Feedback on an archetype governance issue please
Hi One side point: Grahame advises that from a pure semantic view, pathology tests are really a subset of lab tests and justifies using a more specific term. What I recall is that we said that In Australia lab and pathology are synonymous, and that everyone uses pathology. However this is not at all true in the US, for instance, where common usage is that pathology = histopathology. I think we settled on pathology in the Australian ckm because we were having enough trouble with names without introducing international alignment there too. I expected that the name would revert to lab when the work was migrated to the main ckm. Grahame On 27/07/2012, at 11:47 PM, Kalra, Dipak d.kalra at ucl.ac.uk wrote: Dear Heather, Thank you for sharing this challenge of defining good practice. Firstly it was very helpful to have your description of the background to the changes made, and to be able to look at both archetypes side-by-side. This makes it easy to see the details not only which nodes have changed, but also to identify the impact that new nodes will have on what information might be placed in nodes that have not changed. My reflections, some of which reiterate what you've said. 1) The NEHTA Pathology Test Result archetype is substantially different from the original Laboratory test archetype. It is not a minor tweak, and it is not backwardly compatible. 2) The scope of both is sufficiently the same that it would not be justified to retain both as current usable archetypes. 3) Even though it is classified as draft, for the reasons you give and the fact that it has been accessible since 2009, the original Laboratory test archetype should be deprecated but not purged. The NEHTA Pathology Test Result archetype is the appropriate successor. 4) It is unfortunate that our archetype identifiers contain strings that imply the concept. We seem here to have two Concept Name strings that are physically different, but are colloquially often considered synonyms. One would surely wish to find the NEHTA path archetype whether searching for a pathology or a laboratory test result archetype? Ideally one would modify both archetypes to include both concepts, or attach a synonym to each to enable them to be cross-referenced (e.g. via the Keywords?). If that is felt not to be appropriate, it would make sense for them both to be classified as pathology test results. (These tests are no longer only done in laboratories!) 5) Any EHR system that has accumulated data according to the old archetype, and any applications that present data or capture data fashioned according to that archetype, will need significant change to use the new one. Changing archetype IDs would seem to be a very small portion of the overall workload involved and yet actually quite important for clinical governance. Whether the NEHTA path archetype identifier includes letters that read like the word lab or letters that read like to work path, and contains a version integer that is one or two, is less important than knowing that it is a unique identifier which is not the same as the older archetype, and that there is a means of knowing in the repository that one is deprecated and the other has succeeded it. I appreciate that this is sometimes done by keeping the archetype identifier string the same and notching up the version integer. Surely this case illustrates why that might not always prove a robust method? I must confess that I have read your options a few times but haven't formed a firm impression on which one is the right choice. I appreciate this may be unhelpful, and apologise for this, but I hope my reasoning above at least helps you, Ian and others to come to a good decision! Well done for pushing the challenges and quality assurance of archetype development to such a high standard that these issues surface and cause us difficulty. It's a real tribute to your success. With best wishes, Dipak Dipak Kalra Clinical Professor of Health Informatics Director, Centre for Health Informatics and Multiprofessional Education University College London Holborn Union Building, Highgate Hill, London N19 5LW Honorary Consultant, The Whittington Hospital NHS Trust, London Phone: +44-20-7288-5966 On 27 Jul 2012, at 01:29, Heather Leslie heather.leslie at oceaninformatics.com wrote: Hi everyone, Ian McNicoll and I, as openEHR CKM Knowledge Administrators, are seeking some feedback regarding a complex governance process in the openEHR CKM. It is a complex area and we will still be learning for some time to come. Your thoughts will help us to develop our current processes further? We have had many archetypes in the draft state for some time in CKM. We think it likely that a number have been used within systems, despite the draft status. We don?t have any metrics
Feedback on an archetype governance issue please
