lessons from Intermountain Health, and starting work on openEHR 2.x
thomas.beale at oceaninformatics.com
Thu Oct 4 12:07:01 EDT 2012
On 03/10/2012 23:26, Gerard Freriks wrote:
>> I just care about getting one model....
> In the case of 13606 _one good model _that describes a generic
> interface for EHR communication, also, for communication with other
> proprietary EHR solutions.
> In the case of openEHR _one good model_ that describes one particular
> implementation of an EHR-system.
> This difference is something the EN1366 Association cares about.
well except that the above is a misunderstanding of openEHR, so if the
13606 association works on that basis they will miss the opportunity to
get harmonisation. openEHR is a model for an open EHR (it's in the name
;-), and includes three kinds of semantics:
* core semantics that apply for any use of health information -
messages, EHR systems, documents etc
* semantics that describe accessing EHR information in repositories -
* semantics that describe EHR information in an Extract from one
system to another - any kind of system
These are used to specify the interfaces of EHR systems, EHR gateways
(that sit next to existing EMR systems), and EHR Extracts. The openEHR
architecture describes the externally shareable information semantics,
not the internal implementation. The implementations are the business of
vendors, and are all different. In other words, openEHR is an
interoperability description of the system - how the information and
services look from the outside.
Insofar as 13606 has been used (uptake by industry vendors appears very
low as far as we can tell), it has been used to build either EHR systems
or gateways, rarely messages, which is what it designed for. This seems
a fair indication that what the sector wants is a specification for the
interoperability interface of the systems and gateways required to even
connect a healthcare enterprise to the outside world - and additionally,
a specification for making EHR Extracts in these systems.
A specification only for EHR Extracts is not that useful, what the
sector clearly wants are specifications of the interoperability
interface of systems, as well as messages they might create. That's the
opportunity here for us working on these standards.
13606 needs to be updated a priori, and has lessons from use waiting to
be implemented; openEHR has lessons from the last 5 years of use which
will lead to changes, so there is scope for change and harmonisation. I
think the community here, and also the stakeholders are interested in
practical proposals for a new set of standards that actually address needs.
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