Thank you for your insight and help. Let me clarify a tiny corner of my heresy. I wasn't speaking against standards...at all. ICD-9, CPT, NDC, etc., all the standards that address agreed upon ways to represent medical data are completely necessary. I also wasn't saying that everyone would have different tables, rather that as tables were published and criticized they would gradually merge, so that ultimately everyone would have the same tables, or a subset from the same superset of tables. Sort of like SABRE in the airline industry: nearly everyone has the same set of tables for airline reservations...which happen to be proprietary. What I was saying was that if there were a master set of tables, a "standard" set, dare I say it, and a set of standards for representing data, ICD-9/10, NDC, (well, the same set of data representation standards that are enumerated in HIPPA), then where do HL7 and GEHR fit in? HL7 2x was a messaging standard for incompatible proprietary medical devices. HL7 3 is clearly something quite different. Thank you for your patience with these ideas. John Gage David Forslund wrote: > > There is a lot to say here. If you simply want to do your own thing and > make it work locally, this is a good approach. However, if you want to > link with other information, add new information types, work over a > wide-area network, deal with security and confidentiality, there is a lot > more than database tables and publishing them to the net. Standard data > representations help in the exchange of information and service oriented > approaches providing a middle tier of data management can make your system > much more extensible and adaptable. > One should do a system design, but database tables do not constitute a > system. Various components > make up a system and they should be exchangable over time as needs change > and grow. Standards can help a great deal here. There is a lot more to > say, but this is a start. There are a lot of good books on the subject > out there. > > Dave > At 08:50 PM 11/19/99 -0500, John S. Gage wrote: > >I have a question that bedevils me. Tim has published his table definitions. > >They may not be perfect, they may need to be revised a great deal over time, > >but if you have table definitions, if you have an interface (the browser), and > >if you have a network (the internet), then don't you have an electronic > >medical record? I know this makes me sound like the most ignorant heretic > >from the darkest corner of hell, but where do HL7, GEHR, etc. fit in? Why are > >they needed? If someone explains this to me, I will feel alot less dumb and > >alot happier. I want to believe. I truly want to believe. > >John Gage > > > > > Tim Cook wrote: > > > > > > > > > What guided you in building your databases? > > > > I originally tossed out a basic 'starter design' and then was > > subjected to > > > > about 6 weeks of intense re-training by several physicians that had > > joined > > > > the project (many of them are here as well). When we finished this is > > what > > > > we had: > > > > http://www.magicnet.net/~jackb/FreePM/file_index.html > > > > > > > > There have been some spelling & data type corrections and user tables > > added > > > > but nothing that really impacts the actual model of the EMR. > > > >
