table. Fortunately there is a better approach that is emerging, whereby these classes/XSDs/etc can be generated from templates, in such a way that the data created can always be converted back to canonical form. Athanassios: I simply cannot imagine how one can escape completely from defining the overall picture at conceptual (programming level), i.e. defining standard, common, general ?archetypes? (core classes depending on the problem to use). I suppose in many cases one would like to build a completely new clinical information systems based on these core classes and I expect highly complex business logic behind that to capture both online and offline, dynamic and static, clinical, administrative processes. So If there is indeed such a different way to view software engineering as you mentioned, I think it will have to become more understandable and common across developer communities including RIMBAA and others. From: [email protected] [mailto:openehr-clinical-bounces at openehr.org] On Behalf Of Colin Sutton Sent: Tuesday, May 10, 2011 5:21 AM To: 'For openEHR clinical discussions' Subject: RE: on the possibility of 'one information model' in e-health Is there a ?healthcare workflow? ontology? E.g an ?encounter? archetype showing the possible interactions with the EHR, specialised into ?Visit a GP?, ?Nursing housecall?, ?Hospital Grand Rounds?, ?Specialist? templates etc. If these use cases could be agreed they could be a basis for separate compatible implementations. Regards, Colin Sutton P.S. my interest is in including clinical trial registration and feedback of clinical trial conclusions and systematic reviews into the processes. From: [email protected] [mailto:openehr-clinical-bounces at openehr.org] On Behalf Of pablo pazos Sent: Tuesday, 10 May 2011 9:46 AM To: openehr clinical Subject: RE: on the possibility of 'one information model' in e-health Hi Ian, As I see the issue, the medical record internal structure (as a model) could be an instance of "the healthcare ontology", and if some of these models do not follow the general semantic rules of the ontology, then we can say that they are bad defined. I mean that the ontology shouldn't model the internal structure of the medical records, I think it have to model the big record entities (maybe compositions, sections and entries), and other related entities like persons, organizations, roles, resources, processes, etc. There's one (bad) thing we do over and over again while modeling clinical records: separating the clinical process from the record of the process. If this "almighty healthcare ontology" can be created some day, I think we must model the clinical process first, and then the clinical record that tells the story of one excecution of the process (because the record is just that, information about an instance of the clinical each process). Just my grain of sand :) -- 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: [email protected] Date: Mon, 9 May 2011 14:03:18 +0100 Subject: Re: on the possibility of 'one information model' in e-health To: openehr-clinical at openehr.org Hi Pablo, At a very high-level you may be correct but the big problem with most medical record structures is that they are currently too variably defined used and understood to be ontologised. Try thinking about the challenges of ontologising the structures of governments across perhaps Europe and you will get a flavour of the challenge. One of the benefits of the archetype approach is that it allows us to focus on small areas but with a broad audience to try and get small pockets of usable consensus. Perhaps in the future much of this will be 'true' enough to define ontological relationships but we are a long way from that position. Ian Dr Ian McNicoll office +44 (0)1536 414 994 +44 (0)2032 392 970 fax +44 (0)1536 516317 mobile +44 (0)775 209 7859 skype ianmcnicoll ian.mcnicoll at oceaninformatics.com Clinical Modelling Consultant, Ocean Informatics, UK openEHR Clinical Knowledge Editor www.openehr.org/knowledge Honorary Senior Research Associate, CHIME, UCL BCS Primary Health Care www.phcsg.org On 9 May 2011 13:51, pablo pazos <pazospablo at hotmail.com> wrote: Hi Thomas, I've left a comment in your blog but is not appearing, so I comment your idea here. I don't think today it can be possible to have one information model agreed by all the medical informatics community, but I think if we can agree in a common metamodel like an ontology that represent the more generic concepts in medicine, like people, processes, resources, records, etc, we will be one step closer to a common IM. Because if we can agree on that ontology, all the information models in healthcare MUST follow the ontology, so, different information models can live together, but they model the same concepts (semantically speaking). With different models, but semantically equivalent, the point of convergency will be closer. -- 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 _____ Date: Thu, 5 May 2011 17:20:59 +0100 From: [email protected] To: openehr-technical at openehr.org; openehr-clinical at openehr.org Subject: on the possibility of 'one information model' in e-health this is an often debated question, and after coming across (for the 100th time) just such a debate recently online, I thought it might be interesting to try to get to the bottom of the question in some way. The basic idea posted here <http://wolandscat.net/2011/05/05/no-single-information-model/> . It is of course not scientific work, but I would be interested in the views of others on this concept. - thomas beale _______________________________________________ openEHR-clinical mailing list openEHR-clinical at openehr.org http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-clinical _______________________________________________ openEHR-clinical mailing list openEHR-clinical at openehr.org http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-clinical _______________________________________________ openEHR-clinical mailing list openEHR-clinical at openehr.org http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-clinical _____ This e-mail message has been scanned for Viruses and Content and cleared by MailMarshal _____ _____ IMPORTANT NOTICE: This e-mail and any attachment to it are intended only to be read or used by the named addressee. It is confidential and may contain legally privileged information. 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