# Layers of interoperability, OWL and openEHR **Category:** [Technical (archive)](https://discourse.openehr.org/c/technical-archive/156) **Created:** 2009-04-21 10:25 UTC **Views:** 1 **Replies:** 30 **URL:** https://discourse.openehr.org/t/layers-of-interoperability-owl-and-openehr/13891 --- ## Post #1 by @Seref Dear members of the list, I'd appreciate your opinions and guidance about a particular topic. As most of you probably know, the work in the ontology domain has been the flagship of semantic interoperability for many projects now, and there is a large amount of researchers active in the field. I've been involved in use of ontologies for semantic interoperability for the first time in 2002, and since then, ontologies have become a frequently pronounced solution for a large set of problems. However, I have a feeling that the nature of this work creates just a layer in the multilayer interoperability space. Expressing relationships among different entities and doing this in a formal way (OWL) is nice. OWL also allows you to do processing, reasoning on the defined relationships, but unless I'm missing something, this is all about relationships, and concepts. I mean the capabilities of OWL seem to be valid in the relationships is defines. What about the actual things, data items, entities that OWL links together? I've been a proponent of well defined type systems and object hieararchies in healthcare interoperability solutions, since I've spent years in the software development side of the domain, and a huge number of issues arise from the developers interpreting losely defined types, or inventing their own types. Now pinning down concepts either by using terminologies or ontologies is good. It is good to know that two fields on two different data structures are pointing to the same concept. This however, is the beginning of the process. Pointing at the same thing and processing it in the same way are different things. Just because we agree that we are pointing to body temperature in two different documents does not stop us from processing one of them with a double, and the other one with a float. There is a great deal of information out there expressed in the form of OWL, or other formalisms, but I can't see this covering all aspects of interoperability, but (no offense) there is a large crowd out there who think they have solved the problem of semantic interoperability. Though it may be an undervaluation of the work, "mappings" are nice, but they don't ease the rest of the work, where mapped items are processed in different domains. Are there resources or works that you know of, that try to link type systems in openEHR or other formalisms like 13606 or HL7 to these semantic expressions? How does a DVQuantity instance and an OWL expression play together? Best Regards Seref --- ## Post #2 by @Derek_Meyer Dear List People, Another view, and my two \(euro\) cents, for what they are worth:\- There are many philosophical difficulties in the concept of semantic interoperability which technology cannot address\. Put simply, semantic interoperability requires an agreement on meaning, and meaning is not a 'thing'\. Semantic interoperability requires uses of a system to think in the same way \- or at least in mutually understandable ways \- and informaticians do not \(yet\) have the power to change the ways people think\. So semantic interoperability is a kind of philosopher's stone\. The search for the original philosopher's stone, which could turn base metal into gold, simply showed that alchemists misunderstood chemistry and sub\-atomic physics\. Maybe the search for semantic interoperability simply shows that informaticians misunderstand linguistics and the nature of knowledge\. OK \- you can shoot me down now\.\.\.\.\.\. Derek\. --- ## Post #3 by @thomas.beale Derek Meyer wrote: --- ## Post #4 by @system Derek, Shooting? No. I agree with you. And I disagree. I think that there are clinical informaticians that know, implicitly or explicitly, about semantics, about language and the philosophical aspects. At least clinicians and nurses do (and most patients and other people) since they communicate using voice, writings and gestures. The problem is that technicians do not understand semantic interoperability. And I must say that many informaticians are actually technicians without any understanding of semantics. Gerard > Dear List People, > > Another view, and my two (euro) cents, for what they are worth:- > > There are many philosophical difficulties in the concept of semantic > interoperability which technology cannot address. Put simply, semantic > interoperability requires an agreement on meaning, and meaning is not a > 'thing'. Semantic interoperability requires uses of a system to think > in the same way - or at least in mutually understandable ways - and > informaticians do