Re: Fw: Interoperability with HL7
On 10/02/2010 12:00, Andrew McIntyre wrote:
I think a DCM format should exclude the administrative attributes, such as Author and Observation Time Andrew, I could agree in principle, but how could Observation time be an 'adiministrative' attribute? and leave those to the Information model. Drawing that line is potentially tricky, but needs to be done in order to allow each Information model to do it the way it wants to. Things like order numbers and links to orders should also stay out of the DCM model. In the end we want the pure clinical hierarchical structure that does not conflict with the information model and ideally does not conflict with the Terminology Model. is DCM now trying to be totally model-agnostic? The line between the DCM and terminology is also hard to draw as it varies depending on the ability of the terminology. eg SNOMED-CT is quite rich wrt its models and ICD-X is quite poor. well... sometimes. Have a look here for SNomed's context model - it is in poor shape... http://www.openehr.org/wiki/display/term/Information+Model+-+Terminology+Equivalence A DCM optimised for SNOMED-CT will be inadequate if the only coding system is ICD-10. I guess including SNOMED-CT context structures with the option to use them for ICD-10 and move them to the terminology for SNOMED-CT is one possibility? 2 similar DCMs (?archetypes) with stated terminology affinity would be another. many countries are using things like ICD9 or 10, ICPC+, vocabularies for nursing, procedures, devices, prostheses and drugs. Snomed actually doesn't figure that highly in the list of currently used terminologies - i.e. actually in production. Re-imbursement-related terminologies and vocabularies are far more important right now. So optimising DCM (whatever DCM now is) for Snomed would be quite wrong-headed, unless DCM is also destined for 'in 5y+' time. I appreciate this is an openEHR list, and maybe this discussion should be transferred to a DCM list, but I don't think there are enough resources to model every clinical concept in every information model and there is enormous value in a neutral DCM format. The archetype concept is a good way to achieve this, but perhaps a generic "DCM only" Reference Model that does not try and be a EHR model would help? I am still interested to see what the concrete objections to the openEHR reference model classes as the basis forDCM archetypes are. - thomas beale |
_______________________________________________ openEHR-technical mailing list openEHR-technical@openehr.org http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-technical