openEHR-clinical Digest, Vol 35, Issue 4

WILLIAM R4C wgoossen at results4care.nl
Wed Mar 11 09:16:03 EDT 2015


Hi all,

As one of the author's of the criticized paper by Blobel et al, I feel some need to react and give you some thoughts:

- OpenEHR after 20 or more years is still largely under construction. I have asked many times to get names and locations of reference sites where I can see a real world archetypes based system in action. No response.

- the approach with the archetypes is technology driven: implementation specific, not clinically driven. It lacks the basic conceptual, logical, implementation perspective of ISO 11179. In particular the logical modeling is what Blobel et all discuss.

- use and grounding the Modelling in formal ontologies is lacking in any of the Modelling approaches: HL7 templates, HL7 FHIR, OpenEHR archetypes, 13606 archetypes, CEMLS, CIMI, DCM in UML. The articles discussed that with respect to 3 examples. All modelers have a job to do. For justification have a look at semantic health net work.

- the GCM model allows a much deeper analysis of domain, modeling and implementation eg through domains on z axis, business bottom up and top down on y axis, and Reference Model – Open Distributed Processing (RM-ODP) system development standard on x axis.
OpenEHR, like many others have not a complete picture.

Of course you may critique a paper exposing this lack. But it feels like shooting the messenger(s) instead of listening to the message.

Guys, you've got work to do.

