# Medinfo 2010 **Category:** [Implementers (archive)](https://discourse.openehr.org/c/implementers-archive/158) **Created:** 2009-06-01 13:14 UTC **Views:** 22 **Replies:** 45 **URL:** https://discourse.openehr.org/t/medinfo-2010/14994 --- ## Post #1 by @system Hi, all In the next year 2010, Medinfo 2010 will be held in Captown, South Africa\.\(http://medinfo2010.org/) I would like to have a workshop in the openEHR implementation in Eiffel, Java, Python and Ruby to examine the universality and availability of openEHR specification\. It is interesting that each implementation has its own feature in contrast\. Fortunately our Ruby implementation is progressing step by step, some demo will be shown in the session\. I would like to hear comments by other language leaders\. Is'nt this a good idea? Cheers, --- ## Post #2 by @system An excellent idea, Shinji\! It will be great to demonstrate archetype based interoperability between different openEHR implementations on different platform\. Will you coordinate such workshop proposal? Cheers, Rong --- ## Post #3 by @Hugh_Leslie1 Can't we include .net in the interoperability stakes as well :( --- ## Post #4 by @Peter_Gummer1 Hugh Leslie wrote: > Can't we include \.net in the interoperability stakes as well :\( Shinji already did so more or less, because the \.NET ADL parser is written in Eiffel\. But there's more to openEHR than just parsing and serialising ADL, of course, so you do have a point there, Hugh :\-\) \- Peter --- ## Post #5 by @system Thank your quick responce, Rong\! I will do coordinate if you think so\. --- ## Post #6 by @system Yes we include \.Net\(C\#\) that uses Eiffel library\. --- ## Post #7 by @system Hi I would suggest that we show interoperability in action\. Lets send a couple of extracts between a few different systems such as those by Tim Cook, Bert Verhes, Rong Chen, Shinji KOBAYASHI, Opereffa, OceanEHR\.\.\.\. Cheers, Sam --- ## Post #8 by @system Hi Sam, Yes, it would be a great impact to show such 'archetype connectathon' amongs diferent systems\. Otherwise, all the people shown bellow will not be able to join the Medinfo2010 because of their schedules\. Please reply this mailing list or direct to me, if you will join the Medinfo2010\. Moreover, please help me to organise this workshop, Sam\. It is no doubt that you are one of the most suitable people for this session\. --- ## Post #9 by @Tim_Cook2 I agree that we should begin developing a plan for this\. I will likely NOT be at Medinfo but as long as we have internet connectivity that should not be a problem\. At first thought; though I haven't looked at the artifacts in detail: 1\) We should probably use the SOAP note approach that Operffera has started with\. 2\) We should define 3\-5 patients \(maybe Ocean can contribute here\)\. 3\) Possibly have one source point to create documents and then pass them around making minor additions/changes and recording screen shots from each application\. 4\) The documents end up back at the source point to validate all original data plus changes\. Other thoughts? \-\-Tim --- ## Post #10 by @tonyshannon Hi Tim Good ideas\.\. thanks for that\. Some more thoughts \.\.\. I hope that as we push for a focus on SOAP & Summary clinical material to get the archetypes/templates right, that would form the basis of a simple yet effective requirement for that Medinfo interoperability demo\. A variety of SOAP notes could be generated per patient\.\. A Summary view of each patient should pick up the relevant material from those SOAP notes to populate the summary\. Users should perhaps be able to see the patient summary from any system, perhaps just the SOAP notes within the originating system? Further thoughts welcome\.\. Tony Tim Cook wrote: --- ## Post #11 by @system Hi Tim and all As Tony Shannon pointed out, SOAP note has much diversity\. We needs to implement the versioning system and how to serialize the versions\. Although the versioning system of the openEHR specification seems to be perfect for such distributed versioning condition, the common information system specification has not determined the serialization\(http://www.openehr.org/releases/1.0.2/architecture/rm/common_im.pdf , p44\) I think the referral letter amongs organisation is preffer because it needs less strict versioning\. > I agree that we should begin developing a plan for this\. I will likely > NOT be at Medinfo but as long as we have internet connectivity that > should not be a problem\. It is regr --- ## Post #12 by @system Hi Shinji I believe the XML schema has sorted the serialisation\. I do not think it very onerous\. Heath might help here\. Cheers, Sam --- ## Post #13 by @Tim_Cook2 Hi All, Medinfo2010 is 13 months away\. Seems like a long time in some respects but if we are going to really put on a "road show" of interoperability then we really need to start developing a solid action plan\. KOBAYASHI, Shinji made a good point about referral letters simplicity\. But\.\.