'Histopathology test results' should by definition only include cell/tissue sample diagnostics, which would exclude molecular tests. As measurement devices become available outside the laboratory, simpler to operate and cheaper, 'Laboratory results' become a subset of diagnostic tests. 'Pathology' and 'Laboratory Results' are both subsets of 'Diagnostic tests': those diagnostic tests that use devices or processes that need monitoring by lab assistants or device auditors. The results should be communicated to the eHR using the same protocol. On Heather's original question, I agree with Option 1, making it clear that the old archetype is a 'deprecated draft', annotating it with a reference to the new archetype. Regards, Colin Sutton From: openehr-technical-bounces at lists.openehr.org [openehr-technical-bounces at lists.openehr.org] On Behalf Of Grahame Grieve [graha...@gmail.com] Sent: Saturday, 28 July 2012 7:14 AM To: For openEHR technical discussions Cc: For openEHR technical discussions; openehr-implementers at openehr.org Subject: Re: Feedback on an archetype governance issue please Hi One side point: Grahame advises that from a pure semantic view, pathology tests are really a subset of lab tests and justifies using a more specific term. What I recall is that we said that In Australia lab and pathology are synonymous, and that everyone uses pathology. However this is not at all true in the US, for instance, where common usage is that pathology = histopathology. I think we settled on pathology in the Australian ckm because we were having enough trouble with names without introducing international alignment there too. I expected that the name would revert to lab when the work was migrated to the main ckm. Grahame On 27/07/2012, at 11:47 PM, Kalra, Dipak d.kalra at ucl.ac.ukmailto:d.kalra at ucl.ac.uk wrote: Dear Heather, Thank you for sharing this challenge of defining good practice. Firstly it was very helpful to have your description of the background to the changes made, and to be able to look at both archetypes side-by-side. This makes it easy to see the details not only which nodes have changed, but also to identify the impact that new nodes will have on what information might be placed in nodes that have not changed. My reflections, some of which reiterate what you've said. 1) The NEHTA Pathology Test Result archetype is substantially different from the original Laboratory test archetype. It is not a minor tweak, and it is not backwardly compatible. 2) The scope of both is sufficiently the same that it would not be justified to retain both as current usable archetypes. 3) Even though it is classified as draft, for the reasons you give and the fact that it has been accessible since 2009, the original Laboratory test archetype should be deprecated but not purged. The NEHTA Pathology Test Result archetype is the appropriate successor. 4) It is unfortunate that our archetype identifiers contain strings that imply the concept. We seem here to have two Concept Name strings that are physically different, but are colloquially often considered synonyms. One would surely wish to find the NEHTA path archetype whether searching for a pathology or a laboratory test result archetype? Ideally one would modify both archetypes to include both concepts, or attach a synonym to each to enable them to be cross-referenced (e.g. via the Keywords?). If that is felt not to be appropriate, it would make sense for them both to be classified as pathology test results. (These tests are no longer only done in laboratories!) 5) Any EHR system that has accumulated data according to the old archetype, and any applications that present data or capture data fashioned according to that archetype, will need significant change to use the new one. Changing archetype IDs would seem to be a very small portion of the overall workload involved and yet actually quite important for clinical governance. Whether the NEHTA path archetype identifier includes letters that read like the word lab or letters that read like to work path, and contains a version integer that is one or two, is less important than knowing that it is a unique identifier which is not the same as the older archetype, and that there is a means of knowing in the repository that one is deprecated and the other has succeeded it. I appreciate that this is sometimes done by keeping the archetype identifier string the same and notching up the version integer. Surely this case illustrates why that might not always prove a robust method? I must confess that I have read your options a few times but haven't formed a firm impression on which one is the right choice. I appreciate this may be unhelpful, and apologise for this, but I hope my reasoning above at least helps you, Ian and others to come to a good decision! Well done for pushing the challenges and quality assurance
