Link between goals and other clinical concepts

Thomas Beale thomas.beale at
Thu Jun 26 03:57:08 EDT 2014

On 26/06/2014 08:33, Bert Verhees wrote:
>>> You can use multiple in archetypes-based reference models to 
>>> validate and store and query data. You can allow certain parts of an 
>>> healthcare organization, without any technical provision, to 
>>> implement new ideas about medical data structures, maybe necessary 
>>> for specific treatment.
>> sure, but like I said, this is just the same problem moved up one 
>> level. At some point, you still have to write classes with the 
>> semantics of things like Observation or Composition or whatever.  
>> Otherwise you can't get the data on the screen, or compute with it in 
>> any meaningful way.
> I think this can be solved with templates and information which can be 
> in the archetype-meta-data. Don't you agree? What am I missing?

example: this structure 
is inside an openEHR OBSERVATION, and most implementations use full 
Java/C#/other implementations of these classes. That enables you to do 
things like handle openEHR OBSERVATION data representing time series 
from a device natively, including varying periodicity, varying sample 
widths, and varying math functions (max, min, ave etc). This makes it 
very easy for an implementer to get time-based data from an EHR and 
populate a screen graph widget.

Without any of this built in, e.g. as in 13606, CDA, or other models, 
you have no guarantee that this kind of data (very common you will 
appreciate) is even represented in a standard way, nor do you have any 
classes to process it with. You have to assume that each CDA or 13606 
data source has its own representation of such data, and build N 
implementations to deal with it. For openEHR implementers, openEHR is 
the target data, so we convert data into openEHR, which is a 
higher-fidelity format, and the problems go away. You could potentially 
convert them into a sort of standardised 13606, representing the same 
thing but then you'd still have to build your own classes to implement 
time-based data rather than re-use the standard classes everyone else 
uses. I don't see the point. Especially as openEHR has AQL.

Now, there are things that are not actually in openEHR, that you might 
want. So you can take the 'reference archetype' approach to that, and 
build local classes. But you might as well still use openEHR as 13606 or 
CDA as the basis, since you will get more for free - if you make your 
local native format something completely custom, then there is no 
community or software you can use - you have to build everything yourself.

- thomas

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