\. my belief is that \*THIS\* is the opportunity for openEHR implementations to come out of the closet and make the splash that commercial and open source systems of different sizes can shared information without loss of semantic interoperability; using significant and meaningful information\. I think that Tony's ideas below are something that we should work towards detailing out for a true demonstration "with meaning"\. But, we must begin to get organized\. Who's in and commited? Should we scheduled quarterly conference \(Skype\) calls? Say beginning in September? I do not believe that we must be in attendance at MedInfo\. In fact it may be a much better demo if at least some of the sites are remote\. I'll volunteer to begin organizing this project unless someone else prefers to do it\. Cheers, Tim --- ## Post #14 by @Hugh_Leslie1 Hi Tim I am sure that Ocean would be interested in participating\. Regards Hugh --- ## Post #15 by @system > > In the next year 2010, Medinfo 2010 will be held in Captown, South > Africa\.\(http://medinfo2010.org/) > I would like to have a workshop in the openEHR implementation in Eiffel, > Java, Python and Ruby to examine the universality and availability of > openEHR specification\. It is interesting that each implementation has > its own feature in contrast\. Hi Shinji, it is a good idea, to show what several people/companies have achieved\. It can really draw new attention\. This will be beneficial to us all\. I don't think of traveling to SA myself\. To be honest, it is rather expensive to travel from the Netherlands, hotel expenses, etc\. As being an independent developer no\-one is paying my expenses\. There is no direct return on investment expected if I would pay it myself, because I am targeting to the Dutch market to sell my work\. But generally spoken, it is a good idea to show the strength of Openehr, not only in idea, but also in follow up on the market\. As Sam suggested, there may be a way for people not going to SA, to contribute, in some way\. It is some time until September 2010, but when time comes, if some one has ideas how I can contribute, just ask\. I will be glad to participate\. Bert --- ## Post #16 by @Tim_Cook2 > But generally spoken, it is a good idea to show the strength of Openehr, > not only in idea, but also in follow up on the market\. > As Sam suggested, there may be a way for people not going to SA, to > contribute, in some way\. > > It is some time until September 2010, but when time comes, if some one > has ideas how I can contribute, just ask\. I will be glad to participate\. Bert, I am also an independent developer \(not certain if I am going or not yet\) but anyway this is why I followed up on the earlier recommendation for the CONNECT\-A\-THON\. I'm quite certain that we could get Internet access there and we could demonstrate actually transfering documents \(Tony suggested a SOAP note\) between sites making modifications along the way\. This will certainly require some logistical planning that is why I suggest we start soon\. Cheers, Tim --- ## Post #17 by @Tim_Cook2 http://www.ihe-europe.net/content/connectathon_vienna.htm --- ## Post #18 by @Greg_Caulton > > Well, tuning API's is easy between openEHR systems. It's called an > > Extract. > > [http://www.openehr.org/releases/1.0.2/architecture/rm/ehr_extract_im.pdf](http://www.openehr.org/releases/1.0.2/architecture/rm/ehr_extract_im.pdf) > > > > We may want to demonstrate various transport methods such as a SOAP > > envelop, secure email etc. > > > I hadn't seen this document yet, I forgot to look for quite sometime. I Is that the only documentation on how to create an extract? It seems to be lacking in examples and missing content unless you perhaps wrote OpenEHR :-) It would be a lot easier to do data exchange if someone define a WSDL and used the archetype identifiers inside an structured XML document. --- ## Post #19 by @Tim_Cook2 Hi Greg, First of all I cannot speak for Tom Beale or Heath Frankel \(primary authors of the draft specs\)\. But I will speak in their defense\. > Is that the only documentation on how to create an extract? It seems > to be lacking in examples and missing content unless you perhaps wrote > OpenEHR :\-\) You of course need to combine this document with all of the other openEHR documents\. Especially the service model\. You may find the architecture overview helpful http://www.openehr.org/releases/1.0.2/architecture/overview.pdf Please note that section 1\.2 contains this as well as several other related documents in order to attain full understanding\. > It would be a lot easier to do data exchange if someone define a WSDL > and used the archetype identifiers inside an structured XML document\. If you would like to be that someone to define an XML schema that meets all of the version control, audit trail response, security, etc\. requirements of openEHR queries I am sure the community would be grateful\. "Keep everything as simple as possible; but no simpler\." \-\- Albert Einstein If you'll notice; the extract document is a 2 year old draft that is heavily dependent upon the settling out of