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Monday, January 31, 2011

Return after hiatus

It has been far too long since I was last on-line, and it is high time to resume some discussions about the importance of proper modeling of clinical content.

There are a lot of balls in the air in the healthcare IT world today. With so many different, often disconnected, efforts, we risk the creation of specifications which impair large scale interoperability, secondary use of information, and the benefits of clinical decision support as part of the order entry functions of an electronic health record system.

Several efforts are underway which will help pave the way. The Health Story project, which I am providing technical assistance, will seek to consolidate the existing discrepencies between HL7 v3 CDA r2 implementation guides. This helps to both correct some of the issues many have had, but also is a great illustration of the divergence in approaches which occurs without an overarching information model for the content.

The clinical statement pattern is the current foundation for modeling HL7 clinical content, be it for a message, a clinical document or as part of a web service. The clinical statement pattern provides a mechanism to create interoperable detailed clinical models, but does in an of itself will not provide this. Experience has shown that there are 'many ways to skin a cat'; the DCM effort simply exists to provide one best practice for doing so which can be shared between applications.

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