Re: HL7 too expensive, too complex and inconsistent

["Dr Carola Hullin Lucay Cossio" <carolhullin@hotmail.com>]

As discussed by many of you and readers of these comments, the time is now 
to move forward safely with these initiatives.
The level of evolution is not necessarilly required from the creators of 
this innovation but the manner OpenEHR is used on the ground level. I see 
many factors need clarification and introduction of new dimensions to move 
forward...
Such as:

Open source is a burning issue for developing countries...and specially the 
space do not have the resources to contract experts from the north to 
introduce these innovations to the operational level.

For clinicians the ACCESS TO INFORMATION what is matters, specially for the 
countries where a computer is a luxery.........even a well model of 
information in paper is a progress for current documentation. So the fast 
changes in developing template and exchange of data may be as critical for 
developed countries but in poor countries this expertise does not 
exist........they do not see the differences between GOOD QUALITY data 
elements and what is the power of STANDARDS....that is the strenghts of 
OpenEHR.....

The funding area is A BURNING ISSUE for us to survive or the real needs from 
clinicians using ICT for service delivery will never be improved and 
interoperability will remain a dream...to see but do not touch.

In regards to the evidence to date......organic open source EMR are a real 
solution for spaces that NOTHING EXIST....however, this cannot be confused 
with achieving INTEROPERABILITY...since the initial need is ACCESS TO 
INFORMATION in the first place.....without a real understanding of 
exchanging data or information....well if we start to discuss the level of 
KNOWLEDGE of medicine, nursing, health sciences in those 
areas.......ARQUETYPES are the only answer.....at this stage-..

Finally, each member of the EHR initiatives has developed an understanding 
of the complexity of introducing these technologies to healthcare, and 
according to my experience, there is not ONLY ONE SOLUTIONS to any health 
system...BUT MANY..........in form of COLLABORATION.....


I would like to add, that the idea is to provide a sense of TRUST for people 
who does not got the time or motive to see the power of open EHR...and the 
only channel to achieve this is GOVERNANCE FRAMEWORK.......not by 
controlling each project that is using openEHR...quite the 
opposite......providing the tools to the people who must need it.......

Cheers Carol
Melbourne Australia


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From: "Thomas Beale" <thomas.beale@oceaninformatics.com>
Sent: Thursday, December 04, 2008 12:36 AM
To: "For openEHR clinical discussions" <openehr-clinical@openehr.org>
Subject: Re: HL7 too expensive, too complex and inconsistent

> The report was done based on a survey of 94 responding 'experts',
> whoever they were. They didn't get openEHR at all, and made some errors
> to do with other standards orgs in the report. I don't see open source
> as a burning issue - open data and open (service) interfaces are what
> matter to clinical users (particularly secondary - medical research &
> public health) and system vendors respectively. Open source is a nice
> development paradigm - but mainly for software where the developers are
> more or less the same pool of people as the users - hence Linux, Samba,
> Apache, Zope, and all the other big projects. Health software is
> specialised and to make open source fly it needs to be funded and
> directed in my view - hence the Open Health Tools (OHT) initiative.
> Based on the evidence to date, anyone who thinks that organic open
> source EMR or other projects are going to magically solve e-health
> interoperability is dreaming.
>
> Ed's comment about not wanting to spend the effort on open source
> directly in HL7 reflects this reality (and I think it was most likely
> the correct decision). openEHR's open source projects only solve
> interoperability problems because they are 100% based on the open
> specifications (i.e. some kind of standard), not because they are open
> source.
>
> - thomas beale
>
>
> William E Hammond wrote:
> > Thanks to Bert in bring this article to our attention.  Although I 
> > haven't
> > read every word, I did not see the reference that HL7 was too expensive.
> > To my knowledge, HL7 is the most widely used standard by the large HIS/IT
> > vendors.  I think some of the references to v2.x vs v3 were interesting.
> > It is true that v3 has yet to penetrate the US as far as messaging is
> > concerned.  On the other hand, CDA - also a v3 standard is gaining
> > increasing use in the US.  A number of health care facilities are using 
> > CDA
> > to define notes/summaries in a number of clinical domains.
> >
> > The discussion of open, open source, and openess is quite interesting.  I
> > believe that HL7 is open in the sense that anyone can particiapte in
> > creating the standards.  It is closed in the sense that the standards it
> > creates have a price, altho relative low.  HL7 look at integrating true
> > open source into is structure and finally decided the gains were not 
> > worth
> > the effort.  I participate in a couple of open source organizations, and
> > the openess is quite interesting, surprising and challenging.
> >
> > I think the article is an excellent reference.  I disagree with some
> > statements about HL7, but I doubt if anyone could write an article that
> > everyone would agree with all the content.
> >
> > Ed Hammond
> *
> *
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