Dear Ian,

Thanks also for your helpful reflections. I agree that once the standard is 
close to final we should perform and publish a detailed comparison and cross 
mapping between the reference models, as an aid to system implementers and tool 
makers.

With best wishes,

Dipak Kalra

On 26 Aug 2015, at 17:20, Ian McNicoll 
<[email protected]<mailto:[email protected]>> wrote:

Thanks Dipak,

A very clear and helpful statement of current and future intent. I too agree 
that we should not focus negatively on the differences and that they are 
mutually reinforcing but people do ask and it's important that we are clear 
that while 13606 and openEHR share a number of tools, technologies, 
philosophies and even people + good relationships), they are not currently 
interchangeable or directly interoperable.

>From a high-level perspective they are indeed very similar but the detailed 
>differences do matter to implementers, and I think we need to be clear to the 
>market about these differences.

Thanks too for the perspective on AQL adoption - makes complete sense to me in 
the 13606 context.

Ian

Dr Ian McNicoll
mobile +44 (0)775 209 7859
office +44 (0)1536 414994
skype: ianmcnicoll
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[https://docs.google.com/uc?id=0BzLo3mNUvbAjT2R5Sm1DdFZYTU0&export=download]
Co-Chair, openEHR Foundation 
[email protected]<mailto:[email protected]>
Director, freshEHR Clinical Informatics Ltd.
Director, HANDIHealth CIC
Hon. Senior Research Associate, CHIME, UCL

On 26 August 2015 at 15:33, Kalra, Dipak 
<[email protected]<mailto:[email protected]>> wrote:
Dear All,

This is an interesting discussion, and I would like to stress the 
complementarity of the two.

openEHR is, as others have said, an important consolidator of the 
state-of-the-art in best practices for the design of an electronic health 
record architecture, repositories and the underpinning of EHR systems. An 
important advantage is that it specifications are publicly accessible, and of 
course it has a vibrant community and a large number of tools to support its 
use.

13606 has always had a good relationship with openEHR, but is primarily 
intended to be an interface standard between heterogeneous EHR systems, and is 
therefore optimised for that purpose (e.g. for mappings), which means its 
reference model is definitely simpler. There are many countries and situations 
where it is essential to have a formal international standard in order for it 
to be acceptable as part of a national strategy. Some vendors have also 
indicated that they like the inevitable stability of a standard, which changes 
infrequently. 13606 also has a community and tools, and of course many of its 
community are also part of openEHR, and vice versa.

If one takes a high-level look at the many different globally-used 
representations of health data, it is easy to see that these two reference 
models are indeed very similar. Whilst near to the ground we can easily be 
tempted to focus on their minor differences, I believe it is of greater value 
to society and to our field if we can regard them - and champion them - as a 
mutually reinforcing pair of models.


The specification of archetypes is very mature, and during the revision we 
expect to upgrade to the latest AOM (which is 2.0). This part of the standard 
will also remain focused on a logical representation supporting archetype 
interchange.


As has been pointed out, AQL could in theory have been added to the standard, 
since it could “work" with 13606. However, another important imperative for a 
standard is that it has reached a sufficient level of maturity and stability. 
It was also felt important by the working groups of CEN and ISO that we do not 
introduce something very novel into this revision process. I did suggest that 
we consider adding a sixth part to the standard to support the distributed 
analysis of electronic health records (such as communicating queries). It was 
felt wiser, and I support this view, not to introduce something new to these 
five parts of the standard, but once it has finished its revision to propose a 
new work item to CEN and ISO on the querying of EHRs. AQL will inevitably be an 
important contribution to that new work item, and hopefully by the time we are 
ready for it the AQL specification will be very mature and there will be much 
more experience of its use, making it an ideal specification to standardise.


Thank you all for your excellent contributions in different areas of EHR 
representation, communication and implementation - to keep advancing our field 
and the quality of EHRs world wide.


With best wishes,

Dipak
________________________________________________________
Dipak Kalra
Clinical Professor of Health Informatics
Centre for Health Informatics and Multiprofessional Education
University College London

President, The EuroRec Institute
Honorary Consultant, The Whittington Hospital NHS Trust, London

On 26 Aug 2015, at 14:44, Ian McNicoll 
<[email protected]<mailto:[email protected]>> wrote:

Hi Bert,

"I would leave it with: AQL is an archetype bound query language, and every 
system which is build on archetypes is able to implement AQL."

That is fair enough but we were asked to characterise the differences between 
13606 and openEHR and I am comfortable that the actual and formal adoption of 
AQL is one of those  differences.

AQL is on the openEHR specifications roadmap but AFAIK this is not the case for 
13606. Of course that does not stop 13606 vendors implementing AQL but in terms 
of actual differences between the 2 communities the adoption, or intention to 
adopt AQL seems (from the outside) somewhat different both at a practical and 
formal level.

Although AQL adoption in the openEHR community is far from universal, most of 
the vendors/developers that I have spoken to see it as something they want to 
implement, particularly as GDL is somewhat dependent on AQL.

I am just trying to ascertain if there is similar enthusiasm/intention amongst 
13606 vendors, or if AQL forms part of the current 13606 refresh discussions.

Ian




Dr Ian McNicoll
mobile +44 (0)775 209 7859<tel:%2B44%20%280%29775%20209%207859>
office +44 (0)1536 414994<tel:%2B44%20%280%291536%20414994>
skype: ianmcnicoll
email: [email protected]<mailto:[email protected]>
twitter: @ianmcnicoll

[https://docs.google.com/uc?id=0BzLo3mNUvbAjT2R5Sm1DdFZYTU0&export=download]
Co-Chair, openEHR Foundation 
[email protected]<mailto:[email protected]>
Director, freshEHR Clinical Informatics Ltd.
Director, HANDIHealth CIC
Hon. Senior Research Associate, CHIME, UCL

On 26 August 2015 at 13:28, Bert Verhees 
<[email protected]<mailto:[email protected]>> wrote:
On 26-08-15 14:23, Ian McNicoll wrote:
but am not aware of any non-openEHR
implementations
Is there a Xhosa implementation of 13606 or OpenEHR?

Does that mean OpenEHR or 13606 are not able to support Xhosa?

I would leave it with: AQL is an archetype bound query language, and every 
system which is build on archetypes is able to implement AQL.


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