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Re: FW: A Fresh Look Proposal (HL7)

From: Jim McCusker <james.mccusker@yale.edu>
Date: Mon, 22 Aug 2011 09:39:46 -0400
Message-ID: <CAAtgn=SnOowYkC_ugBe_t3havuJxio0kjXVhhhYgzW2G=_AEnA@mail.gmail.com>
To: conor dowling <conor-dowling@caregraf.com>
Cc: "Hau, Dave (NIH/NCI) [E]" <haudt@mail.nih.gov>, "public-semweb-lifesci@w3.org" <public-semweb-lifesci@w3.org>
I was just crafting a mail about how our investment in XML technologies
hasn't paid off when this came in. What he said. :-)

On Mon, Aug 22, 2011 at 9:33 AM, conor dowling
<conor-dowling@caregraf.com>wrote:

> >> The content matters, the format does not.
>
> should be front and center. Talk of XML that or JSON this, of RDF as XML in
> a chain is a distraction - it's just plumbing. There are many tool-chains
> and implementors are big boys - they can graze the buffet themselves.
>
> Central to any patient model rework (I hope) would be the interplay of
> formal specifications for terminologies like SNOMED along with any patient
> data information model. What should go in the terminology concept (the
> "object" in RDF terms) - what is left in the model (the "predicate"). Right
> now, this interplay is woefully under specified and implementors throw just
> about any old concept into "appropriate" slots in RIM (I know this from
> doing meaningful use tests:
> http://www.caregraf.com/blog/being-allergic-to-allergies,
> http://www.caregraf.com/blog/there-once-was-a-strawberry-allergy ) BTW, if
> SNOMED is the terminology of choice (for most) then the dance of it and any
> RIM-2 should drive much of RIM-2's form.
>
> This is a chance to get away from a fixation on formats/plumbing/"the
> trucks for data" and focus on content and in that focus to consider every
> aspect of expression, not just the verbs (RIM) or the objects (SNOMED) but
> both.
>
> Back to "forget the plumbing": if you want to publish a patient's data as
> an RDF graph or relational tables or you want a "document" to send on a
> wire, if you want to query with a custom protocol or use SPARQL or SQL, you
> should be able to and not be seen as an outlier. Each can be reduced to
> equivalents in other formats for particular interoperability. The problem
> right now is that so much time is spent talking about these containers and
> working between them and too little time is given over to what they contain,
>
> Conor
>
> On Mon, Aug 22, 2011 at 6:01 AM, Hau, Dave (NIH/NCI) [E] <
> haudt@mail.nih.gov> wrote:
>
>> I see what you're saying and I agree.****
>>
>> ** **
>>
>> The appeal of XML (i.e. XML used with an XSD representing model
>> syntactics, not XML used as a serialization as in RDF/XML) is due in part
>> to:****
>>
>> ** **
>>
>> - XML schema validation API is available on virtually all platforms e.g.
>> Java, Javascript, Google Web Toolkit, Android etc.****
>>
>> - XML schema validation is relatively lightweight computationally.  Pellet
>> ICV and similar mechanisms are more complete in their validation with the
>> model, but much more computationally expensive unless you restrict yourself
>> to a small subset of OWL which then limits the expressiveness of the
>> modeling language.****
>>
>> - XML provides a convenient bridge from models such as OWL to relational
>> databases e.g. via JAXB or Castor to Java objects to Hibernate to any RDB.
