openEHR-clinical Digest, Vol 35, Issue 21

Grahame Grieve grahame at healthintersections.com.au
Thu Mar 26 09:01:16 EDT 2015


hi

> If you’d like this community to participate, perhaps an invitation on
behalf would encourage an active joint participation.

well, consider yourself invited, though I'm not exactly sure what kind of
invitation you want here.

k. so I grabbed some time to summarise things because we've got to a stable
point.

Looking through the tasks that have been recorded against the
AllergyIntolerance resource:

http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=3008&start=0:
revise the definitions of the criticality values. The upshot was these
definitions:

HIGH -   Exposure to substance may result in a life threatening or organ
system threatening outcome.
LOW –   Exposure to substance unlikely to result in a life threatening or
organ system threatening outcome.
Unable to Determine – Unable to assess with information available.
Unknown – A proper value is applicable but it is not known.

http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=5322&start=0
- add 'reporter' -aka informant. I think this is already in the OpenEHR
reference model

http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=5724&start=0
- cater for 'recorded in error' - I think this is inherent in the openEHR
reference model?

http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=5737&start=0
- argument about status values and records. I'm not going to precis this
here; it's an open issue. This community might want to comment, though I'm
not entirely sure how well the issue translates in a pure archetype context

http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=5820&start=0
- how do you use comments vs description? At the least, the archetype needs
better definitions to differentiate these.


There's been other ongoing discussions about the comparison with CCDA
and/or clinical practice in USA (at least). There's something solid there
which makes the existing design of both the archetype and resource in need
of redesign. I'll be launching discussion of this issue next week on
several HL7 lists. Perhaps I should cross-post here too?

Grahame





On Thu, Mar 26, 2015 at 5:20 PM, Heather Leslie <
heather.leslie at oceaninformatics.com> wrote:

>  Hi Grahame,
>
>
>
> We very much understand that you are being pulled in gazillions of
> directions at present with the explosion of FHIR on all fronts (excuse the
> pun - I’m sure you’re used to them now) but we are all trying to respond to
> the needs of our respective communities.
>
>
>
> I too would be extremely disappointed if this collaboration had to be
> abandoned. We have been so pleased to see this collaboration start off so
> well, and it really is ground breaking for many reasons. However, from a
> practical point of view, our last review was completed at end of November
> and we have been very patient while waiting for your end to be ready to
> proceed. The patience is not so unreasonably now evolving to some
> impatience, I guess.
>
>
>
> We are happy to explore all alternatives to try to progress this in a
> timely manner for all parties – please suggest an approach and a timeframe.
> We have all our reviewers ready and looking forward to ongoing
> participation.
>
>
>
> If the worst happens and we can’t continue with this particular model, the
> progress that we have made to date will go a long way to ensure that the
> majority of the Adverse Reaction archetype and FHIR resource are well
> aligned, especially in the areas most critical and relevant to support
> interoperability at this time. And of course we can all learn from the
> experience such that when we look to do this next time we might all be
> wiser and clearer in how to manage it for all stakeholders.J
>
>
>
> BTW I’m not sure how many openEHR email listers are aware of the HL7
> conversations that you refer to. Ian and I certainly drop in on them on
> occasions, but we don’t regularly monitor them. If you’d like this
> community to participate, perhaps an invitation on behalf would encourage
> an active joint participation.
>
>
>
> Kind regards
>
>
>
> Heather
>
>
>
> *From:* openEHR-clinical [mailto:
> openehr-clinical-bounces at lists.openehr.org] *On Behalf Of *Grahame Grieve
> *Sent:* Saturday, 14 March 2015 5:25 PM
> *To:* For openEHR clinical discussions
> *Subject:* Re: openEHR-clinical Digest, Vol 35, Issue 21
>
>
>
> hi Heather
>
>
>
>  We are attempting to work with the FHIR/HL7 patient care team for the
> Adverse Reaction archetype at the moment. At present the review is
> effectively stalled while Grahame is trying to harness a collective
> response. This has been the situation since mid November and unfortunately
> rapidly becoming an unworkable proposition.
>
>  There are three different problems here
>
> * I personally overcommitted in this regard. I should have been pro-active
> in this process, and I regret that I didn't
>
> * it's hard to impose arbitrary deadlines on a continuous process
>
> * it's erroneous to think that the communications in a joint process are
> all one way. Ian has been involved in the HL7 discussions, but I have
> missed you from the process
>
>
>
> It would be disappointing if we couldn't keep things together from here.
> Not only is it a nice position, the joint work has proven robust against
> criticism, but not beyond change proposals, and there are a few. In
> particular, I think that we need to invest in more work on the way negation
> works; I have a bunch of research on negation in the real world to bring
> together and contribute, hopefully next week.
>
>
>
> In terms of rectification, it would certainly help to remove me from the
> loop  - to find someone else to catalyse the interaction from the HL7 side.
>
>
>
> Grahame
>
>
>
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> openEHR-clinical at lists.openehr.org
>
> http://lists.openehr.org/mailman/listinfo/openehr-clinical_lists.openehr.org
>



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-----
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