the query language\. It has many places where there are questions to be answered\. It also probably needs heavy review in order to bring it up to date with the latest RM release\. This is an open source project so maybe it is time that some of us step up and take care of this issue instead of just complaining about it being incomplete? --- ## Post #20 by @Greg_Caulton > Message: 2 > Date: Sun, 09 Aug 2009 20:16:56 -0300 > From: Tim Cook <[timothywayne.cook@gmail.com](mailto:timothywayne.cook@gmail.com)> > Subject: Re: Medinfo 2010 > To: For openEHR implementation discussions > <[openehr-implementers@openehr.org](mailto:openehr-implementers@openehr.org)> > Message-ID: <1249859816.4964.61.camel@localhost> > Content-Type: text/plain; charset="us-ascii" > > Hi Greg, > > First of all I cannot speak for Tom Beale or Heath Frankel (primary > authors of the draft specs). But I will speak in their defense. > > > > > > Is that the only documentation on how to create an extract? It seems > > to be lacking in examples and missing content unless you perhaps wrote > > OpenEHR :-) > > You of course need to combine this document with all of the other > openEHR documents. Especially the service model. You may find the > architecture overview helpful > [http://www.openehr.org/releases/1.0.2/architecture/overview.pdf](http://www.openehr.org/releases/1.0.2/architecture/overview.pdf) No I didn't... no offense, just being honest. > Please note that section 1.2 contains this as well as several other > related documents in order to attain full understanding. > > > It would be a lot easier to do data exchange if someone define a WSDL > > and used the archetype identifiers inside an structured XML document. > > If you would like to be that someone to define an XML schema that meets > all of the version control, audit trail response, security, etc. > requirements of openEHR queries I am sure the community would be > grateful. We do plan to expose data exchange via web services out the box and that would include Archetyped data as well as other sources so that is certainly on the cards. For the version control, audit trail, security defined as part of the OpenEHR I think the barrier to entry is too high and we would stick with our own internal system for managing audits and security and provide information more in line with HL7 CDA , CCR requirements. > "Keep everything as simple as possible; but no simpler." > -- Albert Einstein > > If you'll notice; the extract document is a 2 year old draft that is > heavily dependent upon the settling out of the query language. It has > many places where there are questions to be answered. It also probably > needs heavy review in order to bring it up to date with the latest RM > release. This is an open source project so maybe it is time that some > of us step up and take care of this issue instead of just complaining > about it being incomplete? Better to receive some feedback than have it ignored. I suspect that the extract is too complex to gain traction and something simpler is required. I would propose starting by defining some simple REST interfaces or XML over HTTP to allow the community to query our implementations and at least get started. If everyone disagrees and prefer to work the extract then I will put this on the back burner.. --- ## Post #21 by @thomas.beale The Extract does need more work, although the concept is pretty simple (it is really just a set of request/response rules and wrappers for normal openEHR data). A review needs to be done with respect to EN13606-5, a service interface definition to see if we should use some of what is in there. But for practical purposes, we developed an Extract XSD in Ocean that was used at the last MedInfo 2007, and I suggest that this could be used. It is not hard to work with, and some simple questions of identifier types (e.g. Oid versus Guid) were worked out in 2007. The XSD is on the page [http://www.openehr.org/releases/1.0.2/its/XML-schema/index.html](http://www.openehr.org/releases/1.0.2/its/XML-schema/index.html) . I have created a wiki page for the 2010 conference at [http://www.openehr.org/wiki/display/resources/MedInfo+2010+-+South+Africa](http://www.openehr.org/wiki/display/resources/MedInfo+2010+-+South+Africa) so please feel free to use that to coordinate activities. - thomas beale Greg Caulton wrote: [details="(attachments)"] ![OceanC\_small.png|74x72](upload://5I367QG2SMJUp18Pt3jF6yz13Ey.png) [/details] --- ## Post #22 by @Tim_Cook2 Thanks Tom\. I have started a child page where we can start collecting some info about who is interested in participating in the connect\-a\-thon \(onsite or offsite\)\. We can then begin determining exactly what we will be demoing\. Cheers, Tim --- ## Post #23 by @system Thank you for preparing wiki, Thomas, I will operate\. --- ## Post #24 by @system > > The Extract does need more work, although the concept is pretty simple > \(it is really just a set of request/response rules and wrappers for > normal openEHR data\)\. A review needs to be done with respect to > EN13606\-5, a service interface definition to see if we should use some > of what is in there\. If the XSD will be formalized, I will see that I build my services so that the can use it\. No problem\. But we also need a WSDL or another form of formalized API for the message\-processes\. In this way, we can be sure that if we see OpenEHR\-services, we know how to get our data in there\. If this, also is done, I am happy to make my service to conform to that, so that interoperability is a fact\. I understand that with respect to EN13606\-5 \(is it already formalized?