Vriendelijke groet,

Dr. William Goossen

Directeur Results 4 Care BV
+31654614458

> Op 11 mrt. 2015 om 12:27 heeft openehr-clinical-request at lists.openehr.org het volgende geschreven:
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> Today's Topics:
> 
>   1. How to fix CKM biggest issue (Gustavo Bacelar)
>   2. Re: Clinical Modeling - A critical analysis (Thomas Beale)
>   3. RE: Clinical Modeling - A critical analysis (Rong Chen)
>   4. Re: Clinical Modeling - A critical analysis (Diego Bosc?)
>   5. SV: Clinical Modeling - A critical analysis (Mikael Nystr?m)
>   6. Re: How to fix CKM biggest issue (Sebastian Garde)
> 
> 
> ----------------------------------------------------------------------
> 
> Message: 1
> Date: Wed, 11 Mar 2015 09:54:12 +0000
> From: Gustavo Bacelar <gbacelar at gmail.com>
> To: openEHR clinical discussions <openehr-clinical at lists.openehr.org>
> Subject: How to fix CKM biggest issue
> Message-ID:
>    <CACVga3k-hQt8Qhx8tkvazvNgzyqj_C7U3jG6=f3q40UHF_nxrw at mail.gmail.com>
> Content-Type: text/plain; charset="utf-8"
> 
> Dear all,
> I would like to suggest some very important changes for governance model of
> CKM. As you all know, CKM is a keystone to openEHR, but its actual
> governance model is outdated and holds the development and inclusion of new
> archetypes.
> 
> As long as I know there are only 2 main editors that can import any type of
> archetypes to CKM. I'm an editor too, but I can only import to
> Ophthalmology Project and some other Incubators. The inclusion of new
> archetypes can not depend on only 2-3 people. It is a huge constraint to
> the development of openEHR, we must have more main editors.
> 
> What I propose is to follow a governance model similar to Wikipedia. It
> should be possible to anyone to submit archetypes, but these would be in a
> sandbox, which already exists: the Incubators. These would stimulate other
> participants of CKM to develop new archetypes and to improve them much
> faster. When an archetype is sufficiently mature, an editor would include
> it to public use.
> 
> Kind regards
> -- 
> Gustavo Bacelar
> MD + MBA + MSc Med Informatics
> Skype: gustavobacela
> ?r
> LinkedIn: pt.linkedin.com/in/gbacelar
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> ------------------------------
> 
> Message: 2
> Date: Wed, 11 Mar 2015 10:08:16 +0000
> From: Thomas Beale <thomas.beale at oceaninformatics.com>
> To: openehr-clinical at lists.openehr.org
> Subject: Re: Clinical Modeling - A critical analysis
> Message-ID: <55001410.30503 at oceaninformatics.com>
> Content-Type: text/plain; charset=utf-8; format=flowed
> 
> 
> I actually wrote to Jan Talmon about this when I was first aware of it 
> (30 Oct 2013) and gave him my opinion of the quality of the science in 
> this paper (it wasn't very positive;-). His view was that I / we / 
> someone should write a letter to the editor of IJMI in which the errors 
> / shortcomings are discussed. I did not do this for lack of time, but I 
> think it would make sense to still do this and/or write a much better 
> paper on the topic, which could cover actual evidence and science being 
> done in openEHR projects, Intermountain environment, and UPV projects as 
> well.
> 
> thoughts?
> 
> - thomas
> 
>> On 01/03/2015 20:38, Diego Bosc? wrote:
>> I agree, a response paper seems the most logical approach.
>> 
>> 2015-03-01 21:31 GMT+01:00 Koray Atalag <k.atalag at auckland.ac.nz>:
>>> I?m completely disappointed, but not surprised, that this paper was accepted
>>> as a scientific paper in the first place with such bold arguments.
>>> 
>>> We have all seen him advocating on openEHR during quite a few EU FP6 project
>>> proposals ? I certainly attended a few workshops together. At some point he
>>> must have been alienated or something?? At any rate I think it is our
>>> responsibility to publish a formal rebuttal and challenge this paper. That?s
>>> what science is about, isn?t it?
> 
> 
> 
> 
> 
> ------------------------------
> 
> Message: 3
> Date: Wed, 11 Mar 2015 10:33:35 +0000
> From: Rong Chen <Rong.Chen at cambio.se>
> To: For openEHR clinical discussions
>    <openehr-clinical at lists.openehr.org>
> Subject: RE: Clinical Modeling - A critical analysis
> Message-ID:
>    <3DA5EA8C5B1CC94F882C78D81C7D2EA41EA793EF at CSS-MAIL.cambio.se>
> Content-Type: text/plain; charset="utf-8"
> 
> Hi Thomas,
> I think it's a great idea! I fully support you on this.
> Best regards,
> Rong
> 
> Rong Chen, MD, PhD
> VP, Head of Medical Informatics Group 
> CMIO, Director of Health Informatics
> +46 8 691 49 81 
> ?
> Cambio+ Healthcare Systems AB
> Stockholm:
> Drottninggatan 89. SE-113 60 Stockholm
> Vx: +46 8 691 49 00 | Fax: +46 8 691 49 99
> Link?ping:
> Universitetsv?gen 14 SE-583 30 Link?ping
> Vx: +46 13 20 03 00 | Fax: +46 13 20 03 99
> Epost: info at cambio.se? | Hemsida: www.cambio.se 
> 
> -----Original Message-----
> From: openEHR-clinical [mailto:openehr-clinical-bounces at lists.openehr.org] On Behalf Of Thomas Beale
