Paul wrote:
> Heya Tim,
> 
> --- In [email protected], Tim Churches <[EMAIL PROTECTED]> wrote:
> 
>> Yes, it seems to me that openEHR as it stands is an interesting and
>> potentially useful technical advance which permits greater semantic
>> precision and thus may ease the valid interchange of health data, but
>> that there is a whole raft of sociological questions about how it might
>> work in practice which still need to be addressed, and which probably
>> can't be answered until more people start to use it and there is an
>> openEHR "ecosystem" to observe.
>>
>> On the other hand, the Regenstreif/OpenMRS approach is arguably less
>> rigorous, but has still been shown to work very well in practice over
>> many decades, at least at the individual clinic/institute/repository
>> level, but that its utility in a fully federated environment is still
>> being explored.
>>
>> But it is not an either/or situation, and one approach does not need to
>> prevail over the other.
>>
>> Tim C
> 
> One quick clarification.  The database approach OpenMRS utilizes, in
> fact *has* been demonstrated convincingly to work in a federated
> model.  The INPC is one of the only truly operational RHIOs in the
> country, and it's comprised of over 10 federated repositories all built
> on top of this database design.  Collectively, the INPC has over 2
> million patient records, and over 1 billion clinical observations
> stored within it.

Ah, OK, I misunderstood. That's impressive. But when you say "federated
repositories", what exactly do you mean? Are the 10 repositories
free-standing, self-sufficient entities which exchange data with each
other via messages or some other means, or are they "logical
repositories" all running on the one centrally-hosted system/database?

> However, the INPC is not built upon OpenMRS.  It's built on top of the
> RMRS, which was conceptualized in the early 70's.  We're a close
> cousin, open source, modern version of the RMRS model.

Seems like a very good foundation to build on.

Tim C

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