More generic reference model

GF gfrer at luna.nl
Fri Sep 2 06:13:42 EDT 2016


Daniel,

I agree with your opinions.

And observe - like you - differences where boundaries are drawn.

To me it is logical that there are differences because the scope of Bert is not the same as the scope of OpenEHR or CIMI.
Bert’s scope is implementation in databases
OpenEHR -to me- is a mix of theory and implementation practicality creating archetypes serving clinicians
CIMI’s scope is to create standardised Logical Models that happen to be archetypes. 
CIMI does not expect that CIMI Logical Models will be implemented as is, but implemented after a transformation.


Gerard

> On 2 sep. 2016, at 11:18, Daniel Karlsson <daniel.karlsson at liu.se> wrote:
> 
> Dear All,
> 
> while there is, as you note, overlap and resulting redundancy, I believe this is hard to avoid. If the archetype is an information requirement specification and and the information requirements are different for observations, evaluations, instructions, ... (which I believe they are) then this level is needed. Terminologies typically do not specify which pieces of information are needed in a given situation. CIMI e.g. has drawn the line between the RM and archetypes differently compared to openEHR and introduced more layers (RM, reference archetypes, clinical patterns, etc.) but the overall idea with specific clinically motivated constraints for classes of information. Not-quite-as-similarly, FHIR has specified information requirements in a growing number of clinical resources.
> 
> So, I do not see a trend moving away from information model frameworks (together with terminologies) being central to interoperability.
> 
> This doesn't mean that openEHR shouldn't try hard to improve (the guidance for) use of archetypes together with more terminologies like SNOMED CT, but we still jointly have to identify the "sweet spot" (Heather's words) which gives the most usefulness.
> 
> Cheers,
> Daniel
> 
> 
> On 2016-09-01 09:54, Bert Verhees wrote:
>> Hi,
>> 
>> 
>> I am just wondering if there are some opinions about this.
>> 
>> 
>> Do we still need the not so generic reference model which OpenEhr has, with archetypes denoting Observation, Evaluation etc?
>> 
>> Wouldn't a more  generic reference model, like ISO13606 be sufficient, when the terminology, worldwide, is moving to SNOMED-CT?
>> 
>> Because the SNOMED-concepts already indicate in which hierarchy a data-item belongs (clinical finding, procedure, body structure, etc), and with much more detail then the OpenEHR reference model.
>> 
>> 
>> When using SNOMED in OpenEHR there will be redundant information created, and to not create redundant information is one of the main golden rules in system design.
>> 
>> I think the reference model design needs reconsideration. It comes from a time when there was no SNOMED-CT.
>> 
>> Thanks for any thoughts.
>> 
>> Bert
>> 
>> 
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> 
> -- 
> Daniel Karlsson, PhD, sr lecturer
> Department of Biomedical Engineering/Health informatics
> Linköping university
> SE-58185 Linköping
> Sweden
> Ph. +46 708350109, Skype: imt_danka, Hangout: daniel.e.karlsson at gmail.com
> 
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