> Sent: 11 March 2015 11:08
> To: openehr-clinical at lists.openehr.org
> Subject: Re: Clinical Modeling - A critical analysis
> 
> 
> I actually wrote to Jan Talmon about this when I was first aware of it
> (30 Oct 2013) and gave him my opinion of the quality of the science in this paper (it wasn't very positive;-). His view was that I / we / someone should write a letter to the editor of IJMI in which the errors / shortcomings are discussed. I did not do this for lack of time, but I think it would make sense to still do this and/or write a much better paper on the topic, which could cover actual evidence and science being done in openEHR projects, Intermountain environment, and UPV projects as well.
> 
> thoughts?
> 
> - thomas
> 
>> On 01/03/2015 20:38, Diego Bosc? wrote:
>> I agree, a response paper seems the most logical approach.
>> 
>> 2015-03-01 21:31 GMT+01:00 Koray Atalag <k.atalag at auckland.ac.nz>:
>>> I?m completely disappointed, but not surprised, that this paper was 
>>> accepted as a scientific paper in the first place with such bold arguments.
>>> 
>>> We have all seen him advocating on openEHR during quite a few EU FP6 
>>> project proposals ? I certainly attended a few workshops together. At 
>>> some point he must have been alienated or something?? At any rate I 
>>> think it is our responsibility to publish a formal rebuttal and 
>>> challenge this paper. That?s what science is about, isn?t it?
> 
> 
> 
> _______________________________________________
> openEHR-clinical mailing list
> openEHR-clinical at lists.openehr.org
> http://lists.openehr.org/mailman/listinfo/openehr-clinical_lists.openehr.org
> 
> ------------------------------
> 
> Message: 4
> Date: Wed, 11 Mar 2015 11:35:58 +0100
> From: Diego Bosc? <yampeku at gmail.com>
> To: For openEHR clinical discussions
>    <openehr-clinical at lists.openehr.org>
> Subject: Re: Clinical Modeling - A critical analysis
> Message-ID:
>    <CAFx8UwDX2m48DSsuxOYprPx96zGvHxFWq40Z1B4y6DhkODRYfQ at mail.gmail.com>
> Content-Type: text/plain; charset=UTF-8
> 
> Count us in ;)
> 
> 2015-03-11 11:08 GMT+01:00 Thomas Beale <thomas.beale at oceaninformatics.com>:
>> 
>> I actually wrote to Jan Talmon about this when I was first aware of it (30
>> Oct 2013) and gave him my opinion of the quality of the science in this
>> paper (it wasn't very positive;-). His view was that I / we / someone should
>> write a letter to the editor of IJMI in which the errors / shortcomings are
>> discussed. I did not do this for lack of time, but I think it would make
>> sense to still do this and/or write a much better paper on the topic, which
>> could cover actual evidence and science being done in openEHR projects,
>> Intermountain environment, and UPV projects as well.
>> 
>> thoughts?
>> 
>> - thomas
>> 
>>> On 01/03/2015 20:38, Diego Bosc? wrote:
>>> 
>>> I agree, a response paper seems the most logical approach.
>>> 
>>> 2015-03-01 21:31 GMT+01:00 Koray Atalag <k.atalag at auckland.ac.nz>:
>>>> 
>>>> I?m completely disappointed, but not surprised, that this paper was
>>>> accepted
>>>> as a scientific paper in the first place with such bold arguments.
>>>> 
>>>> We have all seen him advocating on openEHR during quite a few EU FP6
>>>> project
>>>> proposals ? I certainly attended a few workshops together. At some point
>>>> he
>>>> must have been alienated or something?? At any rate I think it is our
>>>> responsibility to publish a formal rebuttal and challenge this paper.
>>>> That?s
>>>> what science is about, isn?t it?
>> 
>> 
>> 
>> _______________________________________________
>> openEHR-clinical mailing list
>> openEHR-clinical at lists.openehr.org
>> http://lists.openehr.org/mailman/listinfo/openehr-clinical_lists.openehr.org
> 
> 
> 
> ------------------------------
> 
> Message: 5
> Date: Wed, 11 Mar 2015 10:55:18 +0000
> From: Mikael Nystr?m <mikael.nystrom at liu.se>
> To: For openEHR clinical discussions
>    <openehr-clinical at lists.openehr.org>
> Subject: SV: Clinical Modeling - A critical analysis
> Message-ID:
>    <6091679361C5CD42AC63CBC47C4550C522DAE33A at MB1-2010.ad.liu.se>
> Content-Type: text/plain; charset="utf-8"
> 
> I might also be interested.
> 
>    Regards
>    Mikael
> 
> 
> -----Ursprungligt meddelande-----
> Fr?n: openEHR-clinical [mailto:openehr-clinical-bounces at lists.openehr.org] F?r Diego Bosc?
> Skickat: den 11 mars 2015 11:36
> Till: For openEHR clinical discussions
> ?mne: Re: Clinical Modeling - A critical analysis
> 
> Count us in ;)
> 
> 2015-03-11 11:08 GMT+01:00 Thomas Beale <thomas.beale at oceaninformatics.com>:
>> 
>> I actually wrote to Jan Talmon about this when I was first aware of it 
>> (30 Oct 2013) and gave him my opinion of the quality of the science in 
>> this paper (it wasn't very positive;-). His view was that I / we / 
>> someone should write a letter to the editor of IJMI in which the 
