Don,
All EMR are different and all are customized to serve the workflow of their specific
domain (e.g. hospital vs. clinic, nephrology vs. psychiatry). None of the "real
world" EMRs fully implement any of these standard models (data definition) to my
knowledge. They may use a subset of a given model but deviation is the norm.
I don't know how far you are in your implementation but I would suggest that you read
Thomas Beale's excellent paper on "archetype"-based approach to implement flexible
data definition (draft available online at
http://www.deepthought.com.au/it/archetypes/archetypes.pdf). It contains an excellent
critique of the traditional "non-flexible" way of using data definition.
If you have been followed the discussion on the open-health list pertaining to GEHR
and OIO
(http://www.mail-archive.com/cgi-bin/htsearch?method=and&format=short&config=openhealth-list_minoru-development_com&restrict=&exclude=&words=gehr+oio),
you will see how GEHR and OIO support flexible data definition.
In the case of OIO, the idea is that whatever data definition / model you choose to
implement, the OIO makes your data definition re-usable by others in a plug-and-play
manner. This means that, for example, if someone else already implemented a subset of
HL7 data definition that you like to use, you could download that collection of terms
(orgainized on one or more OIO Forms) and plug them directly into your EMR for data
collection. In this way, your EMR can be customized and extended over time through
different collection of data definitions or "Forms".
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
On Thu, 21 Dec 2000 10:10:39 Brian Bray wrote:
>[EMAIL PROTECTED] a icrit :
>>
>> Hello,
>>
>> I am developing an EMR system and would like
>> to know if there is a data definition for an EMR
>> (preferably a relational schema) that has been defined
>> or is recommended by one of the standards
>> organizations (e.g. HL7, ANSI).
>>
>> Anyone know of any and if so, do you have
>> any pointers to where they might be on
>> the web?
>>
>> Thanks in advance,
>> Don
>
>A lot of newer projects are looking at object oriented definitions of
>EMRs instead of directly relational ones. This work can be made more
>specific and concrete by using OO models to create relational tables or
>XML schemas, DTDs, archetypes, etc. OO modeling is better able to
>capture the complexity of EMR data.
>
>The major work worldwide is the HL7 RIM Reference Implementation Model
>(RIM) which is being used as the basis for standards outside of HL7 as
>well. They expect to use the model to inform message definition in
>version 3 of the HL7 interface standard.
>
>There were other simpler models developed at the NHS (search for the NHS
>information model) and for the Good European Health Record (GEHR).
>
>Such models describe the health care system in general and can be used
>to guide the development of EMR systems as well as messaging systems and
>cross system interfaces.
>
>If you want something more concrete, you can look at the XML work of the
>OIO project, FreePM, DocScope, the CEN TC.251 standard (search for
>preENV13606) and HL7 Patient Record Architecture (PRA) standard. There
>is also the API focussed work of the GEHR project, LANL Telemed, and the
>CorbaMed standards.
>
>The two projects specifically focussed on general purpose open source
>EMR components are GEHR and DocScope. GEHR is focussed on API access to
>the EMR, while DocScope is based on using XML tools to access files in
>preENV13606 format.
>
>References to related open source projects can be found at
>
>http://openhealth.com/en/healthlinks.html
>
>Links to the standards organizations are:
>
>http://www.hl7.org
>http://www.omg.org/homepages/corbamed/
>http://www.centc251.org
>
>-Brian
>
>
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