More generic reference model

Thomas Beale thomas.beale at
Sat Sep 3 02:51:29 EDT 2016

On 02/09/2016 04:04, Bert Verhees wrote:
> On 02-09-16 11:18, Daniel Karlsson wrote:
>> Terminologies typically do not specify which pieces of information 
>> are needed in a given situation.
> Hi Daniel, I don't have at the moment opportunity to reply to all you 
> write, so excuse me for cherrypicking one idea of your message.
> I thought SNOMED specifies which information is needed in a given 
> situation, but maybe I misunderstand you?

It does various things, but this is not one of them, except by accident ;-)

SNOMED is on the right-hand (ontological) side of the is-about relation, 
EHR information (defined by archetypes) is on the left (epistemological) 

So terminology codes within EHR information can indicate what the items 
'are about' (in terms of real world categories) but the structures and 
data types of information items are not generally known within the 
terminology. Terminology doesn't say why pulse is a good surrogate for 
heart rate, or in what circumstances MAP BP would be used, or the 
structure of data in a liver function test. These are generally 
contingent relations and substitutions, based on cultural, economic and 
other factors. Terminologies (if well defined) mostly deal in necessary 
/ invariant relations between entities. At the next level out, EHR data 
relates to situations, which are full of accidental relationships; 
terminology doesn't easily deal with these either.

- thomas

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