Gentlemen

Current situation, where CEN 13606 deals on en hadn with communication only, 
but pays no attention to the EHR data storage, retrieval and OpenEHR concept on 
other hand leads to some very serious problems in the countries, trying to 
build eHealth system, based on the future proof concept.
Leads to the confusion, regarding the archetypes and the proper tool for their 
creation, maintenance and interchange, and in the end of day to the lack of 
interoperability of basic stones of clinic and demographic information
Leads to the enormous space for private clinical data concepts, leading to the 
growing costs of building and maintaining interface between the CEN 136060 
health messages and EHR data of providers and national system and creates 
obsstackels for international interoperability
Situation in creation of national helath information system in Slovakia suffers 
just due the split of ideology on side of OpenEHR and insolved parts of CEN 13 
606
And country health sector will pay great costs, when this split ones upon the 
time will be solved and CEN will be able to provide for national helath system 
complex
Acceptable solution from creation of heaalth reportt by physician, storage in 
health care data silo, communication between all providers inside of coutnry 
and on international level upt to creatin of national EHR data warehouse.

I hope, Europe/globaly we can agree on single approach for a standard for 
clinical content, fully supporting  generic semantic interoperability, to agree 
on standard for artefact in order to heve interoperability among archetypes, 
created/edited in different editors and due archatype based concept of data 
creation, storage and transport get rid of endless maping, interfacing and data 
mess.

Peter Linhardt
National archetype centre at Slovak university of technology
Bratislava, Slovakia

From: openEHR-technical [mailto:[email protected]] On 
Behalf Of Gerard Freriks
Sent: Thursday, October 04, 2012 8:21 AM
To: For openEHR clinical discussions
Cc: For openEHR technical discussions
Subject: Re: lessons from Intermountain Health, and starting work on openEHR 2.x

Dear Koray,

We both agree that the scopes of CEN/ISO 13606 and openEHR differ, as I wrote.
The scope of 13606 is about EHR communication.
That of openEHR is about the implementation in an EHR system.

At present a standard is missing about defining clinical content.
It would be nice, certainly, when both 13606 and openEHR can share that 
standard for clinical content.
In several places the EN13606 Association, whose scope is wider than the 
European context, is actively working towards that goal.
This single approach for a standard for clinical content is very important when 
we want generic semantic interoperability.
This is the reason why components for a potential standard on archetype 
production are developed inside the Association.
A standard that defines the intersections with: coding systems, ontologies, 
other CEN/ISO standards like System of Concepts for Continuity of Care and the 
Health Information Services Architecture.
All resulting in one basic generic pattern, for all artefacts, that by 
specialisation is able to be used for all kinds of archetypes.
A basis pattern that in more detail allows the definition of more nuances than 
the archetypes we know, so far.
A basic pattern that brings features closer to actual use such as negation, 
semantic ordinals (with inclusion and exclusion criteria), better integration 
with clinical workflow, ontological reasoning over structure and codes, etc.

The EN13606 Association of implementors of the 13606 standard has considerable 
experience in the production of applications based on this standard.
When I look into future needs and developments around the use of coding systems 
and ontologies, I see state of the art developments among the members of the 
Association.

W3C is a good example. indeed.
As far as I know W3C does not prescribes how to implement their standards in 
systems.
This is the responsibility of the industry in all circumstances.


Gerard Freriks
+31 620347088
gfrer at luna.nl<mailto:gfrer at luna.nl>




On 4 Oct 2012, at 02:02, Koray Atalag wrote:


Hi Gerard,
I think getting the content model is absolutely right - no one can argue
But with due respect I disagree with you about the difference. I seriously 
think standards defining clinical content should converge (not even harmonise).
I had the privilege of spending some time with Ed Hammond in NZ and was 
convinced that this is what is needed. Mappings are different and certainly a 
blackhole.
That said EN13606 Association's mission and role is paramount in terms of 
contextualising "exchange" within the European context.

We chose to use openEHR for defining the Interoperability standards in New 
Zealand as we are very mindful of the fact that this formalism has been defined 
and carried on for many years by this group; and it IS naturally the leading 
edge with proven track in implementation (one of which is my own work). I think 
W3C is a good example of how important it is to have a single approach in 
contrast to the situation in health IT. These might sound a bit strong but it 
is what I believe. I acknowledge lack of organisational capacity and skills in 
past though.

Cheers,

-koray


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