Feedback on an archetype governance issue please
hi Colin The trouble with diagnostic tests is that this also includes other things that are contained in a different archetype - Imaging - and also other things for which the requirements were not in our scope, and therefore I'd have no confidence in it's use for them. Note that the imaging archetype and the pathology archetype are very similar, but they also differ in some minor but important ways. Grahame On Sat, Jul 28, 2012 at 10:50 AM, Colin Sutton Colin.Sutton at ctc.usyd.edu.au wrote: 'Histopathology test results' should by definition only include cell/tissue sample diagnostics, which would exclude molecular tests. As measurement devices become available outside the laboratory, simpler to operate and cheaper, 'Laboratory results' become a subset of diagnostic tests. 'Pathology' and 'Laboratory Results' are both subsets of 'Diagnostic tests': those diagnostic tests that use devices or processes that need monitoring by lab assistants or device auditors. The results should be communicated to the eHR using the same protocol. On Heather's original question, I agree with Option 1, making it clear that the old archetype is a 'deprecated draft', annotating it with a reference to the new archetype. Regards, Colin Sutton From: openehr-technical-bounces at lists.openehr.org [openehr-technical-bounces at lists.openehr.org] On Behalf Of Grahame Grieve [grahameg at gmail.com] Sent: Saturday, 28 July 2012 7:14 AM To: For openEHR technical discussions Cc: For openEHR technical discussions; openehr-implementers at openehr.org Subject: Re: Feedback on an archetype governance issue please Hi One side point: Grahame advises that from a pure semantic view, pathology tests are really a subset of lab tests and justifies using a more specific term. What I recall is that we said that In Australia lab and pathology are synonymous, and that everyone uses pathology. However this is not at all true in the US, for instance, where common usage is that pathology = histopathology. I think we settled on pathology in the Australian ckm because we were having enough trouble with names without introducing international alignment there too. I expected that the name would revert to lab when the work was migrated to the main ckm. Grahame On 27/07/2012, at 11:47 PM, Kalra, Dipak d.kalra at ucl.ac.ukmailto:d.kalra at ucl.ac.uk wrote: Dear Heather, Thank you for sharing this challenge of defining good practice. Firstly it was very helpful to have your description of the background to the changes made, and to be able to look at both archetypes side-by-side. This makes it easy to see the details not only which nodes have changed, but also to identify the impact that new nodes will have on what information might be placed in nodes that have not changed. My reflections, some of which reiterate what you've said. 1) The NEHTA Pathology Test Result archetype is substantially different from the original Laboratory test archetype. It is not a minor tweak, and it is not backwardly compatible. 2) The scope of both is sufficiently the same that it would not be justified to retain both as current usable archetypes. 3) Even though it is classified as draft, for the reasons you give and the fact that it has been accessible since 2009, the original Laboratory test archetype should be deprecated but not purged. The NEHTA Pathology Test Result archetype is the appropriate successor. 4) It is unfortunate that our archetype identifiers contain strings that imply the concept. We seem here to have two Concept Name strings that are physically different, but are colloquially often considered synonyms. One would surely wish to find the NEHTA path archetype whether searching for a pathology or a laboratory test result archetype? Ideally one would modify both archetypes to include both concepts, or attach a synonym to each to enable them to be cross-referenced (e.g. via the Keywords?). If that is felt not to be appropriate, it would make sense for them both to be classified as pathology test results. (These tests are no longer only done in laboratories!) 5) Any EHR system that has accumulated data according to the old archetype, and any applications that present data or capture data fashioned according to that archetype, will need significant change to use the new one. Changing archetype IDs would seem to be a very small portion of the overall workload involved and yet actually quite important for clinical governance. Whether the NEHTA path archetype identifier includes letters that read like the word lab or letters that read like to work path, and contains a version integer that is one or two, is less important than knowing that it is a unique identifier which is not the same as the older archetype, and that there is a means of knowing in the repository that one is deprecated