not (yet) have the power to change the ways people think. > > So semantic interoperability is a kind of philosopher's stone. The > search for the original philosopher's stone, which could turn base metal > into gold, simply showed that alchemists misunderstood chemistry and > sub-atomic physics. Maybe the search for semantic interoperability > simply shows that informaticians misunderstand linguistics and the > nature of knowledge. > > OK - you can shoot me down now...... > > Derek. -- -- Gerard Freriks, MD Huigsloterdijk 378 2158 LR Buitenkaag The Netherlands T: +31 252544896 M: +31 620347088 E: [gfrer@luna.nl](mailto:gfrer@luna.nl) Those who would give up essential Liberty, to purchase a little temporary Safety, deserve neither Liberty nor Safety. Benjamin Franklin 11 Nov 1755 --- ## Post #5 by @grahamegrieve Hi Gerard Who does understand semantic interoperability? The beauty of human interaction is that we can get along even without understanding each other. And we’ll never get computers to understand each other. So we shouldn’t aim for semantic interoperability, we should aim for unsemantic interoperability ;-) (kudos to the Health IT Nerd) Grahame --- ## Post #6 by @system Graham, Exactly. Somewhere there is a paradox. Gerard -- -- Gerard Freriks, MD Huigsloterdijk 378 2158 LR Buitenkaag The Netherlands T: +31 252544896 M: +31 620347088 E: [gfrer@luna.nl](mailto:gfrer@luna.nl) Those who would give up essential Liberty, to purchase a little temporary Safety, deserve neither Liberty nor Safety. Benjamin Franklin 11 Nov 1755 --- ## Post #7 by @Hugh_Leslie1 > Who would ever have thought that a technician would have such poetry in their soul - perhaps there is hope for semantic interoperability after all... :) --- ## Post #8 by @Gavin_Brelstaff Hugh Leslie wrote: >> Who would ever have thought that a technician would have such poetry in their >> soul \- perhaps there is hope for semantic interoperability after all\.\.\. :\) >> > >> > >> > >> > Who does understand semantic interoperability? >> > >> > The beauty of human interaction is that we can >> > >> > get along even without understanding each other\. >> > >> > And we’ll never get computers to understand each >> > >> > other\. So we shouldn’t aim for semantic interoperability, >> > >> > we should aim for unsemantic interoperability This is where openEHR gets even more interesting: where Shannon\-Weaver meets Jakobson's six communication functions: http://en.wikipedia.org/wiki/Roman_Jakobson/The_communication_functions poetry is the hardest thing to translate but often worth the while\. Discuss\! --- ## Post #9 by @Gavin_Brelstaff Hugh Leslie wrote: >> Who would ever have thought that a technician would have such poetry in their >> soul \- perhaps there is hope for semantic interoperability after all\.\.\. :\) >> > >> > >> > >> > Who does understand semantic interoperability? >> > >> > The beauty of human interaction is that we can >> > >> > get along even without understanding each other\. >> > >> > And we’ll never get computers to understand each >> > >> > other\. So we shouldn’t aim for semantic interoperability, >> > >> > we should aim for unsemantic interoperability Oops that WikiP url was wrong \-> the one below works This is where openEHR gets even more interesting: where Shannon\-Weaver meets Jakobson's six communication functions: http://en.wikipedia.org/wiki/Roman_Jakobson#The_communication_functions --- ## Post #10 by @system Dear Seref, Ask yourself the question: How do we, humans, deal with interoperability? Do we humans use formally expressed ontologies using OWL\. Do we use rigid formal syntaxes where we use strictly defined formal terms\. Do wet have to express a measurement in DV\-Quantity as Double or Floating Point with Precision x\. All this is the world of zero's and one's, bits and bytes and IT industry\. We humans have a vague knowledge of many concepts in our worlds\. We have a very flexible syntax and many, many terms\. We even invent new ones\. It is a chaotic system based on a limited set of rules with emergent behavior\. We express what we want to document using documents, chapters, sections, paragraphs, words and characters\. This is the world of documentation, concepts, humans\. This the magnificent world of language, prose and poetry\. Where on the basis of a limited set of rules we can document everything\. It is clear that both worlds \(IT and Humans\) overlap in certain areas\. But mostly the do not overlap\. Do not mix them up and when you do, we get confused and create monsters\. Both worlds have to stay absolutely orthogonal to each other\. Any interoperability solution where notions, ways of thinking and expressing, from the IT world with bits and bytes are enforced on humans, will create problems\. Solutions should start at this human documentation/language level\. The EHR is about documentation of events/facts/thoughts/ideas for human consumption primarily\. IT\-systems should support this\. That is all we need for now\. We can try to model real life using the formal, rigid, technical ways\. And create something that doesn't fit the needs of humans or relates to this human world\. Or we use IT and models to support humans to document what they feel they need to document\. Humans are not very precise but language works rather efficiently and well enough\. Modeling knowledge in ontologies is an interesting academic exercise\. Modeling the complex real life is an interesting academic exercise\. But\.