SV: openEHR and IHTSDO (SNOMED CT)

2015-09-29 Thread Mikael Nyström
Hi,

My impression is that IHTSDO prioritize collaboration with organizations with 
products that are actively used in IHTSDO:s member countries. I guess that 
might be the reason why collaboration with for example WHO (ICD, ICF), 
Regenstrief Institute (LOINC) and International Council of Nurses (ICNP) have 
been prioritized in favor of openEHR. Proprietary information models are also 
more common than openEHR models and collaboration with the organizations 
(companies) behind the proprietary information models are probably done via 
IHTSDO's Vendor Liaison Forum.

Regards
Mikael


-Ursprungligt meddelande-
Från: openEHR-clinical [mailto:openehr-clinical-boun...@lists.openehr.org] För 
Hardiker Nicholas
Skickat: den 28 september 2015 18:58
Till: For openEHR clinical discussions 
Ämne: RE: openEHR and IHTSDO (SNOMED CT)

While the reasons for collaboration may be different, I felt like I should 
report that we have been working very successfully under a collaboration 
agreement between the International Council of Nurses and IHTSDO on the 
development of equivalency tables between the International Classification for 
Nursing Practice (ICNP) and SNOMED CT. I have no reason to doubt the 
possibility a similar arrangement between the openEHR Foundation and IHTSDO. 

With best wishes
 
Nick
 
Nick Hardiker RN PhD FACMI
Professor of Nursing and Health Informatics | Associate Dean (Research & 
Innovation) School of Nursing, Midwifery, Social Work & Social Sciences MS1.12, 
Mary Seacole Building, University of Salford, Salford  M6 6PU
t: +44 (0) 161 295 7013
n.r.hardi...@salford.ac.uk | www.salford.ac.uk 
www.seek.salford.ac.uk/profiles/HARDIKER514.jsp
 
Director, eHealth Programme, International Council of Nurses Professor 
(Adjunct), College of Nursing, University of Colorado Denver, USA 
Editor-in-Chief, Informatics for Health and Social Care
 



-Original Message-
From: openEHR-clinical [mailto:openehr-clinical-boun...@lists.openehr.org] On 
Behalf Of Mikael Nyström
Sent: 27 September 2015 17:08
To: For openEHR clinical discussions; Openehr-Technical
Subject: RE: openEHR and IHTSDO (SNOMED CT)

Hi Tom,

I found the responsible person at IHTSDO for the collaboration with openEHR 
Foundation. According to her, there are active discussions to be able to soon 
sign a collaborative agreement between IHTSDO and openEHR and then continue to 
work with how SNOMED CT and openEHR artefacts practically can be used together.

IHTSDO also states over and over again that SNOMED CT needs to be implemented 
together with good information models to reach its full potential and IHTSDO 
hosted (at least) the CIMI autumn meeting in Amsterdam last year. I therefore 
don't understand your very negative attitude towards IHTSDO collaboration Tom.

Regards
Mikael


-Original Message-
From: openEHR-clinical [mailto:openehr-clinical-boun...@lists.openehr.org] On 
Behalf Of Thomas Beale
Sent: den 26 september 2015 06:36
To: openehr-clini...@lists.openehr.org; Openehr-Technical
Subject: Re: openEHR and IHTSDO (SNOMED CT)


A number of approaches have been made in the recent past by openEHR and CIMI, 
led by Dr stan Huff. The outcome is that IHTSDO do not appear to be currently 
interested in a formal working relationship with the content modelling 
communities (openEHR, Intermountain Healthcare, CIMI, ISO 13606, ...).

I personally don't understand why, but this is the line they are taking. 
I'm not aware of any new plans.

None of this precludes openEHR actively using IHTSDO-issued standards and 
specifications, which we do. ADL / AOM 2 and tooling has now been converted to 
using IHTSDO concept referencing URIs for example.

- thomas

On 25/09/2015 18:26, Mikael Nyström wrote:
> Hi,
>
> I wonder if there are any current collaborations or collaboration 
> plans between openEHR Foundation and IHTSDO (which is the organisation 
> that owns and maintains SNOMED CT.)
>
>   Regards
>   Mikael
>
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> hr.org
>


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SNOMED CT constraint syntax - for querying instances or terminology?

