Hello, especially to Tom and Segun,
Segun, thanks for your interest, if you are willing to join work on
connecting medical devices to health record systems using available
standards, then please contact me. We are looking for companies and groups
of users, and want to implement real clinical usecases over the next four
years. Everybody else who is interested in that, too.
Tom, if you say that archetypes are available in XML, then I guess you refer
to the archetype itself. It is good to know that this is available in XML as
well, and not only in ADL.
What about instances? I know that transportation of instances in real life
has been demonstrated, but not by many, and the world still needs to be
tought that this really happens. The world being implementers in a wide
range of companies that are designing products, EHRs, medical devices, lab
machines, etc.
These implementers are very much focusing on transport formats. We veteran
standards heroes know that the transport formats of instances need to be
automatically derived from archetypes, and both XML and ASN.1 (and many
others) need to be available, and are available if you whom to ask exactly
how. I did ask Bernd Blobel, and he told me that I had to do a doctoral
thesis at his lab to exactly learn how. I myself am willing to go that far
in our research project (Bernd, sorry but I may eventually have to skip the
thesis part, but this will definitely be a heavy learning experience).
The average implementer will not have the time. They still are firmly
convinced that a transport format worth its salt is handcrafted, and a
"reference model" is something for enlightened souls and philosophers. This
is the gap that I think needs to be addressed now. Tens of thousands of
implementers all over the planet have to learn the "new archetyped way" to
generate transport formats.
It is not enough to just say "It is possible, it has been done." We have
been on the moon, but we now need to get mass tourism going there.
Archetypes are at the moment not something for the average traveller.
Implementers need very well defined, simple, proven development toolpaths
that plug and play.
What we therefore want to do in this reasearch project is the following:
- to take IEEE 11073.20601 (+ device specialisations) information models
(e.g pulsoximetry samples, weight scale, blood pressure, ... They have a
number of them ready with nomenclature and all, more to come)
- make archetypes out of them
- do the same for other domains like the laboratory report. (this is a
slightly different line, but fits nicely)
- find or create tools that can handle these models and archetypes in
numerous ways:
- assemble messages and documents in correct ways, compliant to the
reference model
- generate code that can fill these models with content and generate
instances
- generate code that can convert these instances to XML (with CDA a
high priority)
- generate code that can convert these instances to ASN.1 (according
to the 11073, or other appropriate coding rules)
- generate code that can take an ASN.1 coded instance and fully
automatically convert it e.g. to an XML (CDA) coded one, so that it can be
fed into a EHR system with full semantics. Also do other conversion and
reassembly tasks.
- do this in close cooperation with companies (tools developers, device
developers, clinical IT vendors, etc) and clinical users, so that the
resulting tools landscape really is forced through the complete range of
requirements, both technical and also management e.g. "delivery on time",
ease of use, low cost, etc.
- target selected clinical applications and cooperate specifically with
whoever it takes from the start
- keep close contact to all necessary standardisation groups and projects,
so that "not invented here" and "reinvent the wheel" can be avoided wherever
possible
- demonstrate that it works
- demonstrate that it scales, both in numbers, richness of semantics,
complexity, and range of usecases and settings.
- demonstrate the many other beautiful things that you can do with a nice
and fat pack of sematically structured data: searches, decision support,
etc.
My experience is that no single tool exists at the moment to cover all of
these things. We will therefore have to identify a big bunch of existing
knowledge and tools, and plug them together in a useful way. We (and all the
implementers on this planet) will need a lot of help here, from many groups
of people who have been working on these tools for years. openEHR is
definitely one of these groups, IEEE, CEN, ISO, HL7 are others.
So, anybody who is willing to join in this, or already is on the way, is
very welcome. Should somebody be there already, we are happy to learn from
them, and tell everybody else. We will also do search activities to find
you. Its tooltime.
Sorry for being so long, I hope that this does not blast the bytes limit,
greetings from Vienna, and hope to see you soon, maybe in Istanbul,
Stefan Sauermann