>> ****
>>
>> - Relational querying and XML manipulation skills are much more plentiful
>> in the market than SPARQL skills currently.****
>>
>> - Some of the current HL7 artifacts are expressed in XSD format, such as
>> their datatypes (ISO 21090 ; although there are alternative representations
>> such as UML, and there is an abstract spec too from HL7).  If we operate
>> with OWL and RDF exclusively, would need to convert these datatypes into
>> OWL.****
>>
>> ** **
>>
>> Maybe it'd be worthwhile to get a few of us who are interested in this
>> topic together, with some of the HL7 folks interested, and have a few calls
>> to flush this out and maybe write something up?****
>>
>> ** **
>>
>> - Dave****
>>
>> ** **
>>
>> ** **
>>
>> ** **
>>
>> ** **
>>
>> *From:* Jim McCusker [mailto:james.mccusker@yale.edu]
>> *Sent:* Sunday, August 21, 2011 6:12 PM
>> *To:* Hau, Dave (NIH/NCI) [E]
>> *Cc:* public-semweb-lifesci@w3.org
>> *Subject:* Re: FW: A Fresh Look Proposal (HL7)****
>>
>> ** **
>>
>> I feel I need to cut to the chase with this one: XML schema cannot
>> validate semantic correctness.****
>>
>> ** **
>>
>> It can validate that XML conforms to a particular schema, but that is
>> syntactic. The OWL validator is nothing like a schema validator, first it
>> produces a closure of all statements that can be inferred from the asserted
>> information. This means that if a secondary ontology is used to describe
>> some data, and that ontology integrates with the ontology that you're
>> attempting to validate against, you will get a valid result. An XML schema
>> can only work with what's in front of it.****
>>
>> ** **
>>
>> Two, there are many different representations of information that go
>> beyond XML, and it should be possible to validate that information without
>> anything other than a mechanical, universal translation. For instance, there
>> are a few mappings of RDF into JSON, including JSON-LD, which looks the most
>> promising at the moment. Since RDF/XML and JSON-LD both parse to the same
>> abstract graph, there is a mechanical transformation between them. When
>> dealing with semantic validity, you want to check the graph that is parsed
>> from the document, not the document itself.****
>>
>> ** **
>>
>> The content matters, the format does not. For instance, let me define a
>> new RDF format called RDF/CSV:****
>>
>> ** **
>>
>> First column is the subject. First row is the predicate. All other cell
>> values are objects. URIs that are relative are relative to the document, as
>> in RDF/XML.****
>>
>> ** **
>>
>> I can write a parser for that in 1 hour and publish it. It's genuinely
>> useful, and all you would have to do to read and write it is to use my
>> parser or write one yourself. I can then use the parser, paired with Pellet
>> ICV, and validate the information in the file without any additional work
>> from anyone.****
>>
>> ** **
>>
>> Maybe we need a simplified XML representation for RDF that looks more like
>> regular XML. But to make a schema for an OWL ontology is too much work for
>> too little payoff.****
>>
>> ** **
>>
>> Jim****
>>
>> On Sun, Aug 21, 2011 at 5:45 PM, Hau, Dave (NIH/NCI) [E] <
>> haudt@mail.nih.gov> wrote:****
>>
>> Hi all,****
>>
>>  ****
>>
>> As some of you may have read, HL7 is rethinking their v3 and doing some
>> brainstorming on what would be a good replacement for a data exchange
>> paradigm grounded in robust semantic modeling.****
>>
>>  ****
>>
>> On the following email exchange, I was wondering, if OWL is used for
>> semantic modeling, are there good ways to accomplish the following:****
>>
>>  ****
>>
>> 1.  Generate a wire format schema (for a subset of the model, the subset
>> they call a "resource"), e.g. XSD****
>>
>>  ****
>>
>> 2.  Validate XML instances for conformance to the semantic model.  (Here
>> I'm reminded of Clark and Parsia's work on their Integrity Constraint
>> Validator:  http://clarkparsia.com/pellet/icv )****
>>
>>  ****
>>
>> 3.  Map an XML instance conformant to an earlier version of the "resource"
>> to the current version of the "resource" via the OWL semantic model****
>>
>>  ****
>>
>> I think it'd be great to get a semantic web perspective on this fresh look
>> effort.****
>>
>>  ****
>>
>> Cheers,****
>>
>> Dave****
>>
>>  ****
>>
>>  ****
>>
>>  ****
>>
>> Dave Hau****
>>
>> National Cancer Institute****
>>
>> Tel: 301-443-2545****
>>
>> Dave.Hau@nih.gov****