2015-09-29 Thread Thomas Beale


The latest version of the SNOMED CT constraint language 
proposes expressions like the 
following:


Section 6.3

To find those capsules  that have a strength between 500 and 800 mg 
(inclusive), the following expression  constraint  may be used:


<  27658006 |amoxicillin| :
46001 |has  dose form| = <<  385049006 | capsule|,
{ 15 |has basis of strength| =  ( 15 |amoxicillin only| :
15 |strength magnitude| >=  #500, 15 |strength 
magnitude| <= #800,

15 |strength unit| =  258684004 |mg|)}

The purpose of this is apparently as a query to find instances of 
Amoxycillin recorded somewhere - presumably in EHRs, or some kind of 
prescriptions database? However, the document talks of executing queries 
over a 'Substrate', defined as 'The SNOMED CT content over which an 
expression constraint is evaluated or a query is executed.'.


Elsewhere (p12) it says:

Please  note  that  the  substrate  over which  the  expression  
constraint  is evaluated is  not explicitly defined within the 
expression constraint, and must therefore be established by some other 
means. By  default,  the assumed  substrate  is the  set of  active  
components  from  the snapshot release  (in distribution normal form) of 
the SNOMED CT versioned edition currently loaded into the given tool.


It is also not clear what the query really means - is it a query for 
Amoxycillin that has been prescribed for a specific patient? For any 
patient in some cohort? Or for a medication order that has been 
suspended, postponed, or completed?


More generally, I am not clear how the one language is intended to be 
used across SNOMED CT itself (e.g. to generate intentional ref sets) and 
also across instance data. If it's the former, it can only be 
concept-based; if the latter, the query won't correspond to whatever 
information model is in use for the data.


How would it be used with data based on (for example) the openEHR 
medication item archetype in the UK clinical models CKM 
, shown below?





The recommendations in section 7.5 for executing the queries seem to 
imply that they are for evaluation against SNOMED CT.


There are various other oddities, but I'll leave them for later.

if anyone who is working with this can clarify, it would be most 
appreciated.


- thomas
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Re: SNOMED CT constraint syntax - for querying instances or terminology?

2015-09-29 Thread Michael.Lawley
Hi Thomas,

These constraints are essentially queries over the snomed definitional content 
(ie the Relationships), not queries over external data (ie not EHRs).  The 
intent is to identify sets of snomed concepts that satisfy the constraint 
criteria. These sets could be subsequently used to join against/filter records 
in an EHR/EMR.

Work is ongoing for a full featured query language to address this larger 
problem, but the expression constraint language can be used to great effect 
when combined with SQL or other database tech to query health records.

Michael

Sent from my iPhone

On 29 Sep 2015, at 11:11 PM, Thomas Beale 
> 
wrote:


The latest version of the SNOMED CT constraint language 
 proposes expressions like the 
following:

Section 6.3

To find those capsules  that have a strength between 500 and 800 mg 
(inclusive), the following expression  constraint  may be used:

<  27658006 |amoxicillin| :
46001 |has  dose form| = <<  385049006 | capsule|,
{ 15 |has basis of strength| =  ( 15 |amoxicillin only| :
15 |strength magnitude| >=  #500, 15 |strength magnitude| <= 
#800,
15 |strength unit| =  258684004 |mg|)}

The purpose of this is apparently as a query to find instances of Amoxycillin 
recorded somewhere - presumably in EHRs, or some kind of prescriptions 
database? However, the document talks of executing queries over a 'Substrate', 
defined as 'The SNOMED CT content over which an expression constraint is 
evaluated or a query is executed.'.

Elsewhere (p12) it says:

Please  note  that  the  substrate  over which  the  expression  constraint  is 
evaluated is  not  explicitly defined within the expression constraint, and 
must therefore be established by some other means. By  default,  the  assumed  
substrate  is the  set of  active  components  from  the  snapshot release  (in 
distribution normal form) of the SNOMED CT versioned edition currently loaded 
into the given tool.

It is also not clear what the query really means - is it a query for 
Amoxycillin that has been prescribed for a specific patient? For any patient in 
some cohort? Or for a medication order that has been suspended, postponed, or 
completed?

More generally, I am not clear how the one language is intended to be used 
across SNOMED CT itself (e.g. to generate intentional ref sets) and also across 
instance data. If it's the former, it can only be concept-based; if the latter, 
the query won't correspond to whatever information model is in use for the data.

How would it be used with data based on (for example) the openEHR medication 
item archetype in the UK clinical models 
CKM, shown below?




The recommendations in section 7.5 for executing the queries seem to imply that 
they are for evaluation against SNOMED CT.

There are various other oddities, but I'll leave them for later.

if anyone who is working with this can clarify, it would be most appreciated.

- thomas
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