On 30/08/2013 17:42, William Goossen wrote:
> Semantic interoperability is absolutely compromised when for the same 
> clinical concept variants of archetypes are created.
> If justified for internal system development , the moment exchange with 
> another system requires harmonizing on datapoint to datapoint level. I have 
> done about 2000 in perinatology 800 in stroke care 1250 in youth care 100 in 
> nursing oncology 20 in reuma, 400 in general nursing 250 in diabetes care 200 
> in GP care 100 in cardiology. In the past 13 years.
> The inconsistencies for the same data element in the various domains are BIG, 
> without clinical justifiable reasons.
> That same situation exists if you have locally / vendor specific arechetypes .
>

The same situation exists if you have local, regionally and nationally 
competing HL7 messages, CDAs, FHIR specs, CCDs, DICOM-SR, NCI BRIDG 
models, and all the rest. That /is/ the situation today.

Archetype technology doesn't solve the problem of organisations not 
collaborating, it just gives much better technical support and 
capability for building semantic specifications of content and creating 
software and UI from them.

The sociological problem still needs work. That's why identification, 
governance, and networks of cooperation are important.

Still, we didn't get nowhere. Now everyone seems to agree on how 
systolic BP should be represented :)

- thomas

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