>>
>>  ****
>>
>>  ****
>>
>>  ****
>>
>> *From:* owner-its@lists.hl7.org [mailto:owner-its@lists.hl7.org] *On
>> Behalf Of *Lloyd McKenzie
>> *Sent:* Sunday, August 21, 2011 12:07 PM
>> *To:* Andrew McIntyre
>> *Cc:* Grahame Grieve; Eliot Muir; Zel, M van der; HL7-MnM; RIMBAA; HL7
>> ITS
>> *Subject:* Re: A Fresh Look Proposal****
>>
>>  ****
>>
>> Hi Andrew,****
>>
>>  ****
>>
>> Tacking stuff on the end simply doesn't work if you're planning to use XML
>> Schema for validation.  (Putting new stuff in the middle or the beginning
>> has the same effect - it's an unrecognized element.)  The only alternative
>> is to say that all changes after "version 1" of the specification will be
>> done using the extension mechanism.  That will create tremendous analysis
>> paralysis as we try to get things "right" for that first version, and will
>> result in increasing clunkiness in future versions.  Furthermore, the
>> extension mechanism only works for the wire format.  For the RIM-based
>> description, we still need proper modeling, and that can't work with "stick
>> it on the end" no matter what.****
>>
>>  ****
>>
>> That said, I'm not advocating for the nightmare we currently have with v3
>> right now.****
>>
>>  ****
>>
>> I think the problem has three parts - how to manage changes to the wire
>> format, how to version resource definitions and how to manage changes to the
>> semantic model.****
>>
>>  ****
>>
>> Wire format:****
>>
>> If we're using schema for validation, we really can't change anything
>> without breaking validation.  Even making an existing non-repeating element
>> repeat is going to cause schema validation issues.  That leaves us with two
>> options (if we discount the previously discussed option of "get it right the
>> first time and be locked there forever":****
>>
>> 1. Don't use schema****
>>
>> - Using Schematron or something else could easily allow validation of the
>> elements that are present, but ignore all "unexpected" elements****
>>
>> - This would cause significant pain for implementers who like to use
>> schema to help generate code though****
>>
>>  ****
>>
>> 2. Add some sort of a version indicator on new content that allows a
>> pre-processor to remove all "new" content if processing using an "old"
>> handler****
>>
>> - Unpleasant in that it involves a pre-processing step and adds extra
>> "bulk" to the instances, but other than that, quite workable****
>>
>>  ****
>>
>> I think we're going to have to go with option #2.  It's not ideal, but is
>> still relatively painless for implementers.  The biggest thing is that we
>> can insist on "no breaking x-path changes".  We don't move stuff between
>> levels in a resource wire format definition or rename elements in a resource
>> wire format definition.  In the unlikely event we have to deprecate the
>> entire resource and create a new version.****
>>
>>  ****
>>
>> Resource versioning:****
>>
>> At some point, HL7 is going to find at least one resource where we blew it
>> with the original design and the only way to create a coherent wire format
>> is to break compatibility with the old one.  This will then require
>> definition of a new resource, with a new name that occupies the same
>> semantic space as the original.  I.e. We'll end up introducing "overlap".
>>  Because overlap will happen, we need to figure out how we're going to deal
>> with it.  I actually think we may want to introduce overlap in some places
>> from the beginning.  Otherwise we're going to force a wire format on
>> implementers of simple community EMRs that can handle prescriptions for
>> fully-encoded chemo-therapy protocols.  (They can ignore some of the data
>> elements, but they'd still have to support the full complexity of the nested
>> data structures.)****
>>
>>  ****
>>
>> I don't have a clear answer here, but I think we need to have a serious
>> discussion about how we'll handle overlap in those cases where it's
>> necessary, because at some point it'll be necessary.  If we don't figure out
>> the approach before we start, we can't allow for it in the design.****
>>
>>  ****
>>
>> All that said, I agree with the approach of avoiding overlap as much as
>> humanly possible.  For that reason, I don't advocate calling the Person
>> resource "Person_v1" or something that telegraphs we're going to have new
>> versions of each resource eventually (let alone frequent changes).