\.\. Let humans use words freely, either as free text of better from a common controlled flexible resource \(dictionary=coding system/ terminology/classification\)\. Let humans use words in a syntax \(Reference Model\) to create freely all sentences/screens \(Templates\) they need using agreed documentation patterns \(Archetypes\), using tools based on an Archetype Model\. And that for the moment is good enough at this point in time looking for the Holy Grail called Semantic Interoperability\. Gerard --- ## Post #11 by @grahamegrieve There once was a techie Geek Who snapped off a email real quieek Such poetry they said Without looking in his head If they had, they'd know it was all cheek Grahame --- ## Post #12 by @ian.mcnicoll Can I suggest moving this to the Clinical list? I think it is an important subject ,and rather dear to my own interests but, as Thomas pointed out, we are in danger of submerging Seref's original more technical question\. Any objections? Ian Dr Ian McNicoll office / fax \+44\(0\)141 560 4657 mobile \+44 \(0\)775 209 7859 skype ianmcnicoll ian@mcmi\.co\.uk Clinical Analyst Ocean Informatics ian\.mcnicoll@oceaninformatics\.com BCS Primary Health Care Specialist Group www\.phcsg\.org --- ## Post #13 by @Derek_Meyer No, go ahead\. --- ## Post #14 by @William_E_Hammond An interesting discussion\. However, I am aware that humans oftern make errors, the majority of which is misunderstanding of the words spoken by another\. The commpent "in violent agreement" comes to mind\. Even wars have occured as a result of misunderstanding\. Communications and creativity may be competing terms\. I like this thread of conversation, even tho I don't understand some of the points\. Ed Hammond              Gerard Freriks              <gfrer@luna\.nl>              Sent by: To              openehr\-technical For openEHR technical discussions              \-bounces@openehr\. <openehr\-technical@openehr\.org>              org cc                                                                                                                                                Subject              04/22/2009 02:20 Re: Layers of interoperability, OWL              AM and openEHR                                                                                          Please respond to                 For openEHR                  technical                 discussions              <openehr\-technica               l@openehr\.org>                                                                             Dear Seref, Ask yourself the question: How do we, humans, deal with interoperability? Do we humans use formally expressed ontologies using OWL\. Do we use rigid formal syntaxes where we use strictly defined formal terms\. Do wet have to express a measurement in DV\-Quantity as Double or Floating Point with Precision x\. All this is the world of zero's and one's, bits and bytes and IT industry\. We humans have a vague knowledge of many concepts in our worlds\. We have a very flexible syntax and many, many terms\. We even invent new ones\. It is a chaotic system based on a limited set of rules with emergent behavior\. We express what we want to document using documents, chapters, sections, paragraphs, words and characters\. This is the world of documentation, concepts, humans\. This the magnificent world of language, prose and poetry\. Where on the basis of a limited set of rules we can document everything\. It is clear that both worlds \(IT and Humans\) overlap in certain areas\. But mostly the do not overlap\. Do not mix them up and when you do, we get confused and create monsters\. Both worlds have to stay absolutely orthogonal to each other\. Any interoperability solution where notions, ways of thinking and expressing, from the IT world with bits and bytes are enforced on humans, will create problems\. Solutions should start at this human documentation/language level\. The EHR is about documentation of events/facts/thoughts/ideas for human consumption primarily\. IT\-systems should support this\. That is all we need for now\. We can try to model real life using the formal, rigid, technical ways\. And create something that doesn't fit the needs of humans or relates to this human world\. Or we use IT and models to support humans to document what they feel they need to document\. Humans are not very precise but language works rather efficiently and well enough\. Modeling knowledge in ontologies is an interesting academic exercise\. Modeling the complex real life is an interesting academic exercise\. But\.