\) things can change\. But on the other hand, we can do with something we can expect it will be\. I will wait on further instructions, and hope we are able to show some really good things in september 2010\. We need a coordinator to arrange all necessary formats\. Who will volunteer? Bert --- ## Post #25 by @Greg_Caulton `But for practical purposes, we developed an Extract XSD in Ocean that` `was used at the last MedInfo 2007, and I suggest that this could be` `used. It is not hard to work with, and some simple questions of` `identifier types (e.g. Oid versus Guid) were worked out in 2007. The` `XSD is on the page` `[http://www.openehr.org/releases/1.0.2/its/XML-schema/index.html](http://www.openehr.org/releases/1.0.2/its/XML-schema/index.html) . I` `have created a wiki page for the 2010 conference at` `[http://www.openehr.org/wiki/display/resources/MedInfo+2010+-+South+Africa](http://www.openehr.org/wiki/display/resources/MedInfo+2010+-+South+Africa)` `so please feel free to use that to coordinate activities.
` `
` `- thomas beale
` Tom do you have a small sample XML from MedInfo 2007 that is valid for the extract xsd ? e.g. one patient with blood pressure ? --- ## Post #26 by @system > Tom do you have a small sample XML from MedInfo 2007 that is valid for the > extract xsd ? e\.g\. one patient with blood pressure ? > Greg, the sample xml files can be found at here: http://www.openehr.org/svn/ref_impl_java/SANDBOX/ehr-bank/src/res/xml/ /Rong Gregory Caulton --- ## Post #27 by @ian.mcnicoll This project sounds very exciting but I wonder if the use of an EHR Extract will fire up sufficient clinical/managerial interest. As an alternative how about considering a patient's path from an Emergency visit, looking up/importing data from a GP-held summary (or even a Google Health summary), Tony's Soap stuff then eventual discharge letter. Being able to do this seamlessly across different 'vendors' and platforms would be compelling, especially if the contents could be changed at the whim of one of us annoying clinicians e.g Revise an archetype by adding some new elements, rerun the pathway and see how each individual system should be able to handle the change, including those who do not have access to the newer archetype. This could make use of the CKM 'top 20 archetypes' work' (and anything else), which will be at the heart of almost all clinical communications - ADR, medication, Diagnosi, lab tests etc. Or is this too adventurous... Ian Dr Ian McNicoll office / fax +44(0)141 560 4657 mobile +44 (0)775 209 7859 skype ianmcnicoll [ian@mcmi.co.uk](mailto:ian@mcmi.co.uk) Clinical Analyst Ocean Informatics [ian.mcnicoll@oceaninformatics.com](mailto:ian.mcnicoll@oceaninformatics.com) BCS Primary Health Care Specialist Group [www.phcsg.org](http://www.phcsg.org) 2009/8/12 Rong Chen <[rong.acode@gmail.com](mailto:rong.acode@gmail.com)> --- ## Post #28 by @Greg_Caulton > Message: 2 > Date: Wed, 12 Aug 2009 15:17:03 +0100 > From: Ian McNicoll <[Ian.McNicoll@oceaninformatics.com](mailto:Ian.McNicoll@oceaninformatics.com)> > Subject: Re: Medinfo 2010 > To: For openEHR implementation discussions > <[openehr-implementers@openehr.org](mailto:openehr-implementers@openehr.org)> > Message-ID: > <[d52774ce0908120717j574224d8kf1074d32c2a54fcd@mail.gmail.com](mailto:d52774ce0908120717j574224d8kf1074d32c2a54fcd@mail.gmail.com)> > Content-Type: text/plain; charset="iso-8859-1" > > This project sounds very exciting but I wonder if the use of an EHR Extract > will fire up sufficient clinical/managerial interest. > > As an alternative how about considering a patient's path from an Emergency > visit, looking up/importing data from a GP-held summary (or even a Google > Health summary), Tony's Soap stuff then eventual discharge letter. Being > able to do this seamlessly across different 'vendors' and platforms would be > compelling, especially if the contents could be changed at the whim of one > of us annoying clinicians e.g Revise an archetype by adding some new > elements, rerun the pathway and see how each individual system should be > able to handle the change, including those who do not have access to the > newer archetype. > > This could make use of the CKM 'top 20 archetypes' work' (and anything > else), which will be at the heart of almost all clinical communications - > ADR, medication, Diagnosi, lab tests etc. > > Or is this too adventurous... > > Ian > > Dr Ian McNicoll > office / fax +44(0)141 560 4657 > mobile +44 (0)775 209 7859 > skype ianmcnicoll > [ian@mcmi.co.uk](mailto:ian@mcmi.co.uk) > > Clinical Analyst Ocean Informatics [ian.mcnicoll@oceaninformatics.com](mailto:ian.mcnicoll@oceaninformatics.com) > BCS Primary Health Care Specialist Group [www.phcsg.org](http://www.phcsg.org) I agree that extract is a dull word. The problem we still seem to be missing key pieces. The xml e.g. [http://www.openehr.org/svn/ref_impl_java/SANDBOX/ehr-bank/src/res/xml/blood-glucose-sample.xml](http://www.openehr.org/svn/ref_impl_java/SANDBOX/ehr-bank/src/res/xml/blood-glucose-sample.xml) does not seem to have any patient identifiers. Without the basic functionality of being able to even match a patient its hard to get the data into the system in the first place. I have several questions around the archetype identifiers when we get there. I think we need a simple step by step test case which walks through the process and identifies what data is being sent where. The actual protocols are not important but the content and how patients, visits and clinical content is *matched* is important. --- ## Post #29 by @Tim_Cook2 Hi Greg, The Answers you seek are in understanding of the overview and of the reference model\. Without them; archetypes have no meaning\. \-\-Tim --- ## Post #30 by @tonyshannon Thanks Tim & co for moving on this\. Tim You kindly offered to help organise this, please let me know if I can help in any way\. Shinji You mentioned the abstract submission deadline of Sept 30th\. What do we need to prepare as a group to organise ahead of this date? I agree with Ian that we should try to follow patient journey stuff, EM Summary to SOAP note updated on discharge to EM Summary again\. This deadline should help us all focus efforts\.\.\. Kind Regards, Tony Dr\. Tony Shannon Consultant in Emergency Medicine, Leeds Teaching Hospitals Clinical Lead, Clinical Content Service, NHS Connecting for Health Chair, Clinical Review Board, openEHR Foundation \+44\.789\.988 5068 tony\.shannon@nhs\.net Ian McNicoll wrote: --- ## Post #31 by @system Thank you for your follow, Dr Tony Shannon, I confirmed the instructions for authors of Medinfo 2010\. http://medinfo2010.org/Instruction_for_authors.pdf First of all, we have to decide the type of presentation\. We can choice papers, posters, scientific demonstrations, panels and pre\-congress tutorials and workshops\. I think \*pre\-congress tutorials and workshops and \*scientific demonstration will be suitable to present our discussion\. or Panel? Please advise me\. At the second, we have to fix the authors, presentors\. Who will join? In the mails so far, Rong Cheng, Ocean Informatics group and I will join the medinfo2010\. Tim will join online/offsite\. Will your Opefera group join? --- ## Post #32 by @erik.sundvall Or a hopefully slightly more helpful reply might be: \- The blood\-glucose\-sample\.xml is not a complete extract, it needs to be encapsulated in a proper extract\. \- The line <subject xsi:type="PARTY\_SELF"/> says that the glucose value belongs to the patient who's record the extract comes from \(not information about a relative etc\. that might also be in the record\)\. \- The patient record identity information should be in the enclosing extract\. In http://www.openehr.org/releases/1.0.2/its/XML-schema/Extract.xsd I think it would be under <xs:complexType name="EXTRACT\_ENTITY\_IDENTIFIER"> wich in turn refers to demographic information that can be included in another part of the extract \(or if not present\) can be requested separately as an extract\. See http://www.openehr.org/releases/1.0.2/architecture/rm/ehr_extract_im.pdf I believe this would be easier for many to understand if there were some COMPLETE extract instance examples \(and extract requests\) available\. \(On an HL7 course I learnt that many/most developers prefer first looking at HL7 instance examples instead of trying to understand the underlying model\. I think the same could apply to some openEHR use\-cases\)\. Best regards, Erik Sundvall erisu@imt\.liu\.se http://www.imt.liu.se/~erisu/ Tel: \+46\-13\-227579 --- ## Post #33 by @Tim_Cook2 Tony, I think that you will be key in leading the charge to be sure that we have the correct archetypes in place\. Maybe even if they haven't all passed review by then???? We at least need to have a MedInfo2010 Set defined\. Probably no later than 1 December\. So we have the list prior to everyone going on the holiday break\. This will provide time for the various application developers to do template building and testing\. Maybe enough time for CKM/ARB certification as well? But of course this means that we also need to define the number of use cases and number of patients we will be demoing\. Comments please\.\.\.\.\.\.\.\. \-\-Tim --- ## Post #34 by @Heath_Frankel3 Hi Erik and others, I will provide an EHR\_EXTRACT to the list as soon as possible\. I have been absolutely snowed under doing software releases and currently at an IHE Australia connect\-a\-thon where I am using archetype models as the semantics basis for transforming HL7 V2 messages to an IHE Medical Summary compliant level 3 CDA and openEHR via the same template data document\. If I don't get one out by early next week please remind me\. Heath --- ## Post #35 by @tonyshannon Thanks Tim, In reply\.