>>  Introduction of a new version of a resource should only be done when the
>> pain of doing so is outweighed by the pain of trying to fit new content in
>> an old version, or requiring implementers of the simple to support the
>> structural complexity of our most complex use-cases.****
>>
>>  ****
>>
>>  ****
>>
>> Semantic model versioning:****
>>
>> This is the space where "getting it right" the first time is the most
>> challenging.  (I think we've done that with fewer than half of the normative
>> specifications we've published so far.)  V3 modeling is hard.  The positive
>> thing about the RFH approach is that very few people need to care.  We could
>> totally refactor every single resource's RIM-based model (or even remove
>> them entirely), and the bulk of implementers would go on merrily exchanging
>> wire syntax instances.  However, that doesn't mean the RIM-based
>> representations aren't important.  They're the foundation for the meaning of
>> what's being shared.  And if you want to start sharing at a deeper level
>> such as RIMBAA-based designs, they're critical.  This is the level where OWL
>> would come in.  If you have one RIM-based model structure, and then need to
>> refactor and move to a different RIM-based model structure, you're going to
>> want to map the semantics between the two structures so that anyone who was
>> using the old structure can manage instances that come in with the new
>> structure (or vice versa).  OWL can do that.  And anyone who's got a complex
>> enough implementation to parse the wire format and trace the elements
>> through the their underlying RIM semantic model will likely be capable of
>> managing the OWL mapping component as well.****
>>
>>  ****
>>
>>  ****
>>
>> In short, I think we're in agreement that separation of wire syntax and
>> semantic model are needed.  That will make model refactoring much easier.
>>  However we do have to address how we're going to handle wire-side and
>> resource refactoring too.****
>>
>>  ****
>>
>>  ****
>>
>> Lloyd****
>>
>> --------------------------------------
>> Lloyd McKenzie
>>
>> +1-780-993-9501
>>
>>
>>
>> Note: Unless explicitly stated otherwise, the opinions and positions
>> expressed in this e-mail do not necessarily reflect those of my clients nor
>> those of the organizations with whom I hold governance positions.****
>>
>> On Sun, Aug 21, 2011 at 7:53 AM, Andrew McIntyre <
>> andrew@medical-objects.com.au> wrote:****
>>
>> Hello Lloyd,
>>
>> While "tacking stuff on the end" in V2 may not at first glance seem like
>> an elegant solution I wonder if it isn't actually the best solution, and one
>> that has stood the test of time. The parsing rules in V2 do make version
>> updates quite robust wrt backward and forward inter-operability.
>>
>> I am sure it could be done with OWL but I doubt we can switch the world to
>> using OWL in any reasonable time frame and we probably need a less abstract
>> representation for commonly used things. In V2 OBX segments, used in a
>> hierarchy can create an OWL like object-attribute structure for information
>> that is not modeled by the standard itself.
>>
>> I do think the wire format and any overlying model should be distinct
>> entities so that the model can be evolved and the wire format be changed in
>> a backward compatible way, at least for close versions.
>>
>> I also think that the concept of templates/archetypes to extend the model
>> should not invalidate the wire format, but be a metadata layer over the wire
>> format. This is what we have done in Australia with an ISO 13606 Archetypes
>> in V2 projects. I think we do need a mechanism for people to develop
>> templates to describe hierarchical data and encode that in the wire format
>> in a way that does not invalidate its vanilla semantics (ie non templated V2
>> semantics) when the template mechanism is unknown or not implemented.
>>
>> In a way the V2 specification does hit at underlying objects/Interfaces,
>> and there is a V2 model, but it is not prescriptive and there is no
>> requirement for systems to use the same internal model as long as they use
>> the bare bones V2 model in the same way. Obviously this does not always work
>> as well as we would like, even in V2, but it does work well enough to use it
>> for quite complex data when there are good implementation guides.
>>
>> If we could separate the wire format from the clinical models then the 2
>> can evolve in their own way. We have done several trial implementations of
>> Virtual Medical Record Models (vMR) which used V3 datatypes and RIM like
>> classes and could build those models from V2 messages, or in some cases non
>> standard Web Services, although for specific clinical classes did use ISO
>> 13606 archetypes to structure the data in V2 messages.
