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| OpenEMR HQ CEO calls for universal data storge format for EHR/EMR systems |
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 Posted by David Kennerson on Friday August 22, 2008 @ 12:50 AM
from the OpenEMR dept.
During the company's weekly conference call with its customers, OpenEMR HQ CEO Anthony Papillion stressed the need for records storage and data exchange between commercial EMR/EHR packages such as OpenEMR, VistA, and others: Digg this article
"Customers are demanding choice. They're not satisfied or accepting of companies who try to lock them in with proprietary formats that hold their data hostage", Papillion said when asked why the company was making such a strong call for shared standards. Papillion also said he believes that closed standards and data lock-in are an affront to good customer service and scream of poor software quality:
"Would you buy a car that you knew nothing about and could find out nothing about how it worked? Of course not! But physicians make such huge decisions every single day on EHR products that they spend hundreds of thousands of dollars on. If you have to hide the underlying workings of your product, then, one has to ask, what are you really hiding"?
Papillion cited how open standards in other industries like voting, manufacturing, and even airline design are actually helping vendors sell their product as they present their customers their products with pride and backed by what Papillion calls "the open source insurance policy" that guarantees that companies have to perform up to snuff or their customers can easily go elsewhere.
During her turn in the call, OpenEMR HQ's Chief Stratagy Officer, Michelle Sundar, said the company will soon be reaching out to other vendors - both proprietary and open - to work together to establish a universal data storage standard.
The company also used the meeting to unveil their planned "Universal Health Statistics Network", a network that will allow users of OpenEMR to tap into a nationwide health statistics network that will give them a greater understanding of developing health trends in their region or country.
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Re: OpenEMR HQ CEO calls for universal data storge
by Tim Cook on Saturday August 23, 2008 @ 12:45 PM
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Hmmmm, if this is such a strong call for action then why not adopt the openEHR information model? It is COMPLETELY open. It has been proven through implementability over almost two decades of research and development. See http://www.openehr.org
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Re: OpenEMR HQ CEO calls for universal data storge format for EHR/EMR systems
by Fred Trotter on Sunday August 24, 2008 @ 12:22 PM
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This is embarrassing for OpenEMR as a project and for the FOSS community generally.
There *are* such standards already in place. Tim has already mentioned one of them.
Others are the CCR and CCD standards. There are problems with these, and with any standards, but unless a vendor has implemented these (which several FOSS projects have) then they are hardly in a position to call for a "universal data storage standard".
At this point it appears that OpenEMR HQ has no idea what the heck its talking about. Which puts them on par with most of the proprietary community, but is not representative of the typical FOSS community.
Hard to imagine that I would call someone arrogant, since so many people have that impression of me, but I think arrogance, with a dose of ignorance, is what is happening here.
-FT
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Re: OpenEMR HQ CEO calls for universal data storge
by Tim Cook on Tuesday August 26, 2008 @ 06:26 AM
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Just a quick note of clarification. The openEHR specifications are designed as a language and implementation neutral model. There are multiple implementations in a variety of languages such as Python,Java,Eiffel and C#. They also use different approaches data persistence. But in the end, information in one application can be re-used in any other openEHR based application. Two level modeling is essential for this success.
The CCR and CCD specs are designed to provide a generic (though not lossless) communications format. There already exists openEHR XSLT transforms for HL7 CDA which should be easily adaptable (at least as a model) for CCR and CCD if desired.
It would be very counter productive for any group to launch into defining a data model for health care without informing themselves fully about the work that has been done over the past 40+ years.
Healthcare is a complex domain with intersecting temporal and spatial components. Comparing healthcare information management with other industries is something to be done only with great caution.
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Re: OpenEMR HQ CEO calls for universal data storage format for EHR/EMR systems
by David Kennerson on Thursday August 28, 2008 @ 07:03 AM
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I think you're missing a bit of the point of Mr. Papillion's statements here (which I posted originally). We don't deny that there are standards in place and that many FOSS solutions adhere to them. The problem, and this has been an issue brought up by many of our customers countless times, is that many proprietary vendors don't adhere to a single standard for data storage.
Such non-adherence is, of course, done purposefully in order to lock customers into their software and make it exceptionally difficult should they ever want to leave and go somewhere else. It's really a form of virtual hostage taking. While I can't speak for Mr. Papillion directly, I can say that this *has* been an issue brought up again and again with customers I've personally spoken to (even when I worked for another EHR vendor) and, as far as I can tell, it continues to be a major headache. I'm not really sure how anyone who works in the industry can deny that.
Having standards in place in one thing. Vendor compliance with those standards is a totally different beast altogether.
Have a good one!
Dave Kennerson
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Re: OpenEMR HQ CEO calls for universal data storag
by Tim Cook on Thursday September 04, 2008 @ 02:29 PM
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Well I'm not sure what point it is am missing. The proprietary vendor issue is a well known one. However, the words you posted specifically refer to two open source applications and infer others.
We can do nothing about proprietary vendors. In fact we can *DO* nothing about FOSS apps either without some spirit of cooperation.
I was simply pointing out that a solution DOES exist for FOSS and proprietary apps. If they choose to use it. Many people seem to think that the openEHR specs are over complicated because they do not spend time to understand them.
The reality is that we must:
"Make everything as simple as possible, but no simpler." -- Albert Einstein.
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Re: OpenEMR HQ CEO calls for universal data storge format for EHR/EMR systems
by Michael Gold on Tuesday August 26, 2008 @ 11:51 AM
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Plenty of data models and communications formats, as others mentioned.
But, one place where everyone is still free to choose something on their own is in the persistance mechanism for data at rest.
Perhaps this is what they are referring to when they say "storage format"? Even there, does that mean we all need to agree on whether we want a relational engine, vs an XML DB, vs an object DB, vs a JSON DB, etc... ??
mg
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Re: OpenEMR HQ CEO calls for universal data storge
by Tim Cook on Saturday August 30, 2008 @ 03:32 AM
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This is exactly the point of the openEHR "information model". It always for any type implementation. While my Python implementation currently uses an object database it can easily have a layer added to use a SQL database or XML database.
Most of the other openEHR implementations already use a SQL database and they choose at what granularity they want to store their data. There is a discussion page on the openEHR wiki specifically about different persistence approaches.
http://www.openehr.org/wiki/display/dev/Persistence
(see the two child pages)
The freedom to implement in any OO language and use any persistence model while still maintaining semantic coherence across applications is the foundation of openEHR.
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