\. I am a believer in keeping things simple where possible\. My sense is that we can demostrate an impressive solution if we offer support around a single/few patient journey\(s\) and a limited set of archetypes\. Let me play devils advocate and suggest all we need to address for the majority of this is just 2 overlapping groups of archetypes\. 1\) The Emergency Summary set \(Top10\) that Heather has been polling for 2\) The SOAP note set Note that these have significant overlap\. That journey could begin in any/many ways\.\. eg 1\) Newborn \.\. with a SOAP note > http://74.125.77.132/search?q=cache:YO6tdfa2xXgJ:faculty.washington.edu/alexbert/MEDEX/Spring/MCHNewBornsoapnote.doc+soap+note+newborns&cd=5&hl=en&ct=clnk&gl=uk Home with a Summary note 2\) To the Primary Care doc\.\. with a new SOAP note At end of visit\.\. an updated Summary 3\) To the ED/other Unit\.\. where we access the Summary Then we add a new SOAP note Then we update the Summary 4\)\.\.into old age\.\. When a Long Term condition requires more SOAP notes and updates to the Summary and so on and so on\.\. OK a very simplistic example, but I hope it illustrates a point\. If some think that its too broad then we could use a subset of that journey\.\.again only needing with SOAP and Summary\. The top 10 Summary drive has already begin the process of now starting to explore 15/20 key archetypes, all of which selected can and will provide the basis for the SOAP note too\. One point your question does raise is whether we are aiming for archetypes that have more breadth or depth, or a mix in between\. I would be looking for the Medinfo demo set to provide \*just enough\* \(and no more than that\) detail to get the demo across\. I would not expect us to have finalised the definitive archetypes for Summary/SOAP by then\. There will be never be "final" versions of any of these anwway\.\.always works in progress\. Hope these ideas help\.\. Tony Tim Cook wrote: --- ## Post #36 by @Tim_Cook2 Hi Tony, I have added two potential use cases http://www.openehr.org/wiki/display/resources/Connect-a-thon+Details now I need clinicians to tell the rest of us is this a doable situation\. Can we do these two with the 15\-20 archetypes that were discussed below? If not, what needs to change? I also need feedback on the other items on that page\. Also, please start making commitments to participate\. http://www.openehr.org/wiki/display/resources/Connect-a-thon \+Participants If we do not have systems signed up and committed to participate then we are wasting our time in planning the event\. Cheers, Tim --- ## Post #37 by @tonyshannon Thanks Tim, Thats useful\. Some other feedback from clinical colleagues would be useful on this\. Certainly the high level use cases you posted , ie Newborn and then 65yo with Chronic Diseases should be useful\. The detailed candidate content posted up about these 2 I'm not so concerned about directly replicating\.\. if we can tackle the archetypes needed to do SOAP and Summary noting these can form the basis of the material needed to support both journeys\. The top 10 Emergency Archetype work Heather is currently over seeing will begin that\. Not sure what timetable is realistic for broadening out   CKM input to cover the other material needed for SOAP, but Im sure it will be months rather than weeks\. It may be that a few of us produce a candidate subset of archetypes that can handle both SOAP and Summary for the Connectathon purposes ahead of any ARB/CRB checks, given the time pressures you were suggesting earlier\. Dec 1 gives us about 12 weeks I guess\. My sense is there must be value in agreeing a small set of very basic set of archetypes over the next weeks for these purposes if that helps move forward the Connectathon\.\. Others may have a view on that? \#Heather do you want to comment on this thanks\.\. Perhaps other can comment on the date time and technical issues for the connectathon\. I've updated the wiki as we will be aiming to use Opereffa within the Connectathon, Serefs time will likely be constrained but thankfully he is certainly willing to try\.\.\. Regards, Tony Tim Cook wrote: --- ## Post #38 by @erik.sundvall Hi\! In addition to deciding on archetypes to use, I believe circulating a couple of complete instance examples fairly soon \(this week?