MedInfo 2015 openEHR tutorials

Dear All,

Please take this observation as a help DISCUSSION rather a critic: but the standards difinition is not an awareness issues, instead is a GAP between contexts.
In Latino America and Caribe, there is minimal understanding of what a standard is…as displayed on Pablo´s answer, so the real use of openEHR never is achieved because of this gap.

I was last week in INFOLAC2014 ,where the goverment of Uruguay and several local authorities discussed about standards but the issue was a different one. So, I believe that OpenEHR as foundation and its initial team of founders of this conceptual and technical framework should lead the training contents and validity that developing countries are using.

I was surprise that Uruguay invested 4 million dollars and the concept of openEHR was missing: lost of investment again.
http://www.agesic.gub.uy/innovaportal/file/1443/1/agesic_agendadigital_2011_2015.pdf

Hope this contextual information help to get a good quality training package from the foundation so then it can be shared around the world.

Cheers Carol
(LATAM)

Bert, I’m aware of the definition and I use terms in a very specific way, I said standard because that definition fits what openEHR is.

I don’t think so. And I think there can be reasons why OpenEhr does not try to becomes a standard.

Anyway, we are not discussing definitions but a much broader subject: the board being silent in front on community efforts that need them.

You are right, you just used the word standard a few times, and that is not what it is. That is one reason why I said it, not for discussion.

I agree that there could be done more and could have been done more. It (the board) could try to apply for standardization, could work for it, towards it, It could put more effort in education, it could better document artifacts which are widely used.

I think it is possible that things have to do with each other. That is why I responded to the word standard.

The board doesn’t do these things. It wonders you. In your message, you indicate that possible they are not aware of what you complain about.

You’ll find the names of the members of the board on the website, I think. You can email them and ask. I hope you tell us what they tell you. Maybe it is just money. There ain’t no such thing as a free lunch.

Good luck
Bert Verhees.

In Europe, politicians are afraid to make errors, they are not able to judge if a specification has a high quality. So they go for standards. This is in many countries like this.

That is why HL7 always try to standardize their efforts, and the higher the better. In Europe you go first to your national body, then to the European body, then to ISO.

Alternatives with a little bit less status are Oasis, W3, OMG, and also from there you can go to ISO.

I have never heard that OpenEhr tried to become a standard. In these ten years, they never did, or they did it in silence, or I just missed it, was on holiday when the announcement was done.

But if I am right, then is that a reason why it will never become important on government-level in the Netherlands. And in many other countries this is the same.

No politician in the Netherlands wil ever invest millions in a specification which did not made it to ISO. That is why the Netherlands invested 500 millions Euro in a HL7v3 standard. Because it is an ISO standard, or it was in the traject to become one. Really, 500 millions Euro, half a billion Euro. Just for a message system for the Netherlands, based on HL7v3. And the laugh, it failed.

But that doesn’t matter, the politicians are safe, they favored ISO standards. The companies are safe, they got their money, got well paid, and did what they were asked for. No one ever got fired for choosing an ISO standard.

Why did it fail? Ten years they had spent 50 million Euro, every year. It is a long story, but I can summarize it in a few words. I think they did not want to succeed. They failed for political reasons, they did not want to do concessions with the majority in parliament. So the parliament blew it off. They had chosen to fail.

It would be good for the OpenEhr developing companies if a OpenEhr did more to be acceptable for governments.

Bert

Hi,

What I should offense to is health threating entities/events. I
believe we have wisdom enough to fight against them.
And then, it would be more constructive that we think about what we
can do for healthcare and our community rather than what our community
do for us.
Having workshop and tutorials would be good contribution and make
something happen to outreach.

To Pablo and Latin Americans,
I always respect your contributions and am much interested in your
woks. I am looking forward to meeting you and sharing passion with us.

To Bert,
Thank you for proof-reading. English is too difficult for me,
Japanese. My understanding is openEHR specs are oriented to base of
the standards. Could you let me know the better phrase?

Regards,
Shinji KOBAYASHI

Hi Bert, that is my idea. In fact I’m putting together a small document with bullet points of what we discussed about the training space since 2012, and try to ask if the board should or can be involved in this, why is not already involved, if there are any plans to do it and of course if I can be of help.

