In the Swiss openEHR Data Modelling Exchange Group (DMEG), we are currently developing a guideline on how to reference the administrative case number within compositions. This guideline is intended to be applied consistently across all templates in Switzerland that involve referencing the administrative case number.
At the moment, we are evaluating six very different options proposed by our members. We are actively comparing and discussing these options, and our group will soon make a decision on which one to adopt as the official openEHR.ch guideline.
However, weāre currently uncertain about the correct procedure for making this decision. For example, what if 6 members support option A, 5 prefer option E, and 1 votes for option F? We want to ensure that the Data Modelling Exchange Group follows the appropriate formal process.
Our question is this:
Is there a defined governance model, formal procedure, or balloting/approval process within openEHR for adopting national guidelines?
And if no such formal openEHR process exists:
How do your regional, national, or supranational modelling groups handle balloting and adoption of guidelines?
Unfortunately I donāt have a good solution to offer, other than āreach consensus or accept divergenceā. International openEHR modelling and modelling governance activities (thankfully, in my opinion) have no tradition for balloting, and itās the same in Norway. If something is important enough that divergence is unacceptable, IMHO itās worth putting in the effort to reach consensus.
I realise that my culture is very consensus-oriented in general, so this approach may not work everywhere. Iād be interested in hearing about alternative approaches.
Iām largely in agreement @Silje. Try to work this out from a consus approach but I suspect there are scenarios, especially when trying to enforce/mandate tight standardisation in a focused area (the EncounterID being a good example), that some sort of balloting /voting might be needed to get a decision over the line.
Iād definitely be interested in understanding how colleagues in HL7 would approach this.
Total consensus may not always be possible, in that case documenting diverging practices may also be of help.
I find it important for a national programme to define the structural and process quality they are after in advance: e.g. how much (or little) clinical input they find acceptable as a minimum and from which range of health domains and professions. This may differ per model.
Totally agree with Sebastian. Documenting the variations āsomewhereā and sometimes unfortunately changes, is vital to be able to govern. Itās also important for those implement openEHR solutions, and data retrieval in the future. The āsomewhereā should be available for everyone within the region/nation.
Thank you very much for your helpful responses. We will recommend to the other members of the Swiss openEHR Data Modelling Exchange Group that we follow the procedure you suggested: āreach consensus or accept divergenceā.