Hi Fred, some comments between your lines. Hope we can help you to get the v2.0 of the book soon :D
-- 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: Thu, 16 Feb 2012 19:12:13 -0600 Subject: Re: Meaningful Use and Beyond - O'Reilly press - errata To: openehr-technical at openehr.org As Thomas said, openEHR is not about open source, is about an open standard for globally interoperable EHR architecture. ... I also state in the book: OpenGALEN and OpenEHR are both attempts to promote open source ontology con- cepts. Both of the projects have been maturing but some view these as unnecessary additions or alternatives to SNOMED+UMLS. However, they are available under open source licensing terms might make them a better alternative to SNOMED for certain jurisdictions. Then I wrote: OpenEHR is a controversial approach to applying knowledge engineering principles to the entire EHR, including things like the user interfaces. You might think of Open- EHR as an ontology for EHR software design. Many health informaticists disagree on the usefulness of OpenEHR. Some believe that HL7 RIM, given its comprehensive nature, is the highest level to which formal clinical knowledge managing needs to go. Now, these are complex statements about OpenEHR. I am sure I might have gotten some of the details about OpenEHR wrong here. If I have done that, then please help correct me. I am all ears. The problem here is about context. Comparing adoption for things that are not comparable is not a good thing for any of the SDOs behind the standards and for your readers. People could be really confused about those statements. I agree, and that is a fact, that HL7 RIM is more used than openEHR RM. But what really matters is: what are they used for? Comparing a model that was designed for creating messages with an standard that is more than an information model, as openEHR, is nonsense. Also comparing openEHR vs. SNOMED+UMLS (how an EHR architecture could be compared with a vocabulary?). Again, yes, those other standards are being used more than openEHR, but openEHR was not meant for the area of application of those other standards, in fact openEHR+HL7+SNOMED+UMLS can be implemented all together in the same system to solve different problems. Just an argument to this point: this is like comparing the use level of Ethernet with the use level of HTTP, yes Ethernet is used more because is behind a big part of the network communications, but Eth and HTTP are for different things. Here is the bottom line reality: the Open Source EHR space has matured dramatically in the last 10 years. There are handful of projects that I know of that have literally hundreds of installations worldwide: the VistA variants, OpenMRS, OpenEMR, and ClearHealth. There are some other important projects that have potential, like Tolven, that I know of, but they simply have not garnered hundreds of installations. I would be very happy to be proven wrong here, but as far as I know, there is no Open Source EHR that has been installed at even over 100 sites that has been based on the OpenEHR. openEHR is not about open source: there are openEHR open source EHRs and propietary openEHR EHRs.http://www.openehr.org/shared-resources/usage/commercial.html ... At this point my mental summary for OpenEHR is one of the many "technically right but will never be adopted" technology ideas. I cannot write a book which is intended to warn IT people about all of the fruitless investments that they should expect to see all over the place in Health IT and give OpenEHR a free pass because I know and like some of the founders. I agree in the idea of giving facts instead of oppinions (likes/dislikes). The problem is that you are giving wrong facts, not on the adoption side of the coin, but on the current definition, scope and goals of openEHR. IMO the way you are describing openEHR now diminishes what openEHR is and what is intented for. The main idea behind giving facts is not to promote or demean a standard, is all about facts. When I talk about standards, and I do talks not only on openEHR, I try to give context on what problems we have on Health IT and how those standars fit to solve each problem. And the public of those talks are not health IT experts. IMHO, if a book is written about health IT and mention standards, those standards should be in a framework of 1. what are the current problems, 2. what standards apply for each problem, that should suffice for general IT professionals (not healthcare specific). About adoption: adoption is a process, and our community is walking forward. Is a fact that TODAY the adption level is poor, but as Thomas said, we need to look for what we'll do tomorrow. Is OpenEHR a relevant technology or an interesting foot note? It is my job to make that technical decision and then include the results in the book. Right now, OpenEHR made the cut to get a mention in the book, but not the cut for me to say "hey this is a good idea". I think is a relevant architecture because it defines a new paradigm on EHR development, and that's relevant for the future of EHR development & developers. But, is this relevant in terms of adopton today? I rather say no. To say that "this is a good idea", you need to have some insight of the standard, and that's a tough job. I could say to you why I think this is a good idea, maybe we can doit by private email. What I have to say is when I present the idea to my students, they see the problems with the current software engineering process and the benefits of the process proposed by openEHR. With that in mind, I would be happy to have factual corrections regarding OpenEHR which we can include in the next update to the book. I would also be happy to have someone on this list convince me that I am wrong about my assessment of OpenEHR. It is difficult because I see so much of what I have concerns about already mirrored on the OpenEHR list: http://www.openehr.org/mailarchives/openehr-implementers/msg00880.html Guilty as charged, but we are moving forward and working hard to reach wide adoption. Then we had 36 people in our spanish-speakers openEHR group, now we have 80 professionals and students (and growing). And right now I'm planning the second edition of the openEHR course in spanish: http://informatica-medica.blogspot.com/2012/01/conclusiones-del-curso-de-openehr-en.html Again, you do not need to convince me that you are "right" about the OpenEHR designs, you need to convince me that OpenEHR is "relevant". Being right, sadly, has little to do with adoption. For instance, I am typing on a QWERTY keyboard right now, but I am convinced that this lady is technically right: http://workawesome.com/productivity/dvorak-keyboard-layout/ Hope that helps :D -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.openehr.org/mailman/private/openehr-technical_lists.openehr.org/attachments/20120217/b1ff468e/attachment.html>