\) would be very helpful in detecting differences in specification interpretations\. Having more than one archetype editor certainly helped detect differences and ambiguities in other parts of the specification earlier\. Things to include in the instance examples: \- EHR instance data constructed using comoposition archetypes with a couple of nested entry archetypes \- Several versions within a versionied composition, both IMPORTED \_VERSIONs and ORIGINAL\_VERSIONs \- Several "creating systems" producing version branches \(and possibly a merge\)\. \- Realistic demographic content including some example clinicians, organisations and patients\. \- Use of the "participations" attribute of EVENT\_CONTEXT \(\- Possibly also folders\) The examples do not right now need to use exactly the optimal archetype set intended for the connectathon, we'll probably raise many important implementation issues & discussions anyway\. Question: Is CONTRIBUTION information never sent explicitly between systems, but only backward\-referenced via AUDIT\_DETAILS via the "composer" attribute of COMPOSITION? Best regards, Erik Sundvall erisu@imt\.liu\.se http://www.imt.liu.se/~erisu/ Tel: \+46\-13\-227579 --- ## Post #39 by @tonyshannon Thanks Eric I'll have to admit I dont fully understand that question\.\.\. not sure if thats a good or bad thing ;o\) I am keen to help agree on a starter set of archetypes to use for the demo, though I'm coming at this from purely clinical benefit and communication grounds\. ie what is the minimum patient journey we need to show so that lay clinicians can look at that and say to themselves\.\. "Hmm, so thats what openEHR can do\.\. that looks useful"\. Tim may be able to reply to your technical concerns\.\. Regards, Tony Erik Sundvall wrote: --- ## Post #40 by @Tim_Cook2 > Thanks Eric > > I'll have to admit I dont fully understand that question\.\.\. not sure if > thats a good or bad thing ;o\) > > I am keen to help agree on a starter set of archetypes to use for the > demo, though I'm coming at this from purely clinical benefit and > communication grounds\. ie what is the minimum patient journey we need to > show so that lay clinicians can look at that and say to themselves\.\. > "Hmm, so thats what openEHR can do\.\. that looks useful"\. Thanks for this Tony\. You did a great job of reading my mind\. :\-\) It is my hope that you can get a group of clinicians to add to the wiki \(maybe create a new page?\) to develop this journey\. Then we'll be in a better position to define the operational aspects of the event\. > Tim may be able to reply to your technical concerns\.\. > To respond to Erik\. I, for one, will not be prepared to exchange any instances until Jan/Feb time frame\. I think we should set a goal to do actual testing of instance data exchange for 1 March, 2010\. That still leaves 6 months for any fine tuning; if needed\. Thoughts? \-\-Tim --- ## Post #41 by @heather.leslie Hi Tony, Tim, Sorry for the delay in response - have been travelling. Foundation work for the archetypes that would support a general SOAP and summary have been developed and re-used in previous work, starting with the 2007 NHS project. The best of these, ie those that we considered about 70-80% right have already been uploaded to CKM; some published, some under review, some still as draft. There remain other archetypes that were developed but still need some more work before being ready for CKM upload. It is likely that the more generic the proposed scenarios, the component archetypes comprise published archetypes from CKM; the more specific the proposed scenario, we may have to settle for a hybrid of published and draft archetypes. If we want to develop the specific scenarios as outlined by Tim, this will take additional archetype development work to create new domain specific archetypes. So we definitely don't need to start from scratch, but we do need to consider whether we only want to use agreed archetypes or are happy to use a mixture for this project. In fact by the time Medinfo rolls around they could all conceivably be agreed - will our demonstrator systems be able to absorb the archetypes as they evolve from draft to agreed? First lets agree on scope, then we can identify existing archetypes that can be re-used, and those that need to be created from scratch. Regards Heather --- ## Post #42 by @tonyshannon Thanks Tim, Heather, As Heather points out, there is already a basis on which we can build, we have already done some detailed work in the NHS addressing some of these common clinical documentation requirements in the past\. What we have not had are the vendors who are able to directly leverage the related archetypes\.\.\.hence the push behind the Opereffa development and now the Medinfo connectathon to open this out\.\. As you both suggest the key is to agree the scope and the wiki is a place we can sketch out a few simple patient journeys in pragmatic detail \(not too much, not too little\) which we can then compare against the archetypes that are available/draft/developing, before then making available to those over to those who want to take part\. I'm happy to take a lead on sketching out some very simple, generic but clinically recognisable patient journeys on the wiki, hoping others will critique/add comments/add detail and am happy to try to steer them to a reasonable level of detail\.\. I'll stick with the SOAP and Summary approach, in a vague cradle to grave fashion, as an outline framework to begin\. I'll also draw a line in the sand to say lets try to complete these few patient journeys by end September to allow good time for the related archetype development work to be done by Dec 1\. \(Times might shift a bit but might as well start with some timescales\.