On 07/04/2013 12:11, Grahame Grieve wrote:
> Hi Tom
>
> You ask:
>
> > Is there a better meta-architecture available?
>
> When actually the question at hand appears to be: is it even worth
> having one?
>
> I don't think that this is a question with a technical answer. It's a
> question of what you are trying to achieve. I've written about this
> here: http://www.healthintersections.com.au/?p=820
>
There is always a meta-architecture. It's just a question of whether
system builders are conscious of it. If they aren't, then by definition
they are just doing /ad hoc/ development, with no comprehension of the
semantics of what they build.
I prefer to have conscious design going on, and make some attempts at
defining rules for system semantics. Then you know what you can expect
the system to do or not.
To go back to the question of meta-architecture, let me ask the
following questions...
1. is it worth trying to have a publicly agreed (by some community at
least) information model? I.e. to at least be able to share a
'Quantity', a data tree of some kind, a 'clinical statement' and so on?
=> in my view yes. Therefore, define and publish some information
model. Aka 'reference model' in openEHR.
2. do we really want to redefine the 'serum sodium', 'heartrate' and
'primary diagnosis' data points every time we define some clinical data set?
=> in my view no. Therefore, provide a way to define a library of
re-usable domain data points and data groups (openEHR version of this:
archetypes)
3. do we need a way to define data sets specific to use cases, e.g., the
contents of messages, documents etc etc?
=> in my view, yes, it seems obvious. Therefore, provide a way to
define such data sets, using the library of 'standard data
points/groups', and also the reference model.
and
4. would we like a way of querying the data based on the library of
re-usable data items? E.g. is it reasonable to expect to query for
'blood sugar' across data-sets created by different applications & sources?
=> in my view yes. To fail on this is not to be able to use the
data except in some /ad hoc /brute force sense.
You (I don't mean Grahame, I mean anyone ;-) may answer differently, but
if you don't care about these questions, it means you have a
fundamentally different view about how to deal with information in
complex domains requiring information sharing, computation, and
ultimately intelligent analysis (health is just one such domain). Either
you think that the above is a 'nice idea' but unachievable, or else that
it's irrelevant to real needs, or.. something else.
If you think the questions are relevant but have different answers to
them, it means you believe in a different meta-architecture.
Note that these considerations are actually orthogonal to whether
standards should be built by agreeing only on messages between systems,
or how systems are built (the topic of Grahame's blog post).
- thomas
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