Category Archives: Health Informatics

Directions in clinical guideline programming – CHA2DS2-VASc

Posted on 29/03/2021 by wolandscat

The above shows a typical web form calculator for the CHA2DS2-VASc score, used for estimating the risk of stroke in patients with non-rheumatic atrial fibrillation (AF), primarily for the purpose of deciding the use of anti-coagulant therapy [Wikipedia]. How would such … Continue reading →

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Aide Memoire for Computable Domain Models

Posted on 16/02/2021 by wolandscat

Sometimes a graphic is worth more than words. This is an attempt to capture all the salient features of multi-level modelling, the openEHR way. See the openEHR primer for the story. Although this is ‘our way’ of doing it, I … Continue reading →

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Clinical Decision Logic Fun

Posted on 22/10/2020 by wolandscat

How close can we get to making a clinical decision logic language look like the published guidelines which it is used to encode? Below is an openEHR Decision Logic Module (DLM) example, in the current form of the openEHR Decision … Continue reading →

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Towards a standard analysis of computable guidelines, clinical workflow, decision support and … the curly braces problem

Posted on 24/06/2020 by wolandscat

Why don’t we have widespread clinical decision support (CDS), computable guidelines, clinical workflow (plans), and why don’t the pieces we do have talk to the health record? The first time I heard such challenges framed was around 2000, and even … Continue reading →

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FHIR Fixes – the choice construct part I

Posted on 09/03/2020 by wolandscat

I have posted before on the FHIR ‘choice’ construct, particularly here, where I have explained the problems of the choice construct (essentially: it’s an ad hoc constraint construct that subverts the type system, and doesn’t belong in typed formalisms; none … Continue reading →

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FHIR fixes: why a type hierarchy would help

Posted on 14/11/2019 by wolandscat

One of the principal reasons for why I and others are proposing (some) type hierarchy in the FHIR Admin resources is as follows (my earlier post on this). Working Groups (i.e. committees) building Resources are currently in the situation of … Continue reading →

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FHIR Fixes – the Observation.value problem

Posted on 12/09/2019 by wolandscat

As described in some detail in this earlier post on the FHIR formalism, a number of FHIR Resources contain ‘choice’ attributes of the form attribute[x], such as the one shown above in Observation. These are mapped in the FHIR UML … Continue reading →

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Fixes for FHIR – the Admin Resources

Posted on 11/09/2019 by wolandscat

In this post I revisit the issues with the FHIR Resources described in the earlier post – A FHIR experience: models or just definitions? To summarise: FHIR has no semantic inheritance, only a generic structural inheritance of Resources from abstract … Continue reading →

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Improving Process State Representation in FHIR

Posted on 08/06/2019 by wolandscat

In this post I document further observations on the FHIR resources, made during the transcription of the DSTU4 FHIR resources to the BMM format used in openEHR, as described here. This post examines the definition of process state in FHIR … Continue reading →

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FHIR versus the EHR

Posted on 24/05/2019 by wolandscat

One of the many things the FHIR silver bullet hype claims FHIR will solve is the EHR, along with Clinical Decision Support (CDS), Care Pathways, and who knows, paving driveways and launching spacecraft. I have made various arguments against silver … Continue reading →

Posted in FHIR, Health Informatics, openehr, standards | Tagged , , , | 1 Comment