>>
>> I think the dream of having direct model serializations as messages is
>> flawed for all the reasons that have made V3 impossible to implement in the
>> wider world. While the tack it on the end, lots of optionality rationale
>> might seem clunky, maybe its the best solution to a difficult problem. If we
>> define tight SOAP web services for everything we will end up with thousands
>> of slightly different SOAP calls for every minor variation and I am not sure
>> this is the path to enlightenment either.
>>
>> I am looking a Grahams proposal now, but I do wonder if the start again
>> from scratch mentality is not part of the problem. Perhaps that is a lesson
>> to be learned from the V3 process. Maybe the problem is 2 complex to solve
>> from scratch and like nature we have to evolve and accept there is lots of
>> junk DNA, but maintaining a working standard at all times is the only way to
>> avoid extinction.
>>
>> I do like the idea of a cohesive model for use in decision support, and
>> that's what the vMR/GELLO is about, but I doubt there will ever be a one
>> size fits all model and any model will need to evolve. Disconnecting the
>> model from the messaging, with all the pain that involves, might create a
>> layered approach that might allow the HL7 organism to evolve gracefully. I
>> do think part of the fresh look should be education on what V2 actually
>> offers, and can offer, and I suspect many people in HL7 have never seriously
>> looked at it in any depth.
>>
>> Andrew McIntyre****
>>
>>
>>
>> Saturday, August 20, 2011, 4:37:37 AM, you wrote:****
>>
>> Hi Grahame,
>>
>> Going to throw some things into the mix from our previous discussions
>> because I don't see them addressed yet.  (Though I admit I haven't reread
>> the whole thing, so if you've addressed and I haven't seen, just point me at
>> the proper location.)
>>
>> One of the challenges that has bogged down much of the v3 work at the
>> international level (and which causes a great deal of pain at the
>> project/implementation level) is the issue of refactoring.  The pain at the
>> UV level comes from the fact that we have a real/perceived obligation to
>> meet all known and conceivable use-cases for a particular domain.  For
>> example, the pharmacy domain model needs to meet the needs of clinics,
>> hospitals, veterinarians, and chemotherapy protocols and must support the
>> needs of the U.S., Soviet union and Botswana.  To make matters more
>> interesting, participation from the USSR and Botswana is a tad light.
>>  However the fear is that if all of these needs aren't taken into account,
>> then when someone with those needs shows up at the door, the model will need
>> to undergo substantive change, and that will break all of the existing
>> systems.
>>
>> The result is a great deal of time spent gathering requirements and
>> refactoring and re-refactoring the model as part of the design process,
>> together with a tendency to make most, if not all data elements optional at
>> the UV level.  A corollary is that the UV specs are totally unimplementable
>> in an interoperable fashion.  The evil of optionality that manifested in v2
>> that v3 was going to banish turned out to not be an issue of the standard,
>> but rather of the issues with creating a generic specification that
>> satisfies global needs and a variety of use-cases.
>>
>> The problem at the implementer/project level is that when you take the UV
>> model and tightly constrain it to fit your exact requirements, you discover
>> 6 months down the road that one or more of your constraints was wrong and
>> you need to loosen it, or you have a new requirement that wasn't thought of,
>> and this too requires refactoring and often results in wire-level
>> incompatibilities.
>>
>> One of the things that needs to be addressed if we're really going to
>> eliminate one of the major issues with v3 is a way to reduce the fear of
>> refactoring.  Specifically, it should be possible to totally refactor the
>> model and have implementations and designs work seemlessly across versions.
>>
>> I think putting OWL under the covers should allows for this.  If we can
>> assert equivalencies between data elements in old and new models, or even
>> just map the wire syntaxes of old versions to new versions of the definition
>> models, then this issue would be significantly addressed:
>> - Committees wouldn't have to worry about satisfying absolutely every
>> use-case to get something useful out because they know they can make changes
>> later without breaking everything.  (They wouldn't even necessarily have to
>> meet all the use-cases of the people in the room! :>)
>> - Realms and other implementers would be able to have an interoperability
>> path that allowed old wire formats to interoperate with new wireformats
>> through the aid of appropriate tooling that could leverage the OWL under the
>> covers.  (I think creating such tooling is *really* important because
>> version management is a significant issue with v3.  And with XML and
>> schemas, the whole "ignore everything on the end you don't recognize" from
>> v2 isn't a terribly reasonable way forward.