Feedback on an archetype governance issue please
Hi Grahame, I was only suggesting not to use the term 'Laboratory results' , since information from other devices could match the pattern: the accepted usage of 'Pathology' is better, in my opinion; I agree that separate constructs are more useful for imaging - and DNA results. regards, Colin From: openehr-technical-bounces at lists.openehr.org [openehr-technical-bounces at lists.openehr.org] On Behalf Of Grahame Grieve [grah...@healthintersections.com.au] Sent: Saturday, 28 July 2012 10:55 AM To: For openEHR technical discussions Subject: Re: Feedback on an archetype governance issue please hi Colin The trouble with diagnostic tests is that this also includes other things that are contained in a different archetype - Imaging - and also other things for which the requirements were not in our scope, and therefore I'd have no confidence in it's use for them. Note that the imaging archetype and the pathology archetype are very similar, but they also differ in some minor but important ways. Grahame On Sat, Jul 28, 2012 at 10:50 AM, Colin Sutton Colin.Sutton at ctc.usyd.edu.au wrote: 'Histopathology test results' should by definition only include cell/tissue sample diagnostics, which would exclude molecular tests. As measurement devices become available outside the laboratory, simpler to operate and cheaper, 'Laboratory results' become a subset of diagnostic tests. 'Pathology' and 'Laboratory Results' are both subsets of 'Diagnostic tests': those diagnostic tests that use devices or processes that need monitoring by lab assistants or device auditors. The results should be communicated to the eHR using the same protocol. On Heather's original question, I agree with Option 1, making it clear that the old archetype is a 'deprecated draft', annotating it with a reference to the new archetype. Regards, Colin Sutton From: openehr-technical-bounces at lists.openehr.org [openehr-technical-bounces at lists.openehr.org] On Behalf Of Grahame Grieve [grahameg at gmail.com] Sent: Saturday, 28 July 2012 7:14 AM To: For openEHR technical discussions Cc: For openEHR technical discussions; openehr-implementers at openehr.org Subject: Re: Feedback on an archetype governance issue please Hi One side point: Grahame advises that from a pure semantic view, pathology tests are really a subset of lab tests and justifies using a more specific term. What I recall is that we said that In Australia lab and pathology are synonymous, and that everyone uses pathology. However this is not at all true in the US, for instance, where common usage is that pathology = histopathology. I think we settled on pathology in the Australian ckm because we were having enough trouble with names without introducing international alignment there too. I expected that the name would revert to lab when the work was migrated to the main ckm. Grahame On 27/07/2012, at 11:47 PM, Kalra, Dipak d.kalra at ucl.ac.ukmailto:d.kalra at ucl.ac.uk wrote: Dear Heather, Thank you for sharing this challenge of defining good practice. Firstly it was very helpful to have your description of the background to the changes made, and to be able to look at both archetypes side-by-side. This makes it easy to see the details not only which nodes have changed, but also to identify the impact that new nodes will have on what information might be placed in nodes that have not changed. My reflections, some of which reiterate what you've said. 1) The NEHTA Pathology Test Result archetype is substantially different from the original Laboratory test archetype. It is not a minor tweak, and it is not backwardly compatible. 2) The scope of both is sufficiently the same that it would not be justified to retain both as current usable archetypes. 3) Even though it is classified as draft, for the reasons you give and the fact that it has been accessible since 2009, the original Laboratory test archetype should be deprecated but not purged. The NEHTA Pathology Test Result archetype is the appropriate successor. 4) It is unfortunate that our archetype identifiers contain strings that imply the concept. We seem here to have two Concept Name strings that are physically different, but are colloquially often considered synonyms. One would surely wish to find the NEHTA path archetype whether searching for a pathology or a laboratory test result archetype? Ideally one would modify both archetypes to include both concepts, or attach a synonym to each to enable them to be cross-referenced (e.g. via the Keywords?). If that is felt not to be appropriate, it would make sense for them both to be classified as pathology test results. (These tests are no longer only done in laboratories!) 5) Any EHR system that has accumulated data according to the old archetype, and any applications that present data
Feedback on an archetype governance issue please
