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 »
The CDA ‘dual-content’ conundrum
28/01/2012
3 Comments | 
Health Informatics | Tagged: CDA, e-health, EHRs, HL7, standards | 
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Posted by wolandscat
DCM – Data Types and Reference Model considerations
11/09/2011Following 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’.
Read the rest of this entry »
1 Comment | Health Informatics, openehr | Tagged: archetype, CEN, DCM, Health Informatics, HL7, ISO, ISO 21090, models, openEHR | Permalink
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Information models, DCMs and Archetypes
07/07/2011I will be attending a ‘Fresh Look’ meeting in Washington next week. The idea is to make some progress on the topic of ‘detailed clinical models’ (DCMs). Some of the goals include setting up a repository of DCMs, establishing governance, and defining a roadmap for tooling. Underlying all this is a huge list of formalisms and models, including OWL, UML, ADL, HL7 MIF, XSD, LRA, RMIMs, CDA templates, greenCDA and so on.
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7 Comments | Computing, Health Informatics, openehr | Tagged: archetype, e-health, HL7, models, openEHR, standards | Permalink
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Detailed Clinical Models (DCMs) – some basic facts
03/06/2011The New Zealand e-health programme architecture task-force has published its Working Interoperability Reference Architecture blueprint document. With respect to the document and the comments posted (I tried to post myself, but the comment disappeared), it seems worth making a couple of points on DCMs, of whatever flavour. If a DCM is to be expressed in a way useful to building and managing health IT infrastructure, there are two possibilities. Read the rest of this entry »
5 Comments | Health Informatics, openehr | Tagged: archetype, DCM, e-health, Health Informatics, HL7, openEHR, standards | Permalink
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Ontologies and information models: a uniting principle
24/05/2011Software developers and ontologists generally live in two different worlds. The former group think they are building systems to perform information processing and computation, and the latter group think they are formally describing some aspect of the world.
[Note: slight change to wording of FOPP on 30/May/2011]
9 Comments | Computing, Health Informatics | Tagged: Health Informatics, HL7, ontologies, software engineering, standards | Permalink
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The HL7 Null Flavor Debate – part 2
18/05/2011Previous: HL7 null flavors part 1
Null flavors – Objection #3: ontological problems
The following table shows the current HL7v3 null flavor values. A full version of the table appears in Grahame Grieve’s blog post. Read the rest of this entry »
4 Comments | Computing, Health Informatics, openehr | Tagged: data types, Health Informatics, HL7, ISO 21090, models, openEHR, standards | Permalink
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The HL7 Null Flavor Debate – part 1
18/05/2011(With apologies to those who use international English and normally spell it as ‘flavour’; in this post, I will spell it properly in informal text, and in the US way when referring to the formal HL7 null flavour concept.)
Grahame Grieve has pointed out in a recent blog post that I am a major critic of HL7 ‘null flavours’. This is correct, but the reasons are probably misunderstood, so I will try to clarify here. Read the rest of this entry »
7 Comments | Computing, Health Informatics, openehr | Tagged: data types, Health Informatics, HL7, ISO, ISO 21090, models, openEHR, standards | Permalink
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How could HL7 refresh?
01/05/2011Continuing on from the basis established in the previous post, here I will say what I think HL7 could do to help here. My suggestions are as follows: Read the rest of this entry »
2 Comments | Health Informatics | Tagged: e-health, HL7, openEHR, standards | Permalink
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What needs fixing in e-health?
01/05/2011or, e-health seen through the prism of an ancient pantheon of gods…
Grahame Grieve’s recent blog entry on the HL7 Fresh Look Task Force seems a good excuse for me to have another big picture look at e-health. The fact that HL7 is doing this indicates two things at least: that it thinks something is wrong in the HL7 organisation, and that it thinks something is not going right in e-health in general. That’s good to see. HL7 has been the single most influential standards body in e-health for at least 15 years. It has spent massive effort in the last decade on an effort called HL7v3, or ‘version 3′. This effort has not been a resounding success, indeed the evidence indicates the opposite. I have historically been one of the strongest critics of the technical architecture of this effort, so my statements here won’t come as any surprise. To give credit where it is due however, I have come to see that HL7 was trying to the right kind of thing, just that they lacked the appropriate expertise to do it. Solving the challenges in the area of e-health is no mean feat, and maybe some of them are unsolvable, so take that statement as a commiseration rather than a criticism. Read the rest of this entry »
2 Comments | Computing, Health Informatics | Tagged: e-health, Health Informatics, HL7, standards | Permalink
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The crisis in e-health standards III – solutions
18/10/2009Prev: The crisis in e-health standards IIa
Stakeholder Aspirations and Needs
Before going so far as to offer a solution to the e-health standards problem, I want to have a look at what we consider to be the requirements that such standards, and indeed health informatics in general is meant to address.
The most typically repeated aspirations I hear regularly from government e-health programmes (which are usually staffed by ‘believers’ in e-health) include the following: Read the rest of this entry »
5 Comments | Health Informatics, openehr | Tagged: 13606, ehealth, Health Informatics, HL7, IHTSDO, ISO, openEHR, standards | Permalink
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