>>
>> I think it's important to figure out exactly how refactoring and version
>> management will work in this new approach.  The currently proposed approach
>> of "you can add stuff, but you can't change what's there" only scales so
>> far.
>>
>>
>> I think we *will* need to significantly increase the number of Resources
>> (from 30 odd to a couple of hundred).  V3 supports things like invoices,
>> clinical study design, outbreak tracking and a whole bunch of other
>> healthcare-related topics that may not be primary-care centric but are still
>> healthcare centric.  That doesn't mean all (or even most) systems will need
>> to deal with them, but the systems that care will definitely need them.  The
>> good news is that most of these more esoteric areas have responsible
>> committees that can manage the definition of these resources, and as you
>> mention, we can leverage the RMIMs and DMIMs we already have in defining
>> these structures.
>>
>>
>> The specification talks about robust capturing of requirements and
>> traceability to them, but gives no insight into how this will occur.  It's
>> something we've done a lousy job of with v3, but part of the reason for that
>> is it's not exactly an easy thing to do.  The solution needs to flesh out
>> exactly how this will happen.
>>
>>
>> We need a mapping that explains exactly what's changed in the datatypes
>> (and for stuff that's been removed, how to handle that use-case).
>>
>> There could still be a challenge around granularity of text.  As I
>> understand it, you can have a text representation for an attribute, or for
>> any XML element.  However, what happens if you have a text blob in your
>> interface that covers 3 of 7 attributes inside a given XML element.  You
>> can't use the text property of the element, because the text only covers 3
>> of 7.  You can't use the text property of one of the attributes because it
>> covers 3 separate attributes.  You could put the same text in each of the 3
>> attributes, but that's somewhat redundant and is going to result in
>> rendering issues.  One solution might be to allow the text specified at the
>> element level to identify which of the attributes the text covers.  A
>> rendering system could then use that text for those attributes, and then
>> render the discrete values of the remaining specified attributes.  What this
>> would mean is that an attribute might be marked as "text" but not have text
>> content directly if the parent element had a text blob that covered that
>> attribute.
>>
>>
>>
>> New (to Grahame) comments:
>>
>> I didn't see anything in the HTML section or the transaction section on
>> how collisions are managed for updates.  A simple requirement (possibly
>> optional) to include the version id of the resource being updated or deleted
>> should work.
>>
>> To my knowledge, v3 (and possibly v2) has never supported true "deletes".
>>  At best, we do an update and change the status to nullified.  Is that the
>> intention of the "Delete" transaction, or do we really mean a true "Delete"?
>>  Do we have any use-cases for true deletes?
>>
>> I wasn't totally clear on the context for uniqueness of ids.  Is it within
>> a given resource or within a given base URL?  What is the mechanism for
>> referencing resources from other base URLs?  (We're likely to have networks
>> of systems that play together.)
>>
>> Nitpick: I think "id" might better be named "resourceId" to avoid any
>> possible confusion with "identifier".  I recognize that from a coding
>> perspective, shorter is better.  However, I think that's outweightd by the
>> importance of avoiding confusion.
>>
>> In the resource definitions, you repeated definitions for resources
>> inherited from parent resources.  E.g. Person.created inherited from
>> Resource.Base.created.  Why?  That's a lot of extra maintenance and
>> potential for inconsistency.  It also adds unnecessary volume.
>>
>> Suggest adding a caveat to the draft that the definitions are placeholders
>> and will need significant work.  (Many are tautological and none meet the
>> Vocab WG's guidelines for quality definitions.)
>>
>> Why is Person.identifier mandatory?
>>
>> You've copied "an element from Resource.Base.???" to all of the Person
>> attributes, including those that don't come from Resource.Base.