\.\. Let humans use words freely, either as free text of better from a common controlled flexible resource \(dictionary=coding system/ terminology/classification\)\. Let humans use words in a syntax \(Reference Model\) to create freely all sentences/screens \(Templates\) they need using agreed documentation patterns \(Archetypes\), using tools based on an Archetype Model\. And that for the moment is good enough at this point in time looking for the Holy Grail called Semantic Interoperability\. Gerard --- ## Post #15 by @ian.mcnicoll With Derek's permission, I have started a thread in openEHR\-clinical to continue the clinical /philosophical aspects arising from his reply to Seref's original post\.\. "So semantic interoperability is a kind of philosopher's stone\.\.\.\." Hopefully this will allow Seref to get some sensible technical solutions to his query and let anyone who fancies a bit of a philosophical battle to indulge over in openEHR\-clinical\. Regards, Ian Dr Ian McNicoll office / fax \+44\(0\)141 560 4657 mobile \+44 \(0\)775 209 7859 skype ianmcnicoll ian@mcmi\.co\.uk Clinical Analyst Ocean Informatics ian\.mcnicoll@oceaninformatics\.com BCS Primary Health Care Specialist Group www\.phcsg\.org --- ## Post #16 by @Seref I am happy to see responses in the non-technical level too. Well, in case someone has a technical comment regarding binding ontologies to archetypes and openEHR RM objects, I'll be around :) Kind regards Seref --- ## Post #17 by @Charles_McCay Seref I am just starting to look at something in this area. I am working on how the NHS Logical Record Architecture (LRA) asserts conformance/compliance to external standards. One thing that is required is a semantic mapping between the LRA specifications and the external standard. Initially I am mainly interested in mapping the static models. (Reference models, datatypes, templates, archetypes, etc) So far I have been interested by the lack of existing work that I have been able to find that asserts the relationship between two specifications – either between two standards, or between a standard and the specification for an implementation. Any suggestions as to where such material may be found would be welcome. Why has it been hard to find them? Clearly the cost and effort of creating and maintaining such mappings is significant – I suspect that many implementations are developed by rapid prototyping, and the value of maintaining such specifications has not been apparent (maybe because there really was not much value). Maybe part of the reason is that folk have not been actively maintaining specification stacks as systems undergo rapid prototyping. Maybe formal mappings are less important/useful than iterative testing working through examples and scenarios – certainly none of the systems testing that I have seen done in practice has made use of formal conformance statements. I am looking at OWL and/or ISO 11179 metadata repository specifications as possible formalisms to use – but again would welcome suggestions / comments. There is a common perception that we have too many overlapping standards in the healthcare space, and that there is a need for consolidation / collaboration and I believe that establishing clear semantic links between specifications may be a way to contribute to convergence. I also believe that it may be a useful contribution to more graceful version management of reference model based specifications within a single standards framework such as HL7v3, 13606, or openEHR All the best Charlie Charlie McCay, charlie@RamseySystems.co.uk Ramsey Systems Ltd, 23D Dogpole, Shrewsbury, Shropshire SY1 1ES tel +44 1743 232278 / +44 7808 570172 skype: charliemccay linkedin:charliemccay --- ## Post #18 by @system Dear Seref As a more technical continuation: When ontologies and syntaxes are orthogonal the two meet in one place At that spot on the syntax will refer to a code from a coding system (terminology, classification, code list) Technically it boils down to how semantically correct and safe can we define this reference? Ontologies can play a role in the prlduction of codes Gerard --- ## Post #19 by @Derek_Meyer You might find Rahil Qamar's work helpful \- http://www.cs.man.ac.uk/~qamarr/ --- ## Post #20 by @Seref Hi Charlie, a couple of good points! Comments are inline. > I am working on how the NHS Logical Record Architecture (LRA) asserts conformance/compliance to external standards. One thing that is required is a semantic mapping between the LRA specifications and the