On Tue, 15 May 2001, David W Forslund wrote:
...
> I don't see the OIO system as being "portable". I can't get it to
> "interoperate" with other systems, can I?
Hi Dave,
Excellent point! Although the OIO system can import/export its data and
metadata in XML, it still does not "interoperate" with other systems. At
least one additional step is necessary to "interoperate": knowing what the
second system can import/export.
> A lot more than "easy-to-use import/export" is needed. It is a
> terminology service to translate between different terms and their
> varying definitions, it is an integration of data between multiple
> sources without having to pull all external data into ones own system.
Yes, but we have to start somewhere. You have seen my proposal - I am most
willing to consider an alternative plan.
> The copy-left license isn't the issue. It is who owns the content.
For the specific purpose of exchanging the contents of the "projects
database", the copy-left license is sufficient.
> Is
> this the patient? Open-source systems should be interoperable with
> proprietary systems. But the ownership of the data is unrelated to this.
I agree. Patient data cannot be distributed under copy-left license,
therefore it will be more complicated to setup a test bed that exchanges
real patient data.
...
> > I agree. This is exactly analogous to the requirement for medical record
> > systems where clinicians and patients need to be able to move data from
> > one information system to another. If we cannot support this for the
> > projects database, we might as well forget about it for medical reoords.
> >
> As I said above we need a lot more than the ability to be able to move
> data from one information system to another. We should be able to have
> a distributed set of resources that can be integrated on the fly as
> needed.
All true. But if we cannot even move data from one information system to
another, then IMHO a federated system is also be out-of-reach.
> Nothing less than this will really benefit the patient, IMHO.
O.K., but lets get started with step 1.
> This is what we have been trying to do for the past 5 years. But our
> success in getting people to understand what we are proposing has been
> poor.
This is valuable information Dave. I can't impose my interpretation of
your results on you but I really think "virtual" medical records is too
radical a step for most clinicians to take all at once.
> We are not claiming "our" system should have all the data or that
> people need to do what we are doing. We only claim that people should
> be trying to agree on providing integrated information following the
> various international standards. We have attempted to demonstrate a
> way to do this. Most systems that have been developed appear to want to
> handle all of the patient data, not be a component of a distributed
> medical record system.
I don't think the problem is technology because you have already
demonstrated feasibility.
How about starting with a viable local system and then becoming a node in
a distributed system?
> Beyond the political problem of sharing data, there is the security
> problem of sharing data and the HIPAA regulations in the US, which make
> this very challenging.
No kidding! How about tackling one little piece of the problem at a time?
...
> I think everyone is interested in participating. GEHR, in
particular,
> has been working hard on archetypes which are crucial for the success of
> what I'm suggesting.
How would you envision OpenEMed participating in the "projects database"
testbed?
Best regards,
Andrew
---
Andrew P. Ho, M.D.
OIO: Open Infrastructure for Outcomes
TxOutcome.Org (hosting OIO Library #1)
Assistant Clinical Professor
Department of Psychiatry, Harbor-UCLA Medical Center
University of California, Los Angeles