>>
>> Obviously the workflow piece and the conformance rules that go along with
>> it need some fleshing out.  (Looks like this may be as much fun in v4 as it
>> has been in v3 :>)
>>
>> The list of identifier types makes me queasy.  It looks like we're
>> reintroducing the mess that was in v2.  Why?  Trying to maintain an ontology
>> of identifier types is a lost cause.  There will be a wide range of
>> granularity requirements and at fine granularity, there will be 10s of
>> thousands.  The starter list is pretty incoherent.  If you're going to have
>> types at all, the vocabulary should be constrained to a set of codes based
>> on the context in which the real-world identifier is present.  If there's no
>> vocabulary defined for the property in that context, then you can use text
>> for a label and that's it.
>>
>> I didn't see anything on conformance around datatypes.  Are we going to
>> have datatype flavors?  How is conformance stated for datatype properties?
>>
>> I didn't see templateId or flavorId or any equivalent.  How do instances
>> (or portions there-of) declare conformance to "additional" constraint
>> specifications/conformance profiles than the base one for that particular
>> server?
>>
>> We need to beef up the RIM mapping portion considerably.  Mapping to a
>> single RIM class or attribute isn't sufficient.  Most of the time, we're
>> going to need to map to a full context model that talks about the
>> classCodes, moodCodes and relationships.  Also, you need to relate
>> attributes to the context of the RIM location of your parent.
>>
>> There's no talk about context conduction, which from an implementation
>> perspective is a good thing.  However, I think it's still needed behind the
>> scenes.  Presumably this would be covered as part of the RIM semantics
>> layer?
>>
>> In terms of the "validate" transaction, we do a pseudo-validate in
>> pharmacy, but a 200 response isn't sufficient.  We can submit a draft
>> prescription and say "is this ok?".  The response might be as simple as
>> "yes" (i.e. a 200).  However, it could also be a "no" or "maybe" with a list
>> of possible contraindications, dosage issues, allergy alerts and other
>> detected issues.  How would such a use-case be met in this paradigm?
>>
>> At the risk of over-complicating things, it might be useful to think about
>> data properties as being identifying or not to aid in exposing resources in
>> a de-identified way.  (Not critical, just wanted to plant the seed in your
>> head about if or how this might be done.)
>>
>>
>> All questions and comments aside, I definitely in favour of fleshing out
>> this approach and looking seriously at moving to it.  To that end, I think
>> we need a few things:
>> - A list of the open issues that need to be resolved in the new approach.
>>  (You have "todo"s scattered throughout.  A consolidated list of the "big"
>> things would be useful.)
>> - An analysis of how we move from existing v3 to the new approach, both in
>> terms of leveraging existing artifacts and providing a migration path for
>> existing solutions as well as what tools, etc. we need.
>> - A plan for how to engage the broader community for review.  (Should
>> ideally do this earlier rather than later.)
>>
>> Thanks to you, Rene and others for all the work you've done.
>>
>>
>> Lloyd
>>
>> --------------------------------------
>> Lloyd McKenzie
>>
>> +1-780-993-9501
>>
>>
>>
>> Note: Unless explicitly stated otherwise, the opinions and positions
>> expressed in this e-mail do not necessarily reflect those of my clients nor
>> those of the organizations with whom I hold governance positions.
>>
>>
>> On Fri, Aug 19, 2011 at 9:08 AM, Grahame Grieve <grahame@kestral.com.au**
>> **
>>
>> > wrote:****
>>
>>
>> hi All
>>
>> Responses to comments
>>
>> #Michael
>>
>> > 1. I would expect more functional interface to use these resources.
>>
>> as you noted in later, this is there, but I definitely needed to make
>> more of it. That's where I ran out of steam
>>
>> > 2. One of the things that was mentioned (e.g. at the Orlando
>> > WGM RIMBAA Fresh Look discussion) is that we want to use
>> > industry standard tooling, right? Are there enough libraries that
>> > implement REST?
>>
>> this doesn't need tooling. There's schemas if you want to bind to them
>>
>> > 2b. A lot of vendors now implement WebServices. I think we should
>> > go for something vendors already have or will easilly adopt. Is that the
>> case with REST?
