Some readers may have read my previous post FHIR compared to openEHR. If not, I recommend you do, it is available in Spanish, Japanese and Chinese as well as English. Here I aim to clarify some of the concrete differences which are increasingly common sources of confusion, particularly with the FHIR hype wave preventing coherent thinking in many places. It seems that the human psychological pre-disposition for uncritical silver bullet thinking is as strong as ever, but I still hope (perhaps vainly) that in e-health we can soon get back to real science and engineering.
For decades, most of us working in health informatics and e-health have lived on the assumption that ‘interoperability’ is one of the main things we are trying to achieve, and that it is the most important because the lack of it blocks progress on nearly every other priority. In the last decade, the gold version of interoperability has become ‘semantic interoperability’, a fabled Nirvana in which today’s sewers of recalcitrant proprietary data are magically transformed into a sea of pure Evian whose meaningful molecules will be ‘understood’ by drooling next generation apps that will instantly discover what is wrong with each of us, and tell us how to fix it.
The openEHR Basic Meta-Model (BMM) that has been in use in some form for nearly 10 years now was recently upgraded to version 3.0.0 (from 2.x), with the persistence format (now called P_BMM) being backwards-compatibly upgraded to version 2.3. The purpose of the upgrade was to improve the separation of class and type, and to greatly strengthen the semantics of generic types and classes.
I just returned from Heidelberg, where another very successful ‘openEHR day’ was held, this time by the HiGHmed research consortium, with 100 attendees. HiGHmed is funded with 20m€ by the German Federal Ministry of Education and Research (BMBF) under the “Medical Informatics” funding scheme, and has as its goal (my bolding):
Amazon, Apple, and Google are all having another go at e-Health. But we have been here before: remember Microsoft HealthVault? It’s still around, and still hasn’t taken off. Google Health went live in 2008, but was retired at end of 2011, due to ‘lack of adoption’.
Fast forward to 2018, and we see Apple, Amazon, Google and Uber making new e-Health plays. Initially each corporation will probably work from its strengths – retail delivery for Amazon, booking for Uber, data for Google, and devices for Apple. In the US at least, some of them will build their own healthcare providers for the workforce, and use the environment as a place to work on next-generation health IT solutions. Some challenges, particularly in the devices area, will undoubtedly see progress – there is no doubt that the tech giants do some things really well.
The REST API Team (Bostjan Lah, Erik Sundvall, Sebastian Iancu, Heath Frankel, Pablo Pazos, and others on the openEHR SEC and elsewhere) have made a 0.9.0 Release of the openEHR ITS (Implementation Technology Specifications) component, in order to make a pre-1.0.0 release of the REST APIs available for wider comment.