I don’t think the problem is money (but maybe I’m also afraid to ask), but IMO is more action fron the board to give us a little push with support (also no talking about money).

I’m also afraid to ask if the lack of endorsement and support is something political, maybe with me working at the MoH, WHO etc. and saying the same things might hace a different effect. I really don’t know and I hope we are still a meritocracy.

Bottom line, I just see a gap between the foundation and the community, and that gap gets bigger because of language and geografical differences. That’s why I created the openEHR course in spanish and the ES community. My proposal is just a “help me help you” situation.

Working towards medinfo, I hope we can join ours efforts in creating awareness, but it is not clear for me if we should organize community stuff separated from the foundation stuff or if we can narrow the gap.

Kind regards,

Pablo.

Pablo Pazos

www.CaboLabs.com

Hi Shinji,

I’m all to collanorayion and adding value.

Abouy the specific topic for the conference, I’m focusing one proposal on openEHR databases, a problem every developer do focus on when they start to work with openEHR. Because the organization is lookinh for tutorials in spanish the tutorial will be offered in spanish.

I’ll update yhe wili soon and start doing social communication to get more people involved.

Cheers,

Pablo Pazos

www.CaboLabs.com

Only strong men can admit their weaknesses. So this is a compliment for you.
My English is not very good also, but I come from a language related to English, while you come from a completely other part of the languages-world.

I know you are doing a great job. I often see your promotion for course in Spanish, on LinkedIn, on Google Plus (maybe). I forgot where, but I see it a few times a week.
That is really a good thing.

And it is necessary. The specs are bad learning material, there are also not meant for that.

I remember, ten years ago, sitting at the swimming pool with my little children, reading OpenEHR-specs. They were hard to read because of their formal language.
It is no material for learning. In learning people things, you need to come with examples, with stories, let the Reference Models and other specs live for people, make it fun to read.

Anyway, I came through, I did my best, and it was rewarded. But many people are not able to do that, because they do not have the freedom to spend 50 hours or so on something which is not required to learn. And reading the OpenEHR specs as a hobby in free time, that is asked too much for most of humanity.

I am an independent developer, almost twenty years now. I choose myself how to spend my time, and a lot of time is used because I make choices which seem irrelevant. But I don't mind. I try to have a Buddhist view on it. It are all steps to greater wisdom. I am a lucky bastard.
"The master moves from program to program without fear. No failure can harm him. Why is this? He is filled with Tao."

But for the other people, young people, needing to study for their masters, old managers, need to understand for their decisions, politicians, relying on ISO, all these people need easy entrance to knowledge. You try to get it of the ground. You should not only do it in Spanish, but also in English.
I think you have a good business-case when OpenEHR as an formal definition tries to get more status.
But you have a bad business-case if it fails on the market. It is not only in your hands.

You can comfort yourself with the thought that nothing in life will be done in vain. In everything is a lesson. With the lessons you have learned, you later can pick up something else.

But besides that, I hope the communities and foundation will support you, because it is important work that you do, for us all. If we want something to be a success, we have to reach the hearts and minds.

Have a nice day
Bert

Hi Pablo,

Firstly, I will be at MEDinfo2015 and would definitely hope to contribute some of the very interesting stuff emerging from HANDI-HOPD.

I do recall our conversation about training and accreditation. Although I am on the Board, my response here is personal, not official!

What you are suggesting is a very good idea, and was discussed further at the Oslo meeting. We know that a number of organisations around the world are now running openEHR related training, we know that trainees frequently ask for accreditation and trainers also see benefits in being able to claim they are ‘openEHR accredited’. So if the Board was asked, “is this a good idea”, I am sure you would get a positive answer.

However a whole number of questions follow …

Is the organisation accredited or the course accredited?
Who decides the criteria for accreditation of a course?

Does every small variant of a course need accredited?
Who checks the course content? In multiple languages?
What are the rules of withdrawing accreditation?
Who pays for all of the above?
How do we ensure that anything that is decided is fair to both existing trainers and to new entrants and how do we ensure that this system is seen to be fair and transparent and not open to abuse.