HI Colin thanks. The problem is that this makes a lot of sense in Australia, but much less in, e.g. USA/Canada I can't speak to how it would work in UK or other non-english speaking countries. Grahame On Sat, Jul 28, 2012 at 11:19 AM, Colin Sutton Colin.Sutton at ctc.usyd.edu.au wrote: Hi Grahame, I was only suggesting not to use the term 'Laboratory results' , since information from other devices could match the pattern: the accepted usage of 'Pathology' is better, in my opinion; I agree that separate constructs are more useful for imaging - and DNA results. regards, Colin From: openehr-technical-bounces at lists.openehr.org [openehr-technical-bounces at lists.openehr.org] On Behalf Of Grahame Grieve [grahame at healthintersections.com.au] Sent: Saturday, 28 July 2012 10:55 AM To: For openEHR technical discussions Subject: Re: Feedback on an archetype governance issue please hi Colin The trouble with diagnostic tests is that this also includes other things that are contained in a different archetype - Imaging - and also other things for which the requirements were not in our scope, and therefore I'd have no confidence in it's use for them. Note that the imaging archetype and the pathology archetype are very similar, but they also differ in some minor but important ways. Grahame On Sat, Jul 28, 2012 at 10:50 AM, Colin Sutton Colin.Sutton at ctc.usyd.edu.au wrote: 'Histopathology test results' should by definition only include cell/tissue sample diagnostics, which would exclude molecular tests. As measurement devices become available outside the laboratory, simpler to operate and cheaper, 'Laboratory results' become a subset of diagnostic tests. 'Pathology' and 'Laboratory Results' are both subsets of 'Diagnostic tests': those diagnostic tests that use devices or processes that need monitoring by lab assistants or device auditors. The results should be communicated to the eHR using the same protocol. On Heather's original question, I agree with Option 1, making it clear that the old archetype is a 'deprecated draft', annotating it with a reference to the new archetype. Regards, Colin Sutton From: openehr-technical-bounces at lists.openehr.org [openehr-technical-bounces at lists.openehr.org] On Behalf Of Grahame Grieve [grahameg at gmail.com] Sent: Saturday, 28 July 2012 7:14 AM To: For openEHR technical discussions Cc: For openEHR technical discussions; openehr-implementers at openehr.org Subject: Re: Feedback on an archetype governance issue please Hi One side point: Grahame advises that from a pure semantic view, pathology tests are really a subset of lab tests and justifies using a more specific term. What I recall is that we said that In Australia lab and pathology are synonymous, and that everyone uses pathology. However this is not at all true in the US, for instance, where common usage is that pathology = histopathology. I think we settled on pathology in the Australian ckm because we were having enough trouble with names without introducing international alignment there too. I expected that the name would revert to lab when the work was migrated to the main ckm. Grahame On 27/07/2012, at 11:47 PM, Kalra, Dipak d.kalra at ucl.ac.ukmailto:d.kalra at ucl.ac.uk wrote: Dear Heather, Thank you for sharing this challenge of defining good practice. Firstly it was very helpful to have your description of the background to the changes made, and to be able to look at both archetypes side-by-side. This makes it easy to see the details not only which nodes have changed, but also to identify the impact that new nodes will have on what information might be placed in nodes that have not changed. My reflections, some of which reiterate what you've said. 1) The NEHTA Pathology Test Result archetype is substantially different from the original Laboratory test archetype. It is not a minor tweak, and it is not backwardly compatible. 2) The scope of both is sufficiently the same that it would not be justified to retain both as current usable archetypes. 3) Even though it is classified as draft, for the reasons you give and the fact that it has been accessible since 2009, the original Laboratory test archetype should be deprecated but not purged. The NEHTA Pathology Test Result archetype is the appropriate successor. 4) It is unfortunate that our archetype identifiers contain strings that imply the concept. We seem here to have two Concept Name strings that are physically different, but are colloquially often considered synonyms. One would surely wish to find the NEHTA path archetype whether searching for a pathology or a laboratory test result archetype? Ideally one would modify both archetypes to include both concepts, or attach a synonym to each to enable them to be cross-referenced
Feedback on an archetype governance issue please