external standard. Initially I am mainly interested in mapping the static models. (Reference models, datatypes, templates, archetypes, etc) Great starting point. My question is: let's assume you'll have the complete mappings tomorrow morning, given to you by someone. For now, let's say they are expressed in OWL. All the possible mappings for static models you've liste are complete. Now, what would you do with them? I'd love to hear your use cases for the situation where you have these mappings. > So far I have been interested by the lack of existing work that I have been able to find that asserts the relationship between two specifications – either between two standards, or between a standard and the specification for an implementation. Any suggestions as to where such material may be found would be welcome. My first ever involvement with the semantic web in healthcare was in Artemis project, back in 2004, and you may consider taking a look at it. [http://www.srdc.metu.edu.tr/webpage/projects/artemis/](http://www.srdc.metu.edu.tr/webpage/projects/artemis/) > Why has it been hard to find them? Clearly the cost and effort of creating and maintaining such mappings is significant – I suspect that many implementations are developed by rapid prototyping, and the value of maintaining such specifications has not been apparent (maybe because there really was not much value). Maybe part of the reason is that folk have not been actively maintaining specification stacks as systems undergo rapid prototyping. Maybe formal mappings are less important/useful than iterative testing working through examples and scenarios – certainly none of the systems testing that I have seen done in practice has made use of formal conformance statements. > > I am looking at OWL and/or ISO 11179 metadata repository specifications as possible formalisms to use – but again would welcome suggestions / comments. Good points. My humble opinion is that, the specifications which are targets of mapping are moving targets, and researchers in the semantic web field seem to be in "art for the sake of art" mode (absolutely no offense) That is, they seem to building capabilities for processing relationships, and processing the actual items involved in relationships is the missing part of the puzzle, or at least that's my holy grail. I ran into Dr. Dipak Kalra today on my way to grab coffee, and he gave me a couple of nice real life examples, about the things he'd expect from a well established system that has semantic interoperability features. Basically as a clinician he is demanding the capability to ask questions in a single form to heteregenous systems (unless I misunderstood), and this is a good example of a use case, where you need access to real life data, therefore crossing the boundaries of semantic web and ehr related research in both ways. When you create a query in sparql for example, asking for results of a particular treatment for diabetes, you need to use both the established mappings, and the actual values of mapped concepts in different locations and formalisms. I want to hear about suggestions for doing this. Another bright guy we have at CHIME, Matthew Darlison has described similar required his genomics related work, for which he has also not been able to find a satisfying solution. > There is a common perception that we have too many overlapping standards in the healthcare space, and that there is a need for consolidation / collaboration and I believe that establishing clear semantic links between specifications may be a way to contribute to convergence. I also believe that it may be a useful contribution to more graceful version management of reference model based specifications within a single standards framework such as HL7v3, 13606, or openEHR Having spend about 7 years in healthcare IT now, I have my own reasons to believe in continuing existence of this situation. I have some core use cases, which may provide good starting points for incremental solution attempts to some of the problems we have. For example, as Tony Shannon has written a couple of times, there is ongoing work at CHIME (which should be revealed quite soon) for implementation of fundemental aspects of an openEHR based system, and I am very willing to consider HL7 V3 or 2.x as a message bus for connecting openEHR repositories to other systems. This will require a mapping mechanism, and I would be willing to employ OWL based opportunites here. This would be a controllable use case for tackling the issues which have been described by you also. In case you have other solid use cases you can share, I'd really like to hear about them. > All the best Many thanks for sharing your opinions, Kind regards Seref --- ## Post #21 by @Tim_Cook2 \[off the topic, needs it own thread I suppose; but\.\.\.\.\.