I am sure there are many more questions, and, of course there are solutions. Other organisations have faced similar problems and come up with answers that we can almost certainly use or adapt.

So, it is doable, but who does it? Who puts in the work and effort to consult with current training organisations, speak to the broader membership, also other organisations what they do etc, etc? Who comes up with a final proposal to submit to the Board that if seen to be fair and sensible will almost cvertainly by ‘rubber-stamped’.

In my view the only people who can do this are those of us who have a commercial or academic interest in training. It is in our interest to have accrediation working - it is something demanded by our customers, and in our commercial interest. We are the ones with the knowledge of what it takes to be a good openEHR course, the ones who stand to lose if the proposals are done favour a competitor, and the only ones who can give up some of our IP, if the idea is to share some ‘standard’ resources.

The Board simply has no capacity to do the ground work here, and in any case that would be inappropriate. Their job is to ratify (or not) a set of proposals coming from the training industry, in exactly the same way that the System Accreditation proposals will have to come from System developers like yourself.

I believe that Heather Leslie and Evelyn Hovenga have been working on some ideas in this area - it might be worth contacting them to see if this could be the nexus of a ‘Training Partners Group’.

I am having a similar conversation elsewhere about Localisation. There have been private conversations about localisation and Koray posted a very detailed proposal but that is not enough, there needs to be input from other localisation groups so that openEHR can come up with a minimum but clear set of criteria for localisation. That takes work and discussion with the various parties around the world who have an interest in this area, but it does have to member-led.

In the coming months, the interim Board will be replaced by an Elected Board (everyone who wants to vote or be nominated should sign up at members.openehr.org) but even then, the level of funding and personal resource that will available, will require Foundation resources to be concentrated on core communications and ‘marketing’ of openEHR.

As I say just my view. Others may feel that openEHR should have much more central power and resource to drive these important and necessary efforts but they will then have to figure out how it gets funded.

I will leave my thoughts on Standards to a different post but remember that there was a major effort led by David and Sam to have openEHR become part of IHTSDO. This went a long way but was ultimately rejected byt the IHTSDO board. I suspect that will not be the end of the story.

Ian

This is such a fun topic I wrote a on it :slight_smile: - thomas

I commented to it: I agree Thomas, it is a fun topic, with billions of dollars involved, not quite so funny for who is paying them. You and me, the taxpayers.

Andrew Tanenbaum: "The advantage of standards is that there are so many to choose from"

(Dr) Adrian V Stokes OBE
97 Millway, Mill Hill, LONDON, NW7 3JL

Unfortunately neither of you were at the recent Oslo meeting (don't worry, there will be more), but the same sentiments about needing better learning materials were expressed by most people who are not already seasoned openEHR developers. So we know we need to work on this, and various people have offered to do this. It will take a combination of people who 'know stuff' and people who are learning to put together materials that work for newcomers. I hope you both contribute.

One big enabling step that is finally about to happen is to move to a new server, where we can easily run multiple sites i.e. subdomains under openEHR.org. So we'll be able to set up some technical spaces for people to work on just those learning materials. The main requirement of course is still people power.

With respect to making governments use openEHR, that's a hard one to solve because there is broken thinking in two places: official SDOs that publish paper, with no active maintenance or update, and governments that think 'official standards' are the only things to use. Almost invariably, official standards in health (and general) IT (with the exception of standards that were already /de facto/ before becoming /de jure/) are the /worst/ place to start. Some governments have smarter people though, and realise this. The ones that don't will waste (sometimes epic amounts of) taxpayers' money.