>>
>> Speaking as a vendor/programmer/writer of an open source web services
>> toolkit, I prefer REST. Way prefer REST
>>
>> > Keep up the good work!
>>
>> ta
>>
>> #Mark
>>
>> > I very much like the direction of this discussion towards web services
>> > and in particular RESTful web services.
>>
>> yes, though note that REST is a place to start, not a place to finish.
>>
>> > At MITRE we have been advocating this approach for some time with our
>> hData initiative.
>>
>> yes. you'll note my to do: how does this relate to hData, which is a
>> higher level
>> specification than the CRUD stuff here.
>>
>> #Eliot
>>
>> > Hats off - I think it's an excellent piece of work and definitely a step
>> in right direction.
>>
>> thanks.
>>
>> > I didn't know other people in the HL7 world other than me were talking
>> about
>> > (highrise).  Who are they?
>>
>> not in Hl7. you were one. it came up in some other purely IT places that I
>> play
>>
>> >  5) Build it up by hand with a wiki - it is more scalable really since
>> you
>>
>> wiki's have their problems, though I'm not against them.
>>
>> > 1) I think it would be better not to use inheritance to define a patient
>> as
>> > a sub type of a person.  The trouble with that approach is that people
>> can
>>
>> On the wire, a patient is not a sub type of person. The relationship
>> between the two is defined in the definitions.
>>
>> > A simpler approach is associate additional data with a person if and
>> when
>> > they become a patient.
>>
>> in one way, this is exactly what RFH does. On the other hand, it creates a
>> new identity for the notion of patient (for integrity). We can discuss
>> whether that's good or bad.
>>
>> > 2) I'd avoid language that speaks down to 'implementers'.  It's
>> enterprise
>>
>> really? Because I'm one. down the bottom of your enterprise pole. And
>> I'm happy to be one of those stinking implementers down in the mud.
>> I wrote it first for me. But obviously we wouldn't want to cause offense.
>> I'm sure I haven't caused any of that this week ;-)
>>
>> > 3) If you want to reach a broader audience, then simplify the language.
>>
>> argh, and I thought I had. how can we not use the right terms? But I
>> agree that the introduction is not yet direct enough - and that's after
>> 4 rewrites to try and make it so....
>>
>> Grahame
>>
>>
>> ************************************************
>> To access the Archives of this or other lists or change your list settings
>> and information, go to: ****
>>
>> http://www.hl7.org/listservice****
>>
>>
>>
>> ************************************************
>> To access the Archives of this or other lists or change your list settings
>> and information, go to: http://www.hl7.org/listservice****
>>
>>
>>
>>
>>
>> *--
>> Best regards,
>>  Andrew                             *mailto:andrew@Medical-Objects.com.au<andrew@Medical-Objects.com.au>
>>
>> *sent from a real computer*****
>>
>>  ****
>>
>>  ****
>>
>> ****************************************************
>>
>> To access the Archives of this or other lists or change your list settings and information, go to: http://www.hl7.org/listservice****
>>
>>
>>
>> ****
>>
>> ** **
>>
>> --
>> Jim McCusker
>> Programmer Analyst
>> Krauthammer Lab, Pathology Informatics
>> Yale School of Medicine
>> james.mccusker@yale.edu | (203) 785-6330
>> http://krauthammerlab.med.yale.edu
>>
>> PhD Student
>> Tetherless World Constellation
>> Rensselaer Polytechnic Institute
>> mccusj@cs.rpi.edu
>> http://tw.rpi.edu****
>>
>
>


-- 
Jim McCusker
Programmer Analyst
Krauthammer Lab, Pathology Informatics
Yale School of Medicine
james.mccusker@yale.edu | (203) 785-6330
http://krauthammerlab.med.yale.edu

PhD Student
Tetherless World Constellation
Rensselaer Polytechnic Institute
mccusj@cs.rpi.edu
http://tw.rpi.edu
Received on Monday, 22 August 2011 13:40:36 UTC

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