\] > solution attempts to some of the problems we have\. For example, as > Tony Shannon has written a couple of times, there is ongoing work at > CHIME \(which should be revealed quite soon\) for implementation of > fundemental aspects of an openEHR based system, and I am very willing > to consider HL7 V3 or 2\.x as a message bus for connecting openEHR > repositories to other systems\. This will require a mapping mechanism, > and I would be willing to employ OWL based opportunites here\. This > would be a controllable use case for tackling the issues which have > been described by you also\. In case you have other solid use cases you > can share, I'd really like to hear about them\. I'm wondering why you would reinvent something when a perfectly good tool \(open source\) already exists for such things? MIRTH is perfectly capable of handling many challenging interface issues\. http://www.mirthproject.org We are in the planning stages of implementing an API for it in OSHIP http://launchpad.net/oship Cheers, Tim --- ## Post #22 by @system Dear Seref, HL7 made serious mistakes. They used the RIM to model the real world events and documentation about it. Mixing two different types of models is impossible. The best that can happen is that in one model-world one refers to constructs in the other world. Models of reality. Ontologies are models of reality and in semantic interoperability we use them to construct lists of codes, labels and descriptions. Because of the ontology we are able to make inferences, to express knowledge behind the lists of codes, labels and descriptions. Because of the ontologies we are able (eventually) to make applications more intelligent and kind of let them reason. Models of documentation. EN13606/openEHR and HL7v3 CDA are models that help people document data and information. It helps them archive, exchange and re-use. All data and information stored, is stored with all contextual information and meta-information about the documentation process. Models of documentation store data and information in named chapters, sections, paragraphs. They allow users to write complex sentences, using documentation patterns humans agreed upon. They use words from dictionaries (coding systems, terminologies, classifications and code lists). They never map to ontologies. Should never map to ontologies and vice versa. Any attempt to try to map Ontologies to Syntax structures is bound to fail. It is squaring the circle. Gerard -- -- Gerard Freriks, MD Huigsloterdijk 378 2158 LR Buitenkaag The Netherlands T: +31 252544896 M: +31 620347088 E: [gfrer@luna.nl](mailto:gfrer@luna.nl) Those who would give up essential Liberty, to purchase a little temporary Safety, deserve neither Liberty nor Safety. Benjamin Franklin 11 Nov 1755 --- ## Post #23 by @Seref Hi Tim, Mirth has been on my list too, and at least in the short run, it has a higher chance of being used by me. The reason I'm investigating OWL in this context is related to my PhD at CHIME. An OWL based attempt, if succeeds may have other uses beyond HL7, and my supervisor is keen to see this investigated :) I've been curious about your work for quite some time, I should create some time to take a deeper look into it. Kind regards Seref --- ## Post #24 by @Seref Hi Gerard, What you have outlined is pretty much what I've been trying to express, and the comments of the people I've mentioned also point out to the differences you've listed. Would you mind commenting on efforts like sparql, or semantic query languages, where the idea is to use a formalism at an abstract level (like ontology level) to process heterogeneous data homogeneously? Do you think that there is no future for these kind of efforts? My discussion with others, and my experience so far points out to the situation you've described, but I'm trying to figure out if this the best we can ever reach. Kind regards Seref --- ## Post #25 by @Colin_Sutton If I understood some of the earlier discussion, HL7 does not have a formal ontology, or at least the implementation is not constrained by it. If HL7 did have a formal ontology, you could map it to the openEHR ontology and develop a combined ontology to resolve differences. Since it doesn't, it's sensible to constrain HL7 messages to fit the openEHR ontology by mapping at the interface level. Colin --- ## Post #26 by @Charles_McCay I would agree that there are limits to the utility of such mappings - indeed it is to explore such limits that we are engaged in this thread. This is a serious area, and openehr, 13606, and hl7 all have mistakes and successes, (and differences and similarities). We have differing perspectives on those, but let's try to put that to one side and address common themes in this thread. I agree that there is a difference between language and ontology. I am less convinced that to serve clinical system interoperability the distinction can be