> Bert,
>
> I don't really understand this. The clinical modellers will decide on
> Observation or Evaluation, and build their archetypes and templates.
> The paths will come from the archetypes, whatever their choices were.
> There might be occasionally some ambiguity for clinical modellers, but
> once they decide on their model, there's no ambiguity.
>
> What innovation are you seeking that is being blocked?
I was looking at the CIMI model, other models are possible too.
Suppose you don't care at design time what kind of Clinical Noun you are
classifying, but you describe your data you want to store using a code,
maybe SNOMED, maybe a section of SNOMED which does not exist right now.
Innovation is a future thing. Let the people afterwards decide how to
use the data.
For example, say an Observation becomes a Evaluation, because there were
reasons to observe something, or a gray area Observation, like an
interpreted combination of ECG, radiology. A mixture between complex
measurement-data and evaluation. Maybe some data-analyst find the strict
separation of observation and evaluation artificial.
Whatever, there is not always a clear reason to classify it in one of
the four nouns, it could be possible that you afterwards just search for
that SNOMED code which is not yet invented. Because you designed a rigid
structure, you always know the path to that code, and you always know
the path to the datetime. Maybe you don't know what you are looking for,
a mysterious decease, and you are just scanning data, or you are
datamining, searching for non-obvious relations between deceases.
Suppose your rigid structure looks like this, always this model, except
the Value, which can be more complex, depending on what it is.
ENTRY[at0001]
Single_Item[at0001.1]
CLUSTER[at0001.1.1]
DateTime[at0001.1.1.1]
Code[at0001.1.1.2]
Value[at0001.1.1.3]
You see, this is not possible in the current RM, first because there is
not yet a generic ENTRY (except the hesitater-generic-entry, which
no-one wants), second, because there is no complex structure possible
under a CLUSTER, so the rigid structure here needs some adjustment. ;-)
But it illustrates what I want to say, there is always a Code at the
same path and archetype_node_id, and there is always a datetime under
same condition. This should give special opportunities, only because
from point of view of indexing, but in more aspects, and of course, it
needs more thinking, this is just an illustration.
But the point is:
It is a semantic structure, completely defined in archetypes. It is an
archetyped schema. This is no chaos, this is order.
And it is making true the promise of two level modeling. All modeling is
in second level.
This should create a complete new playground for medical data-analysts.
Innovation can go its way, there are no semantic boundaries.
The only thing needed for this is a generic non-semantic RM, like the
EHR section in 13606 is more or less, and the next version of OpenEHR
will be, as you say.
Maybe you cannot imagine anything at what I am saying here, my wife
can't (she is a GP), but still you have decided to make of ENTRY a
concrete class, although there already was a GENERIC_ENTRY. Why is that,
if it is not for the reasons I mention?
Thanks,
Bert
