Instruction archetypes and overlaping nodes with INSTRUCTION.narrative

[Dr Ed Hammond, Ph.D.]

A good question.  My opinion is that it will be around for a long time.  As NLM 
becomes more in use, there seems to be a tendency to believe that narrative 
will be around for a long time.  I think what you propose will be an 
interesting discussion.  The problem with narrative is that its contents, 
organization, completeness, and  use of non-standard abbreviations is totally 
uncontrolled.

From: openEHR-technical [mailto:openehr-technical-boun...@lists.openehr.org] On 
Behalf Of Thomas Beale
Sent: Tuesday, October 29, 2013 1:29 PM
To: openehr-technical at lists.openehr.org
Subject: Re: Instruction archetypes and overlaping nodes with 
INSTRUCTION.narrative

On 29/10/2013 16:28, Dr Ed Hammond, Ph.D. wrote:
As a point of interest, the "required" narrative section in CCD was an interim 
step because we (US) still have a number of sites that cannot accommodate 
structured data.  In my opinion it does not imply correctness.


Ed,

I suggested some rules in my blog post for deal with this very ubiquitous 
reality... I wonder if you have any feel for whether the text/structured 
'equivalence' idea will remain in a future CDA - going by Grahame's 
blog<http://www.healthintersections.com.au/?p=1699>, it appears CDA will turn 
into FHIR, i.e. a completely different format? If it is retained, there is an 
opportunity to establish better rules for this. I can imagine upgrading openEHR 
to use such rules as well.

- thomas
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Instruction archetypes and overlaping nodes with INSTRUCTION.narrative

[Dr Ed Hammond, Ph.D.]

As a point of interest, the "required" narrative section in CCD was an interim 
step because we (US) still have a number of sites that cannot accommodate 
structured data.  In my opinion it does not imply correctness.

Ed

From: openEHR-technical [mailto:openehr-technical-boun...@lists.openehr.org] On 
Behalf Of Thomas Beale
Sent: Tuesday, October 29, 2013 9:23 AM
To: openehr-technical at lists.openehr.org
Subject: Re: Instruction archetypes and overlaping nodes with 
INSTRUCTION.narrative


Indeed. We were very wary of this CDA style duplication, which from my point of 
view is pretty ambiguous if not downright 
problematic.

However, unless we develop some new formal relationship between the text and 
the structured part for orders and prescriptions - something which to do 
properly I think is probably a PhD thesis level of work - then for now we have 
to accept this bit of 'duplication' and understand it for what it is. A lot of 
work has been done in the UK in this area, and it may be that there is an 
answer already available - if anyone has information on it, would be useful to 
share.

- thomas

On 29/10/2013 11:48, Diego Bosc? wrote:

The thing is that this reminds me to the CDA narrative part, which is

the only "required" part. If I remember correctly, the only part that

can be assumed right is the narrative. But as openEHR gives a lot of

weight to the structured part, then it could be other way around.



And by the way, I also agree that "none" is a correct answer :)



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Meaningful Use and Beyond - O'Reilly press - errata

[Dr Ed Hammond, Ph.D.]

For the most part, I find that people who write negative remarks most often 
know little about the subject.  I for one have never viewed openEHR as 
controversial.  I think openEHR is competitive as is HL7, IHE and most other 
organizations.  Some of the competition is based on our belief that we are 
right; some on protection of our history and proprietary interests.  Actually, 
much of our life is based on competition, and I don't think it is a bad thing.  
Pot-shots and misstatements like in this book are actually a sign of success 
for openEHR.  Don't sweat it.


W. Ed Hammond
Director, Duke Center for Health Informatics
2424 Erwin Rd, 12th Floor, Room 12053
Phone: 919.668.2408
Fax: 919.668.7868
Assistant: Naomi Pratt
Email: naomi.pratt at duke.edu
Phone: 919.668.8753

From: openehr-technical-bounces at openehr.org 
[mailto:openehr-technical-boun...@openehr.org] On Behalf Of Thomas Beale
Sent: Sunday, February 12, 2012 8:01 AM
To: openehr-technical at openehr.org
Subject: Re: Meaningful Use and Beyond - O'Reilly press - errata


It would be interesting to see what US-based list members think of what Michael 
has quoted below. Is openEHR really seen as 'controversial' in the US? 
(Controversy can be good - at least it means debate).

The quote below about David Uhlman being CTO of openEHR in 2001 is certainly 
incorrect - I imagine it is supposed to read 'OpenEMR', going by what I see 
here in Wikipedia (in any case, 
openEHR has never had a 'CTO' position). That's a surprisingly bad fault in 
O'Reilly editing; worse, the author page for David 
Uhlman on the O'Reilly website repeats 
the same error. This 
review on the 
same website seems to confirm a complete lack of review or editing of the 
original manuscript. O'Reilly obviously is missing basic mechanisms for quality 
control.

But the more interesting question is: are the opinions in this book about 
openEHR representative of a US view?

- thomas

On 12/02/2012 11:22, Michael Osborne wrote:
I read the recently released O'Reilly book "Meaningful Use and Beyond" on 
Safari books today and found the following errors
and some quite blatantly false statements about OpenEHR.

Firstly is the claim by one of the authors, David Uhlman, that he was CTO of 
openEHR in 2001
 - a claim which Thomas Beale denies.

David Uhlman is CEO of ClearHealth, Inc., which created and supports 
ClearHealth,
the first and only open source, meaningful use-certified, comprehensive, 
ambulatory
EHR David entered health-care in 2001 as CTO for the OpenEHR project.
 One of the first companies to try commercializing open source healthcare 
systems
, OpenEHR met face first with the difficult realities of bringing proven 
mainstream
technologies into the complicated and some-
times nonsensical world of healthcare.

Secondly, a nonsensical statement about openEHR in the book...
p.161
OpenGALEN and OpenEHR are both attempts to promote open source ontology con-
cepts. Both of the projects have been maturing but some view these as 
unnecessary
additions or alternatives to SNOMED+UMLS. However, they are available under open
source licensing terms might make them a better alternative to SNOMED for 
certain
jurisdictions.

And this, p163...

OpenEHR is a controversial approach to applying knowledge engineering principles
to the entire EHR, including things like the user interfaces. You might think 
of Open-
EHR as an ontology for EHR software design. Many health informaticists disagree 
on
the usefulness of OpenEHR. Some believe that HL7 RIM, given its comprehensive
nature, is the highest level to which formal clinical knowledge managing needs 
to go.

I'm beginning to lose all respect for O'Reilly press. It's been all downhill 
since the camel book.

Cheers
Michael Osborne



--
Michael Osborne




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