Comments on: EHR System Modeling http://rdn-consulting.com/blog/2008/01/01/ehr-system-modeling/ Software Development and Biomedical Engineering Thu, 20 Nov 2008 17:55:44 +0000 http://wordpress.org/?v=2.6.3 By: Bob on Medical Device Software » Blog Archive » HIPAA and EMR Design http://rdn-consulting.com/blog/2008/01/01/ehr-system-modeling/#comment-414 Bob on Medical Device Software » Blog Archive » HIPAA and EMR Design Fri, 04 Jan 2008 05:19:40 +0000 http://rdn-consulting.com/blog/2008/01/01/ehr-system-modeling/#comment-414 [...] last post prompted a comment from Mary Hawking which asked this question: How does the legal framework in the USA influence the [...] [...] last post prompted a comment from Mary Hawking which asked this question: How does the legal framework in the USA influence the [...]

]]> By: Mary Hawking http://rdn-consulting.com/blog/2008/01/01/ehr-system-modeling/#comment-412 Mary Hawking Thu, 03 Jan 2008 19:38:55 +0000 http://rdn-consulting.com/blog/2008/01/01/ehr-system-modeling/#comment-412 Health records - electronic or otherwise - are held within organisational and legal frameworks which define the professional and legal responsibilities of the people and organisations involved in maintaining and using those records. I'm a GP in England, and paperless - i.e. the only record for my patients is in the EMR (EMIS - if anyone is interested!) How does the legal framework in the USA influence the design of US EMRs? Health records - electronic or otherwise - are held within organisational and legal frameworks which define the professional and legal responsibilities of the people and organisations involved in maintaining and using those records.
I’m a GP in England, and paperless - i.e. the only record for my patients is in the EMR (EMIS - if anyone is interested!)
How does the legal framework in the USA influence the design of US EMRs?

]]> By: Bob http://rdn-consulting.com/blog/2008/01/01/ehr-system-modeling/#comment-411 Bob Thu, 03 Jan 2008 03:42:37 +0000 http://rdn-consulting.com/blog/2008/01/01/ehr-system-modeling/#comment-411 @Werner: Thanks for the feedback. The openEHR concept of "semantic context" is certainly a good one. Every model will need to evolve as more is learned about the nature of the real world it’s trying to represent. One of the hallmarks of a good development framework is its ability to allow these types of changes to be incorporated into the model at minimum cost while maintaining backwards compatibility. This is not an easy task. Software modeling and development technologies have to continue to improve in order to meet these challenges. @Werner: Thanks for the feedback. The openEHR concept of “semantic context” is certainly a good one. Every model will need to evolve as more is learned about the nature of the real world it’s trying to represent. One of the hallmarks of a good development framework is its ability to allow these types of changes to be incorporated into the model at minimum cost while maintaining backwards compatibility. This is not an easy task. Software modeling and development technologies have to continue to improve in order to meet these challenges.

]]> By: Werner http://rdn-consulting.com/blog/2008/01/01/ehr-system-modeling/#comment-410 Werner Wed, 02 Jan 2008 20:19:30 +0000 http://rdn-consulting.com/blog/2008/01/01/ehr-system-modeling/#comment-410 Bob, With so many others, you seem to forget, or at least fail to mention, that a common information/behavior model is not enough to have interoperable systems that do more than just replicating the document-centered approach of paper-based EMRs in an electronic environment. You also need to have a common model of that what the information is about, i.e. of the entities on the side of the patient about which information is stored in information systems. Although the goal of HL7 RIM might be the same as for OpenEHR, it fails seriously in recognizing the distinction that I made. OpenEHR is at least aware of the distinction. Bob,

With so many others, you seem to forget, or at least fail to mention, that a common information/behavior model is not enough to have interoperable systems that do more than just replicating the document-centered approach of paper-based EMRs in an electronic environment. You also need to have a common model of that what the information is about, i.e. of the entities on the side of the patient about which information is stored in information systems. Although the goal of HL7 RIM might be the same as for OpenEHR, it fails seriously in recognizing the distinction that I made. OpenEHR is at least aware of the distinction.

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