On Tue, 2003-12-30 at 09:55, Thomas Beale wrote rather tartly and I smiled 
but won't repeat it.

Tim Churches chipped in 
> there also needs to be mutual (and I stress mutual) respect for the
> different philosophies behind these two projects,  and the different
> world-views of their creators. 

I agree.  And that includes the mutuality and stress on it.
The mass of detailed work done in Open EHR is vastly impressive, and is 
fit for its purpose but the ad hocery of OIO also has value.  

It is clear to me that for a large-sale system to do (a sizeable subset 
of) everything ad hocery won't suffice, and this is partly from being in 
the context of a large healthcare system that has a considerable collision 
between laissez-faire regulated capitalism, anarchy and State constraints 
and has for the last dozen years been being warped into a significant 
degree of concordance on the clinical thesaurus and other organised 
cooperative tools at costs significantly greater than they could be if we 
had known then what we know now.

Large-scale deployed systems need to have layers of subtlety to them, and 
it is a mistake to remove the capacity for ad hoc work from the users, as 
it is a mistake for users to use that to re-invent and diverge on what has 
been done once already.

I've found the dialogue interesting, but I can imagine how frustrating the 
mismatched vocabulary and world models can be for the participants.

-- 
Dr Adrian Midgley          I use Free software because it is better
http://www.defoam.net/    They carefully didn't ask.         

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