>> errors / shortcomings are discussed. I did not do this for lack of 
>> time, but I think it would make sense to still do this and/or write a 
>> much better paper on the topic, which could cover actual evidence and 
>> science being done in openEHR projects, Intermountain environment, and UPV projects as well.
>> 
>> thoughts?
>> 
>> - thomas
>> 
>>> On 01/03/2015 20:38, Diego Bosc? wrote:
>>> 
>>> I agree, a response paper seems the most logical approach.
>>> 
>>> 2015-03-01 21:31 GMT+01:00 Koray Atalag <k.atalag at auckland.ac.nz>:
>>>> 
>>>> I?m completely disappointed, but not surprised, that this paper was 
>>>> accepted as a scientific paper in the first place with such bold 
>>>> arguments.
>>>> 
>>>> We have all seen him advocating on openEHR during quite a few EU FP6 
>>>> project proposals ? I certainly attended a few workshops together. 
>>>> At some point he must have been alienated or something?? At any rate 
>>>> I think it is our responsibility to publish a formal rebuttal and 
>>>> challenge this paper.
>>>> That?s
>>>> what science is about, isn?t it?
>> 
>> 
>> 
>> _______________________________________________
>> openEHR-clinical mailing list
>> openEHR-clinical at lists.openehr.org
>> http://lists.openehr.org/mailman/listinfo/openehr-clinical_lists.opene
>> hr.org
> 
> _______________________________________________
> openEHR-clinical mailing list
> openEHR-clinical at lists.openehr.org
> http://lists.openehr.org/mailman/listinfo/openehr-clinical_lists.openehr.org
> 
> ------------------------------
> 
> Message: 6
> Date: Wed, 11 Mar 2015 12:27:25 +0100
> From: Sebastian Garde <sebastian.garde at oceaninformatics.com>
> To: For openEHR clinical discussions
>    <openehr-clinical at lists.openehr.org>
> Subject: Re: How to fix CKM biggest issue
> Message-ID: <5500269D.7040708 at oceaninformatics.com>
> Content-Type: text/plain; charset="utf-8"; Format="flowed"
> 
> Hi Gustavo,
> 
> What we will have soon with the next release of CKM is the ability for 
> any user to propose new archetypes.
> We call them Archetype Proposals - this is essentially the Sandbox you 
> are suggesting, but it is not yet an incubator - more like an Inbox.
> 
> Archetype Proposals will then be assigned to appropriate projects or 
> incubators by Clinical Knowledge Admins (CKAs).
> Although CKAs are indeed a small number of people, this should not be a 
> bottle-neck because this is a small task only (akin to sorting through 
> the inbox)
> 
> From there on, there can be many editors for the separate 
> projects/incubators in addition who would oversee the further 
> development/review and publishing of the proposed archetypes.
> 
> If you want to check it out, you can go to our Test CKM at 
> http://ckm-test.oceaninformatics.com
> Create an account if you don't have one and go to Archetypes/Propose New 
> Archetype to submit a new archetype.
> (Just note that this is a test/development server and may be unstable, 
> unavailable, and any data on it may be changed or deleted at any time.)
> 
> Having said that, as you say, I think more editors to share the burden 
> in the individual projects would be great, of course.
> 
> Regards
> Sebastian
> 
>> On 11.03.2015 10:54, Gustavo Bacelar wrote:
>> Dear all,
>> I would like to suggest some very important changes for governance 
>> model of CKM. As you all know, CKM is a keystone to openEHR, but its 
>> actual governance model is outdated and holds the development and 
>> inclusion of new archetypes.
>> 
>> As long as I know there are only 2 main editors that can import any 
>> type of archetypes to CKM. I'm an editor too, but I can only import to 
>> Ophthalmology Project and some other Incubators. The inclusion of new 
>> archetypes can not depend on only 2-3 people. It is a huge constraint 
>> to the development of openEHR, we must have more main editors.
>> 
>> What I propose is to follow a governance model similar to Wikipedia. 
>> It should be possible to anyone to submit archetypes, but these would 
>> be in a sandbox, which already exists: the Incubators. These would 
>> stimulate other participants of CKM to develop new archetypes and to 
>> improve them much faster. When an archetype is sufficiently mature, an 
>> editor would include it to public use.
>> 
>> Kind regards
>> -- 
>> Gustavo Bacelar
>> MD + MBA + MSc Med Informatics
>> Skype: gustavobacela
>> ?r
>> LinkedIn: pt.linkedin.com/in/gbacelar <http://pt.linkedin.com/in/gbacelar>
>> 
>> 
>> _______________________________________________
>> openEHR-clinical mailing list
>> openEHR-clinical at lists.openehr.org
>> http://lists.openehr.org/mailman/listinfo/openehr-clinical_lists.openehr.org
> 
> -- 
> *Dr. Sebastian Garde*
> /Dr. sc. hum., Dipl.-Inform. Med, FACHI/
> Ocean Informatics
> 
> Skype: gardeseb
> 
> 
> ---
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> ------------------------------
> 
> End of openEHR-clinical Digest, Vol 35, Issue 4
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