maintained absolutely. At one level there is the blurred boundary between terminology and structure, and at another there is the safe automated reuse of entries/clinical statements - something that happens and for which we need a better understanding, with entries being treated as semantically independent. I beleive that ontologists have much to contribute to this area. I share with Seref a desire to understand why the research work is not getting into practice. If it is not addressing the practical questions then I move on to ask what work is. My interest is in asserting the relationships between standards relevant to interoperability. I beleive that there is value in seeing what is stopping this happening, and whether the cost of addressing some or all of those hurdles would be justified All the best Charlie Charlie McCay. 07808570172 --- ## Post #27 by @system Hi Charlie, I agree. This topic is not about HL7 and/or EN13606. It is about the logical, semantic and technical aspects of semantic interoperability. I like to think about problems using simple, time proven, solutions and ways to deal with complexity. One magic solution for everything is impossible. We humans use the dictionary to describe the meaning of words. Using a syntax we produce sentences. With common knowledge in our heads we know what is relevant and makes sense. We express what we need to express in a context. The dictionary will not tell us what to document. We need a way to capture what we want to express. We all use documentation patterns to express things in a common way. Mental exercise: - Documentation Pattern: " Once upon a time there was a Princess" We humans know that it is the documentation pattern for a fairy tale. Will the ontology be able to 'know' this? Probably not. It will assume: there was a princes, there was a time, there was a place. I see the need for six orthogonal levels (models). 1- A structure describing knowledge = the Ontology 2- Words to express knowledge = Coding system 3- Something else 4- A structure to assemble words into sentences 5- A structure to assemble sentences in documents 6- A structure to store meta-information for archiving purposes, versioning, etc, etc. Without 3 we are able to produce correct sentences and collect them in documents. This does not guarantee that we produce relevant sentences in a particular context. It does not guarantee that sentences produced make sense; they can be non-sensical. Even when they are correct the documentation pattern causes the interpretation to change completely. Using 1 we (and IT-systems) will find out that it is nonsense and not relevant in a context. Therefor we need a structure so users can express want they want to express. This level three are Archetypes/Templates. Level 3 is the Documentation Pattern where context, processes, humans interact with systems and use all the other layers to document, archive, exchange and re-use heir data and information. At level 3 we must know how technically we can refer to codes from coding systems. I know that we have not a universal way to refer to codes and coding systems. Do we have a worldwide agreement how we refer to a coding system? Do we have a worldwide agreement how we refer to a specific code from a coding system? Do we have a worldwide agreement how we refer to a defined subset of codes from a coding system? How do we deal with the variable structure of each code? Do we have a worldwide agreement how to process the presentation labels and descriptions? Do we have a worldwide agreement how to express inclusion and exclusion criteria (in the case of classifications for example)? Do we have a worldwide agreement how we deal with the language in which code and coding system related items are expressed? Do all standards, systems, specify all this in universal way? Gerard -- -- Gerard Freriks, MD Huigsloterdijk 378 2158 LR Buitenkaag The Netherlands T: +31 252544896 M: +31 620347088 E: [gfrer@luna.nl](mailto:gfrer@luna.nl) Those who would give up essential Liberty, to purchase a little temporary Safety, deserve neither Liberty nor Safety. Benjamin Franklin 11 Nov 1755 --- ## Post #28 by @b.cohen Two issues are being conflated herre\. 1\. Standards The sole purpose of a standard is to guarantee interoperability but, to achieve this, the standard itself must satisfy certain criteria\. These criteria are well illustrated by documents such as the old Whitworth standard for nuts and bolts\. This defines the way in which the dimensions of nuts \(diameter, threads per inch, etc\.\) and those of bolts must be specified, this definition being both: a\) formal enough for the manufacturer to be able to prove that his products satisfy their specifications and b\) necessary and sufficient to guarantee to the purchaser of a nut or bolt that it will fit the bolt or nut she already has\. Unfortunately, few, if any, of the 'standards' in Healthcare meet these criteria\. 