In many places, this unholy SDO/government communion actively damages hopes for quality e-health solutions in the future. Government departments or bodies that are wilfully blind make it very hard, since they can't be reasoned with. It's like reasoning with any other ideologue: you can't. The only solutions I know of are a) keep making noise about the de facto standardisation work on the ground and b) wait for the next election :wink:

- thomas

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oh the wastage is a crime, and it should be punishable. The austerity obsessed government here in the UK is causing great pain to people here due to cut-backs in the NHS, in the low £bn range. And yet it was apparently acceptable to spend over £8bn on what I guess is a few hundred million £ worth of IT (most being replaced as we speak anyway). I would like to hear those responsible defend their actions to the current generation of affected patients, and the overworked health carers… We can only try to do better in the future, and that means creating high quality, economically cheap technology. We’re not very efficient yet in doing this in openEHR, but we can improve and I see uptake accelerating, which is good. As always, it’s down to us - how we self-organise and work together. - thomas

Hi Ian that’s an awesome piece of input we can use to epose the main issues we’re havong and maybe delineate actions that can be taken, considering the constraints you mentioned.

For me Evelyn and Heather are key people in matters of education, and also the BR-PT community, and some others interested in training.

I’ll put together all off this, send it to the key people for consideration. Fix the proposals with feedback, share it with the community and try to define a clear guideline we all van follow in terms of what we do and how in terms of training. IMO we can’t have a formal way of certification before having compatible and interoperable training materials, modules, evaluations, …

Cheers,

Pablo Pazos

www.CaboLabs.com

Thanks Pablo

Good feedback. It has been difficult to keep up with everything and I am in no way trying to impede any activity. I believe this is the first International Medinfo in a country where openEHR is up and running.

My wish is to have a group that coordinate the effort. If you feel you have this in hand, lets make sure it is public and people know who to go to.

Are there any plans to have an openEHR stand? This could enable a group of companies to promote what they are doing?

Evelyn Hovenga and Heather Grain have been working with Heather Leslie regarding accrediting training…. have you talked to them? Do we need a group coordinating this?

Cheers Sam

Dr Sam Heard
Chairman, openEHR Foundation

I've added myself and a topic on artefact governance to the main MEDINFO2015 wiki page. I guess this topic belongs more in a tutorial than in a developers' workshop. My participation is however dependent on my employer allowing me to attend the conference, which isn't clear yet.

Kind regards,
Silje Ljosland Bakke
Coordinator, National Editorial Board for Archetypes, National ICT Norway
Adviser, R&D dept, E-health section, Bergen Hospital Trust
Tel. +47 40203298

I replied following to it:

Hello!
If you are talking about "endorsed trainers" then you VERY CLEARY need to define
- what is training
- what is a trainer
- what is endorsed
- how do you get endorsed.

Otherwise very likely somebody will be angry, because
- they are not on the list of "endorsed trainers"
- they feel that the "endorsed trainers" are not as clever as themselves
- .....

So: Similar to standards for software you will also need to define standards / guidelines for
- the intended learning outcome
- different levels of expertise (e.g "certified professional openEHR - basic level", "CP openEHR - advanced level" , ...)
- the methods for assessment
- methods for training
- ......

Having been through this all let me summarise
- it seems sensible to start by defining a "basic" skill level
- to then define the learning outcomes of that skill level
- to then define an exam for that skill level
- to formally provide exams

from there on you can
- extend to "advanced" skill levels, and specialised skill sets
- go on by defining / offering training, courses, trainers etc.

This is no piece of cake. It will not happen in 3 weeks. Along the way you will need to "harmonise" the views of many individuals. We all know that to "harmonise" consumes substantial resources.

This draws from first hand experience on certifying personal skills in the fields of software testing and IT interoperability in healthcare, as well as from years of teaching and building study programs in biomedical engineering.

Hope this helps,
greetings from Vienna,
Stefan

Stefan Sauermann

Program Director
Biomedical Engineering Sciences (Master)

University of Applied Sciences Technikum Wien
Hoechstaedtplatz 5, 1200 Vienna, Austria
P: +43 1 333 40 77 - 988
M: +43 664 6192555
E: stefan.sauermann@technikum-wien.at

I: www.technikum-wien.at/mbe
I: www.technikum-wien.at/ibmt
I: www.healthy-interoperability.at

Dear All,

Just need to be carefull about endorsing, that´s all. I can say.
Just to ensure the quality of the work done internationally.

I see the endorsement as a commercial thing rather than a quality measure at this point.
This observation is based on experience with more than twenty three developing countries.

Cheers Carol
LATAM