The CDA ‘dual-content’ conundrum

28/01/2012

In his recent blog post, Eric Browne highlights what may be a problem in the design of the Australian PCEHR, due to the well-known CDA feature allowing dual forms of content – text and structured, supposedly equivalent – to be stored in the one document. If Eric’s examples are representative of real data in the future PCEHR system, there is definitely a problem. In any case, there is a general problem, to do with common misuse of the CDA architecture, which itself should be changed to remove such possibilities. Read the rest of this entry »


CIMI group goes with openEHR archetypes & UML profile

14/12/2011

The Clinical Information Modelling Initiative (CIMI) group led by Dr Stan Huff (Intermountain Health, Utah) met here in London 29 Nov – 1 Dec to make a final decision on formalism, from the two remaining – openEHR archetypes and various forms of UML (previous posts on CIMI: DCMs & RM, on formalisms). Instead of simply choosing one, the group made a more strategic choice of designating openEHR ADL/AOM 1.5 as the core formalism, with a corresponding profile of UML being developed to enable the more numerous UML-based developers (e.g. VA, NHS etc) to use archetypes within their UML toolchains.

Here is the public announcement resulting from this meeting.

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Never the Bride: real rock with soul

28/11/2011

Every so often I walk over the river to the famous (among Jazz & eclectic music-heads in London at least) Bulls Head in Barnes. Every time I think I am going to see some small possibly interesting gig in the 100 or so seat jazz room. And every time I am blown away by quality, and I think, hm, this should be a 1,500 seat gig. London is funny like that. There are these strange places where hardly any people can fit, and superstar quality just turns up on any night of the week.

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And now the cine-bad: the Unwatchable Films List

22/11/2011

I created a new permanent page for Unwatchable Films. It’s a specific thing – not just bad films, but truly unviewable ones that have a similar effect to a general anaesthetic. They have their own criteria, and are nothing like the ’25 films so bad they’re unmissable’ lists you often see. I am talking cinema CRIMEs here. Please contribute.


Cinema, alive and well

20/11/2011

Over the last few months, I have managed to squeeze in enough thought-provoking films to think that my favourite medium is still alive and well. We drown daily in a such a stultifying rain of nonsense and noise that it sometimes it seems that any sign of intelligence must be a mistake. Here are some rays of hope.

Melancholia (dir. Lars von Trier): *** We need to talk about Kevin (dir. Lynne Ramsay) ***** The battle of Warsaw: 1920 (dir. Jerzy Hoffman) *** Incendies **** (dir. Denis Villeneuve) Tinker, Tailor, Soldier, Spy **** (dir. Tomas Alfredson) The Skin I Live In **1/2 (dir. Pedro Almodovar) The Debt ***1/2 (dir. John Madden).

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CIMI: purpose-built or jury-rigged?

14/11/2011
In recent weeks, the Clinical Information Modelling Initiative (CIMI), led by Stan Huff, has followed its stated process and is nearing a voting process in which a shared health domain modelling formalism is chosen. Proponents of each of the candidate formalisms have been asked to post arguments supporting their work.
A supporting statement for openEHR archetypes as the optimal formalism is posted here, on the CIMI wiki. We have not included any beautiful tool-based views, nor even the ‘latest and best clinical models’, following Stan’s request for the ‘raw’ technical view of the syntax. Accordingly, the only thing with even any colour in it is these screenshots of an ADL archetype in a raw text editor, with syntax highlighting on.
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Sunday, (pre-)occupied at St Paul’s Cathedral, London

07/11/2011

Today on the London tube I was reading the introduction to ‘The Monstrosity of Christ: paradox or dialectic?’, a debate between Slavoj Žižek and John Millbank, edited by Creston Davis, the latter the author of the introduction. My post here is not about the main subject matter of the book (two views of theology / christianity) but the final sentence of the introduction stayed with me for the day:

The monstrosity of Christ is the love either in paradox or in dialectics – and I believe, may be the pathway beyond the current popular-absolutist rule of finance, spectacle, and surveillance.

Although we can argue about the faith part of this (or even reject it out of hand), the two sides this statement resonate nowhere better right now than at tent city in the forecourt of St Paul’s cathedral, in the heart of the City of London.

Occupy London St Pauls Read the rest of this entry »


DCM – Data Types and Reference Model considerations

11/09/2011

Following the DCM meeting convened by Dr Stan Huff (Intermountain Healthcare) in Washington in July, reported in an earlier blog post, there is a further meeting this week in San Diego, which will discuss the issues of ‘data types’ and ‘reference models’ for the purpose of DCM (detailed clinical models).

I created two slideshows to explain my views on these matters (DCM_and_data_types and DCM_and_reference_model [both PDF]). Below is an extract of my arguments in these slideshows, based on experience, for adopting a particular approach to data types and reference model within the stated mission the DCM forum, which is to find formalism and attendant models in which to express universally shareable detailed clinical models. Naturally, my view on ‘the answer’ to that question is ‘openEHR (ADL/AOM) archetypes, templates and terminology’, but what I am providing below is not an argument supporting that, but one proposing how to proceed with respect to the ‘underlying models’.
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Why e-health really is hard

10/08/2011

Every so often, someone asks: why can’t the health sector get its act together with ICT? Tell me why health is ‘different’?

Dilbert

Dilbert - advances in healthcare

Every so often a new and interesting answer to this question pops up… Read the rest of this entry »


John McLaughlin – Ronnie Scotts London July 2011

03/08/2011

A bit late, due to holidays, but too good not to report. I saw the guitar legend and his band the 4th dimension at Ronnie Scott’s in London last month. Probably the most expensive tickets I have ever bought, but to be 10 feet from McLaughlin and the rest of the band … why not?

I won’t bother to try to describe his playing, you can find samples on youtube, but to give an idea, it was in the groove of a) his own music (of course) – louder and tighter than ever, b) reminiscent of Jeff Beck / Jan Hammer in the 80s and c) some sensibilities of Jan Akkerman, the great Dutch Jazz guitarist. McLaughlin goes further and harder than you expect – he plays great jazz lines over hard syncopated rock rhythms.

Gary Husband played keyboards, and as ever, is a great personality in stage. You never know quite what he is going to do. This gig, he left the keyboard for a while and went head to head in a drum duel with Ranjit Barot for around 10 minutes. The presence of two complete drumkits on the stage was a warning that something amusing was likely to happen. It was like the ‘cuttin’ heads’ scene in the Crossroads movie, but with humour. Translated into words… Barot: I’m the real guy here, cop this… Husband: wimp. Take this. Barot: just getting my overcoat off here. Whack! Husband: that sucked, eat my sticks! Barot: off my stage, pretender! …. you get the idea. Etienne Mbappe on bass was just a joy to listen to (especially for me, he was 3 feet away), punching out hard rhythms, lots of slap and melody.

Summary: a bunch of world class musicians + 1 legend in London’s most famous jazz club = perfection.


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