Hi everyone, Ian McNicoll and I, as openEHR CKM Knowledge Administrators, are seeking some feedback regarding a complex governance process in the openEHR CKM. It is a complex area and we will still be learning for some time to come. Your thoughts will help us to develop our current processes further. We have had many archetypes in the draft state for some time in CKM. We think it likely that a number have been used within systems, despite the draft status. We don't have any metrics on the extent of the use - there is no reliable way to tell from downloads of the models, nor any voluntary usage system - but that issue is for solving in the future and not the purpose of this email. While we have a specific use case in mind at present, this scenario has the potential to re- occur with some of the current archetypes that have been in draft state for a length of time. So principles of governance are of high priority, not just reacting to management of one specific model in isolation. Within the Australian context, Grahame Grieve has collaborated to update the current OBSERVATION.lab-test archetype -http://www.openehr.org/knowledge/OKM.html#showarchetype_1013.1.350 - (first authored in 2009), consistent with his knowledge of lab systems and HL7 practice. While there are many data elements consistent with the openEHR archetype, the new NEHTA archetype - http://dcm.nehta.org.au/ckm/OKM.html#showarchetype_1013.1.1019_5 (and currently on a branch) - has had to change in a number of ways to cater for additional use cases and including more alignment with v2 messaging etc - all very useful, I'm sure you'll agree. The NEHTA archetype therefore really reflects our current understanding of 'best practice', although the archetype will no doubt undergo some further refinement in a collaborative review process. So, the major changes affecting implementers: . The ID and concept name of the new archetype has been changed to OBSERVATION.pathology_test and 'Pathology Test Result'. Grahame advises that from a pure semantic view, pathology tests are really a subset of lab tests and justifies using a more specific term. . Unfortunately, the data changes are not backwardly compatible, especially the 'Result' node - largely because of the creation of new paths, rather than deletion of data elements. In the data elements that persist, the atcodes have been carried through into the new archetype to minimise potential confusion, although sometimes the names have been finessed a little J. . There are some new data elements, but these will not impact implementers in the same way as the first two dot points. Our usual governance policy, which I think works sensibly in principle, is that while an archetype is in a draft state, any implementation is at risk as until collaboration has taken place and consensus reached by the review team, it is possible and indeed very likely that the archetype will undergo significant change from its initial upload, and this usually involved breaking changes as we update structure and change paths etc during the refinement process. While Editors seek to ensure only reasonable models are uploaded in the first place, there is no guarantee that they will not change significantly as domain experts impart their wisdom! Further, once an archetype is published as v1, then the current policy requires that backwardly compatible changes can be managed by creating a new revision of the archetype but non-backwardly compatible changes require a new version of the archetype as v2, v3 etc. So in this special situation, where we suspect that there has been a number of implementations of the original draft archetype, we are interested in receiving your feedback as to process you prefer. In all situations, implementers will need to manage the new archetype data element structure in their systems. All options have pros and cons: . Option 1: Reject the original draft 'Laboratory test' archetype and upload the new 'Pathology Test Result' archetype, making sure there is adequate supportive information for implementers to understand why the archetype has been rejected and what has replaced it. All provenance of the original 'Laboratory test' archetype will be preserved. The new Pathology Test Result' v1 archetype will contain a reference to the openEHR 'Laboratory Test' v1 archetype and the NEHTA archetype in its metadata to support provenance (ie provenance will be preserved and the location will be made explicit). o Implementers: will have to modify their systems with the new archetype ID and structure o Knowledge Governance: Semantically clean way to ensure that the CKM pool of archetypes is representing academic best practice. . Option 2: Update the current archetype ID (lab_test.v1 to pathology_test.v1) and Concept name from 'Laboratory test' to 'Pathology Test Result', then upload the new 'Pathology Test Result' archetype content - keeping
Feedback on an archetype governance issue please
