Fresh Look

Note: Please keep the content on this page polite, and insightful. Content here is public, and also community moderated.

Triage

Please add your points as a bullet under here. Links to other pages welcome.

Wishlist items

• Grahame: Keep it simple as can be - implementers first
• Ann's list of 4:
  • PIIM
  • Implementer's Guides
    • What exactly does this mean? Implementer vs Implementation guide .. Rene spronk
  • greenCDA
  • simplified wire format (end-to-end greening)
• William/Michael
  • Clear separation of infrastructure and clinical content. (or clear separation of definitional knowledge and effective exchange - without breaking the connection)
  • Registry of templates / models / DCM / archetypes needs to be operational asap
    • Can we make them available through a website/wiki? Less computable metadata, but quicker availability. (Gerald)
    • OpenEHR has one. What is it that you want this one to achieve? (Grahame) http://www.openehr.org/knowledge/
    • Netherlands has two:
      • one in DCM format: http://www.eenheidvantaal.nl/
      • two in HL7 v3 R-MIM format http://www.zorginformatiemodel.nl and http://www.sre.nl/web/show/id=132128
    • CDISC work on Share: http://http://www.cdisc.org/cdisc-share
    • Korea EHR project: http://www.clinicalcontentsmodel.org
    • Intermountain Healthcare: http://intermountainhealthcare.org/CEM/Pages/LicenseAgreement.aspx
    • US National Cancer Institute: https://cdebrowser.nci.nih.gov/CDEBrowser/
    • Tolven
    • List of template registries
  • Proper rules for transformations from different model artifacts to other artifacts, and validation of these.
  • Clear migration strategy, which is tested to work, before changing HL7 v3 proper to not frustrate the ongoing implementations which are now just starting to be moving ahead (Alexander)
• Rene: implementers either need PIIM for MDA implementations, OR simplified wire format - with normative associated schema.
  • This is AND/OR, not XOR, correct? (Gerald)
  • Yes, AND/OR, although most implementers will choose to use one XOR the other (e.g. if the scope of the project is limited to a very few models, use a simplified wire format. If the project uses tons of models, use MDA). HL7 needs to provide implementers with both options. (Rene)
• Gerald
  • Clear understanding and separation of interaction models
    • Documents - to stand on their own with context included within artifact
    • Messages
    • Services - context determined by service contract (and perhaps federation agreement)

Grahame's Desiderata for a good specification

A good specification should have the following properties:

• It has multiple views that address different concerns
  • different users can easily find the concerns that address them
• Implementers can find a concise view that tells them what they must do to conform
  • first of all described in clear direct terms that takes < 1 hour to get going
  • supported by artifacts that can be used to generate software that can conform
  • can be implemented using ubiquitiously available software tooling
• Business Analysts/Clinicians can easily find the mappings between the artifacts in the standard and business & clinical practice
• Terminologists/Logicians can find a solid computable base upon which the definitions stand
  • this provides computable artifacts that are used internally to ensure that the simple definitions for the implementers are solid and reliable
  • the computable definitions enable semantic interoperability based on the simple exchange formats
• The standard and particularly computable artifacts are free for use
• there is a simple, understandable, implementable and predictable version strategy

Concrete next Steps

For actual things that should be done

• ahh.... ?
• Some ideas (Gerald)
  • Decide which approach to develop as part of this activity
    • My favorite: start with RIM as design model; develop process for creating an implementation model; describe requirements for tracing back to RIM (and/or other semantic models such as Archtypes).
  • Decide on the process for working this - HL7 project? Open participation? Collaboration with other SDO?
  • Setup a conference call/meeting and prepare time line
  • Evaluate existing (partial?) solutions