Re: [COAS-List] tentative model of CEN PT27

["Tom Culpepper" <tcculpepper@wpmail.code3.com>]

Angelo,

>>> Angelo Rossi Mori <rossi@color.irmkant.rm.cnr.it> 02/02 8:52 AM >>>
>>Tom,
>>in order to facilitate the mutual understanding,
>>I tried to produce a model of the Clinical Information,
>>as intended in CEN PT27.

>>I hope it could be useful.

Thank-you for your input.

>>My concern about COAS is that its model is very general,
>>whereas the models in the HL7 RIM (or the equivalent in CEN)
>>are specific.

The COAS model is a logical view. The logical view of a system describes the existence and meaning of the key abstractions that form the design.

What we are providing with COAS is an access service to medical information. These services allow you to ask questions of some Server that will then return to you the pertinent information you requested. In an object-oriented world what I believe CEN and HL7 are providing are the attributes and not the methods or behaviors. COAS is providing the behaviors.

What we see happening is that bodies such as CEN and HL7 will determine "what" is the structure of medical information, what constitutes an "Observation", what are "ObservationQualifiers", and what are "ObservationReferences". I believe much of this is occurring both with CEN and HL7 templates. We hope that this work will move forward quickly.

>>Who will make the bridge, to let them work
>>in synergy ?

The hope is that canonical medical information structures will be constructed and placed in some "metadata registry". Much of the metadata registry work in occurring at the ISO/IEC JTC 1/SC 32/ WG 2 level with the 11179 standard.

There is a meeting of the ISO/IEC JTC 1/SC 32/ WG 2 in Washington DC in February here is a link:
http://sdct-sunsrv1.ncsl.nist.gov/~ftp/l8/sc32wg2/was99/index.html

If differences in these medical information structures exist then they can be mediated by means of accessing the structural information from the metadata registry. Work is under way in defining the behaviors of the 11179 which will allow for such access.

There is an Open Forum which will be discussing the 11179 also in Washington DC in February here is the link:
ftp://sdct-sunsrv1.ncsl.nist.gov/x3l8/sc32wg2/openforum/index.html

>>In other words, I understand that according to an attitude
>>in CORBA, your services are very general,
>>and then you trust in other bodies to complete the gap.

The model denotes a general solution but the services provide a very complete and robust mechanism for extensibility and functionality in the retrieval of medical information. Again, "what" constitutes medical information is best defined by medical domain experts.

>>You know more than me on this topic,
>>and I have to assume that the approach is correct
>>(and robust).

We wanted to provide a framework for extensibility and at the same time accommodate all interested parties. At 3M we have had the opportunities to have experimented with a variety of models and along with Stan Huff and many others concluded that this type of model would be the most advantageous.

>>Novertheless, I ask myself:
>>when HL7 or CEN will produce the intermediate standards
>>that will allow a plug-and-play interoperability ?

As quickly as you can.

Also, while we were at the HL7 meeting you mentioned some terminology about what is a set of observations versus what are qualifiers can you please point me in the right direction of where I can understand more about what you were referring too?
Thanks
Tom

>>Angelo