Horst, You do write some great stuff! I am seriously worried about these standards, their complexity, the continuous chages, their failure to succeed in getting to be used. I have studied them the best I can, and I feel they are hopeless in the way they are implemented.
Just imagine some country starting a EHR and e-health project. To succeed the end usersd must be happy to use them, and must benefit from them immediately. If things are complicated due to the fact that there is conflict in what standards to implement and when, and this affects the speed of implementation, the whole thing may fail. I wonder if standards cannot be implemented to allow communication between systems that already exist, and can be implemented and insinuated into prevailing systems? Will some simple guidelines to the end user software - eg: data should be exportabl;e as XML etc. may not suffice? Excellent end user software in EHR, not having any standards are being used and liked by many clinicians around the world. I feel that end users will go their own way in the prevailing atmosphere relating to "standards". Will it really matter to the patient? to the clinician? If so to what extent? Thank you for any enlightenment :) Nandalal Gunaratne ----- Original Message ----- From: Horst Herb <[EMAIL PROTECTED]> Date: Wed, 7 Jan 2004 21:05:33 +1100 To: [EMAIL PROTECTED] Subject: Re: openEHR, gnumed, OIO,OpenEMed, FreeMED, SQLClinic, VistA, etc. etc. > On Wed, 07 Jan 2004 20:48, Thomas Beale wrote: > > I wouldn't know for most of these but it seems reasonable. My only > > comment is that this classification is fine for a sort of maturity index > > of software; things like openEHR have a lot of work in the specification > > space, shared (pioneered) by OMG HDTF, CEN 13606, HL7 and others, which > > You know that I am all for standards, and you are certainly right in many > ways. > However, the sad reality is that standards in our domain don't work. Very sad. > > But in a world where you can't even get the some rogue but very influential > countries to agree to most sensible standards with straightforward benefits > such as adherence to the metric system, what hope is there for health care > standards? > > Corbamed is sensible and fairly complete in the sense that you can implement > it here and now and do something useful with it. I know OpenEMED has > implemented some, but honestly: hands up how many world wide installations > are there of any Corbamed system? So much for Corbamed as a standard. > > And HL7? It is still a sad joke. Despite it's (probably entirely unnecessary) > complexity it still doesnn't fulfill any expectations. I haven't seen yet > any two not-inhouse systems that can talk to each other HL7 without need for > a home baken translation level. And even then things can go wrong (see the > pathology download tragical comedy in Australia). > > And CEN standards? I'd love to see them work in our domain, but please point > me to any significant installations using them. > > Standards that work nowadays and make everybodies life easier have arisen out > of somebody actually "doing something", and the process of becoming a > de-facto standard has been helped by either sheer commercial market > domination or complete openness. Complex domain specific "standards" > developed on the white board and then imposed onto humanity have not often > worked well AFAIK. > > So, once again: I love standards. I wish standards to penetrate our domain > thoroughly. But for standards to have any impact on evaluation of actually > existing projects they would need to be more meaningful than what we have, > and they definitely would need more acceptance than they currently have. > > Horst > -- ______________________________________________ Check out the latest SMS services @ http://www.linuxmail.org This allows you to send and receive SMS through your mailbox. Powered by Outblaze