Dear Heather, Thank you for sharing this challenge of defining good practice. Firstly it was very helpful to have your description of the background to the changes made, and to be able to look at both archetypes side-by-side. This makes it easy to see the details not only which nodes have changed, but also to identify the impact that new nodes will have on what information might be placed in nodes that have not changed. My reflections, some of which reiterate what you've said. 1) The NEHTA Pathology Test Result archetype is substantially different from the original Laboratory test archetype. It is not a minor tweak, and it is not backwardly compatible. 2) The scope of both is sufficiently the same that it would not be justified to retain both as current usable archetypes. 3) Even though it is classified as draft, for the reasons you give and the fact that it has been accessible since 2009, the original Laboratory test archetype should be deprecated but not purged. The NEHTA Pathology Test Result archetype is the appropriate successor. 4) It is unfortunate that our archetype identifiers contain strings that imply the concept. We seem here to have two Concept Name strings that are physically different, but are colloquially often considered synonyms. One would surely wish to find the NEHTA path archetype whether searching for a pathology or a laboratory test result archetype? Ideally one would modify both archetypes to include both concepts, or attach a synonym to each to enable them to be cross-referenced (e.g. via the Keywords?). If that is felt not to be appropriate, it would make sense for them both to be classified as pathology test results. (These tests are no longer only done in laboratories!) 5) Any EHR system that has accumulated data according to the old archetype, and any applications that present data or capture data fashioned according to that archetype, will need significant change to use the new one. Changing archetype IDs would seem to be a very small portion of the overall workload involved and yet actually quite important for clinical governance. Whether the NEHTA path archetype identifier includes letters that read like the word lab or letters that read like to work path, and contains a version integer that is one or two, is less important than knowing that it is a unique identifier which is not the same as the older archetype, and that there is a means of knowing in the repository that one is deprecated and the other has succeeded it. I appreciate that this is sometimes done by keeping the archetype identifier string the same and notching up the version integer. Surely this case illustrates why that might not always prove a robust method? I must confess that I have read your options a few times but haven't formed a firm impression on which one is the right choice. I appreciate this may be unhelpful, and apologise for this, but I hope my reasoning above at least helps you, Ian and others to come to a good decision! Well done for pushing the challenges and quality assurance of archetype development to such a high standard that these issues surface and cause us difficulty. It's a real tribute to your success. With best wishes, Dipak Dipak Kalra Clinical Professor of Health Informatics Director, Centre for Health Informatics and Multiprofessional Education University College London Holborn Union Building, Highgate Hill, London N19 5LW Honorary Consultant, The Whittington Hospital NHS Trust, London Phone: +44-20-7288-5966 On 27 Jul 2012, at 01:29, Heather Leslie heather.leslie at oceaninformatics.commailto:heather.leslie at oceaninformatics.com wrote: Hi everyone, Ian McNicoll and I, as openEHR CKM Knowledge Administrators, are seeking some feedback regarding a complex governance process in the openEHR CKM. It is a complex area and we will still be learning for some time to come. Your thoughts will help us to develop our current processes further? We have had many archetypes in the draft state for some time in CKM. We think it likely that a number have been used within systems, despite the draft status. We don?t have any metrics on the extent of the use ? there is no reliable way to tell from downloads of the models, nor any voluntary usage system ? but that issue is for solving in the future and not the purpose of this email. While we have a specific use case in mind at present, this scenario has the potential to re- occur with some of the current archetypes that have been in draft state for a length of time. So principles of governance are of high priority, not just reacting to management of one specific model in isolation. Within the Australian context, Grahame Grieve has collaborated to update the current OBSERVATION.lab-test archetype -http://www.openehr.org/knowledge/OKM.html#showarchetype_1013.1.350 - (first authored in 2009), consistent with his knowledge of lab
