Hi everyone,
Pablo Pazos has prompted me to raise the issue of raising the CKM modelling and review activity again… His message prompted me to search for my last call to the community for Editors - it was longer than I remembered, way back in June last year – see below.
The response was….. zero.
The major bottleneck remains the same - limited content Editorial resources. Our long standing issue is that a lack of Editorial skills is holding back the ability to review, refine and publish archetypes. We are really fortunate to have a community of willing volunteers to review archetypes and to translate them, but Ian and I have been the only Editors to date and no additional Editors have been forthcoming.
I have to admit that I have pulled back on my volunteer efforts – it took its toll in the early days – and Ocean has funded a considerable amount of Ian and my work to get CKM to the point that it is. That is not a good or sustainable model for the future.
And there is no doubt that CKM is a high profile resource – we know vendors are implementing the drafts, despite knowing that they are not yet stable. We see the archetypes being referred to in many academic papers and used as resources for other work in HL7 and other organisations.
We need to share the load with other volunteers – it’s that simple! Or we need funding resources to pay for and prioritise Editorial efforts - I believe that this is an issue that has been on the agenda for the Foundation for some time.
We have had some recent success in mentoring another Editor - models for assessment of MS were submitted, for use in a specific research project in Germany. Ian has mentored Michael Braun through the Content review process for one of those models – recently published. Others are now in process but the Editorial commitment and domain knowledge is limited to that MS project. I think Michael found it a positive experience and I am trying to persuade Michael to write up his thoughts on the experience, with the intent of sharing them with others.
Ian McNicoll and I are happy to continue acting as Clinical Knowledge Administrators (CKAs) for CKM for now, until we can upskill others to take on that role. The CKAs have the responsibility for ensuring the coherence of the models in the repository and having oversight to the review and refinement process.
Ian and I are keen to spread the archetype Editorial load and are very keen to find individuals who are interested in a medium- to long-term volunteer commitment, supported by a mentoring process by CKAs until the new Editor is confident. It is probably realistic to assume that potential Editors would prefer to work on the refinement of a group of models that are of interest to them or their work. It is in the interest of CKM governance to keep the Editorial team well-trained and uniform in approach – we don’t want hundreds of people as that will make it harder to ensure consistent Editorial outcomes.
Editors take responsibility for the review process for each archetype – initially content reviews, but later this will happen for translations and terminology binding as well. There is always at least two Editors, often three, appointed per archetype – ensuring that between the Editors there is sufficient domain, openEHR technical and CKM governance knowledge to be able to make reasonable Editorial decisions and not be driven or dominated by any one individual. Provision of the technical and governance oversight is relatively easy to provide, but we really do need extra Editorial input from the clinical and informatics domains especially. The transparency of CKM will also work to ensure that the Editors are accountable for making reasoned and appropriate decisions. Clearly we are looking for individuals who are happy and willing to work collaboratively and to support the CKM-wide principles of modelling and governance, or to actively contribute to the processes to improve them.
Indicative workload estimates for an archetype review, based on experience to date, but varying enormously from archetype to archetype:
· Initiating a review – 3.25 hours:
o Initial finessing and upload to CKM – 2 hours
o Build a review team – 0.5 hours
o Initiate the review, including introduction and identifying specific issues for resolution – 45 minutes
· Facilitating each review round - 3.75 hours
o Respond to comments - average of 2 hours (but can be quite a bit more for the initial review round where there might be considerable design modification and much quicker in the final review rounds where there is mostly word-smithing, typo and grammar corrections)
o Update the archetype – 1 hour
o Review and update the review team – 15 minutes
o Initiate the follow-up review round, including identifying specific issues for resolution – 0.5 hours
Now, a typical review process consists of 6-8 review rounds – the first 3- more intensive due to design modification, the others less demanding.
So an estimate of average Editorial workload per archetype is 25.75 hours:
· Initial – 3.25 hours, plus
· Following – 6 rounds x 3.75 hours
For models such as Adverse Reaction, Problem/Diagnosis, Medication it has taken much longer. For others like weight and height it is much shorter.
We are keen to build up a cohesive and like-minded team from all backgrounds.
Please, let me know if you are interested.
Regards
Heather
Dr Heather Leslie
MBBS FRACGP FACHI
Director of Clinical Modelling - Ocean Informatics
Clinical Program Lead – openEHR Foundation
Phone (Aust) +61 (0)418 966 670
Skype - heatherleslie
Twitter - @omowizard
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