\.\) Heres the placemarker for where the stories can start from\.\. http://www.openehr.org/wiki/display/resources/Connect-a-thon+Details Any issues/comments on that approach please let me know\. Thanks, Tony Dr\. Tony Shannon Consultant in Emergency Medicine, Leeds Teaching Hospitals Clinical Lead, Clinical Content Service, NHS Connecting for Health Chair, Clinical Review Board, openEHR Foundation \+44\.789\.988 5068 tony\.shannon@nhs\.net Heather Leslie wrote: --- ## Post #43 by @Thilo_Schuler1 I am in to help with the journey(s). See my suggestion: [http://www.openehr.org/wiki/display/resources/Connect-a-thon+Details?focusedCommentId=5997155#comment-5997155](http://www.openehr.org/wiki/display/resources/Connect-a-thon+Details?focusedCommentId=5997155#comment-5997155) Cheers -Thilo --- ## Post #44 by @Derek_Meyer Dear ALL, I'm planning to introduce a classroom exercise on developing an archetype and uploading it to Clinical Knowledge Manager\. I've investigated CKM and I can't find a way to: 1\. Add St George's students as a development 'team' 2\. Allow the students to register and upload their archetypes as members of this Team 3\. Delete the team and all associated archetypes later\. Any suggestions? Thanks, Derek\. --- ## Post #45 by @heather.leslie Hi Derek, In order to ensure that CKM becomes a credible and authoritative source of knowledge artefacts we have have quite strict review, publication and governance processes. This is definitely not a trivial task and needs a smaller group of well-trained individuals facilitating these processes carefully to enable the community to actively collaborate on and agree these knowledge artefacts - archetypes in the first instance, templates soon, and then followed by terminology subsets. There are currently a number of defined roles and responsibilities within CKM and at present only those with Editorial role authority can add teams and upload archetypes - this is why you have not been able to access them. CKM is really not the best place to provide your students with some learning experiences, however, we can possibly offer them access to our test server/database where your students can have access to the same functionality as is currently in CKM. Here we could enable them to take on the roles and functions you are seeking without impact on the live instance of CKM. If you are interested, lets continue this discussion offline. Our desire is certainly to get more people taking on Editorial responsibility so that we can keep the momentum building and get more and more archetypes into the active review phase - currently the number of volunteer Editors is definitely a bottleneck - but only after ensuring that they have some training (more like an apprenticeship) and understand the processes that CKM has in place. Otherwise we run the risk of chaos, and the quality of the models produced might be compromised. So for anyone who is interested in taking on an Editor role, please contact me directly. Derek, I know that you have already indicated your interest in doing just this. In the near future we are also planning a more free and fluid area, the archetype 'nursery' or 'sandpit' where people can come together and collaborate on building archetypes, defining projects etc before submitting the resulting draft archetypes, templates etc into the more formal CKM review and governance process. Personally I'd love to see something like proposed Google Wave functionality here, ensuring real collaboration which would be exciting to see come to fruition, but it is still in the planning phase. Regards Heather --- ## Post #46 by @tonyshannon Many thanks Thilo and others for your input on this, I have updated this wiki, building on the suggestions, to try to tell a pretty simple story of a young patient with IDDM as they attend ED & GP on a few occasions over a period of years, using the SOAP approach\. It's remains a pretty rough draft, light on detail, with plenty of room for improvement, but at least it's a simple patient journey that I hope folk should be able to relate to\. Feel free to review and improve, adding more detail as you feel would be useful from your perspective\. I'll also ask Heather to check the overlap with the Top 10 Archetypes "to save a life" \(Emergency Summary\) work that is ongoing\. You may note there is already a good deal of overlap in this short story, which I hope illustrates the value in taking this SOAP and Summary approach\.\. Regards, Tony Dr\. Tony Shannon Consultant in Emergency Medicine, Leeds Teaching Hospitals Clinical Lead, Clinical Content Service, NHS Connecting for Health Chair, Clinical Review Board, openEHR Foundation \+44\.789\.988 5068 tony\.shannon@nhs\.net Thilo Schuler wrote: --- **Canonical:** https://discourse.openehr.org/t/medinfo-2010/14994 **Original content:** https://discourse.openehr.org/t/medinfo-2010/14994