On Tue, 28 Nov 2000 09:28:52 Sam Heard wrote:
...
>HL7 and GEHR are different - HL7 offers an information model for clinical
>and administrative systems. GEHR is a health record architecture and CEN is
>a message architecture. The drift to HL7 from CEN is due to the lack of
>formality in the CEN architecture. GEHR has a two level architecture - the
>information architecture and the clinical information models - expressed as
>archetypes. GEHR folks believe that other EHR solutions will have to do the
>same.
Hi Sam,
Thanks for delineating the differences between these approaches. While I agree with
you 100% that it is helpful to divide the architecture into the information
[infrastructure] architecture and clinical information models, the OIO (and myself)
take the position that the information models need not be pre-defined. Hence, the
focus of the OIO is on the *infrastructure* that facilitates the creation, re-use, and
archival/retrival of the user-defined "information models".
This means that with the OIO, there is democracy at the level of "information model".
...
>
>In HL7 the democracy lies in the RIM (and implementation) which is
>difficult - so we see tools on view at AMIA that process HL7 messages and
>try and retrieve information from them. In GEHR, the democracy lies only in
>the archetypes (and not in the architecture or the - middleware -
>implementation). We have proved this is possible but do not have a large
>scale implementation as yet.
Except that in GEHR, I thought there is a pre-determined set of *required* archetypes.
I thought this is the main difference between GEHR and OIO?
...
>
>Tim Cook and Andrew po-jung Ho have got the ball rolling with Zope and web
>interfaces that promise a lot and should be getting people excited.
Thanks! One of the (proposed) ways for the OIO to inter-operate with arbitrary
dictionaries/term sets etc is to have "Linker"-metadata that allows items on OIO forms
to be mapped to concepts/terms in any standard taxonomy. Since these mapping
information will be "plug-and-play" and available through online libraries just like
all OIO metadata, one can envision using the OIO to translate between data sets
originating from different term-space. Do you think this is a workable solution?
>There
>are no HL7 open source efforts at the moment that I know of but we hope to
>have a project in Australia soon to look at automation of the process of
>incorporating new HL7 messages into the GEHR kernel - this will be an
>advance!
OIO's approach as outlined above for interoperability with HL7 (and other standards)
will be implemented in a "piece-meal" fashion. Perhaps that is also what you have in
mind for GEHR-HL7? What I mean is that if a specific piece of data needs to be
transported between HL7 system and the OIO system, the first step is that an OIO-form
will be created to represent that data. After that, a "Linker"-metadata will be
created to map items on that OIO form to the relevant HL7 terms. Finally, HL7 data
will be converted to OIO data through the OIO Linker- and Form-metadata for storage
and manipulation inside the OIO. For OIO to HL7, the same mechanism applies (except
data flows in reverse).
The "piece-meal" part is important because it is my humble opinion that it is a huge
waste of time to create Linkers that may not ever be used. Consistent with the OIO
design philosophy, an overwhelming task is broken down to 1) put the information
infrastructure in place, and 2) let interested users create the content that they
need. Once the information handling infrastructure is in place, it becomes trivial to
incrementally build all the necessary "Linkers" and OIO "Forms" to manage all
clinically relevant data. In this way, the task of building a comprehensive EHR
system is distributed among many users across space, time, and knowledge domain.
>We are interested in producing different database drivers for the
>GEHR kernel
Sam, I thought Eiffel already has database adapters?
Are you referring to something else?
>and David Forslund is interested in utilising the CORBAmed COAS
>interfaces with the GEHR kernel.
What is the status GEHR-CORBA interface? We like to build CORBA connectivity into OIO
as well - perhaps we can work on this together.
>There is much to be done!
Are we half way there yet?? :=)
Andrew
---
Andrew P. Ho, M.D.
OIO: Open Infrastructure for Outcomes
www.TxOutcome.Org
Assistant Clinical Professor
Department of Psychiatry, Harbor-UCLA Medical Center
University of California, Los Angeles
Join 18 million Eudora users by signing up for a free Eudora Web-Mail account at
http://www.eudoramail.com