2\. Language Languages, both natural and formal, can be described at a number of levels depending on the purpose of the description\. For mere transmission of the symbols, we use lexical definitions\. To identify significant strings of symbols \(i\.e\. to parse\), we use syntactic definition\. To interpret the intended meaning of such strings \(i\.e\. to compile\), we use semantic definition\. These levels suffice for the formal languages\. For natural languages, we need a further level of description that includes the social context of the utterance, this being known as 'pragmatics', a term was by Charles Sanders Peirce who also named the entire field of language description and analysis, at all those levels, as 'semiotics'\. Computational techniques have made huge inroads into semiotics in recent years, particularly up to the level of semantics, but pragmatics is still a dark art\. Ontologies \(another term coined by Peirce, who also did the original work on ontology definition, as Sowa himself acknowledges\) provide some leverage but, since there can be no universal ontology, and the composition of disparate ontologies is not computationally feasible, only those communities who can identify with a common ontology can benefit, and as this identification is always merely temporary, later dissatisfaction with its implications is inevitable\. I hope this is not seen as too pessimistic\. There are effective ways of dealing with these problems but only if we learn how to include the subject, and the subject's models, in our models\. The 'objective' forms of analysis that have been so successful in engineering simply will not suffice\. Quoting Gerard Freriks <gfrer@luna\.nl>: --- ## Post #29 by @yampeku For your interest, there is a Research Group in Spain that is developing an ADL2OWL transformation http://klt.inf.um.es/~cati/Adl2Owl.htm Diego --- ## Post #30 by @thomas.beale b.cohen wrote: > ``` > Two issues are being conflated herre. > 1. Standards > The sole purpose of a standard is to guarantee interoperability but, to achieve > this, the standard itself must satisfy certain criteria. These criteria are > well illustrated by documents such as the old Whitworth standard for nuts and > bolts. This defines the way in which the dimensions of nuts (diameter, threads > per inch, etc.) and those of bolts must be > specified, this definition being both: > a) formal enough for the manufacturer to be able to prove that his products > satisfy their specifications and > b) necessary and sufficient to guarantee to the purchaser of a nut or bolt that > it will fit the bolt or nut she already has. > Unfortunately, few, if any, of the 'standards' in Healthcare meet these > criteria. > > ``` Agree with the above. However, something funny happens with 'standards' in the e-health area - people and even governments assume they are a design for systems (not nessecarily software on a box, but holistic process and information frameworks), and can be used as the intellectual basis for building things. This is almost always a mistake, but the problem is compounded by the fact that some standards seem to be trying to be design paradigms, and it is not clear whether they are a fully specified design for a type of system, or a fully specified standard for interoperability between types of system - often they seem to fail on both counts due to lack of clarity of purpose. --- ## Post #31 by @Seref Hi Tom, Some agreement seems to appear after all :) Just to cover the points I've picked up: there are different views about what is offered by different realms, and the extend to which integration of these realms is possible. It is great to see these options expressed. In addition to absolutely valuable feedback, I can almost see a common interest to further test the usability of existing research in different realms in a more or less well defined scope. Charlie puts this into context of LRA related work, I have targeting HL7 related tasks (mostly as an academic exercise), and Tom suggests narrowing the scope, which may or may not be realized in the context of my or Charlie's efforts. I have an embarrassingly simple expectation for an outcome of the semantic interoperability work that has taken place so far: I want to be able to use medical data in two different systems in a very basic way, that's all. I'll try to make this happen in the smallest, controllable scope I can get my hands on, but I'd like to thank to all contributors of this thread, for it has given me a nice overview of the state of the art and the craft. Kind regards Seref --- **Canonical:** https://discourse.openehr.org/t/layers-of-interoperability-owl-and-openehr/13891 **Original content:** https://discourse.openehr.org/t/layers-of-interoperability-owl-and-openehr/13891