Re: [COI] Clinical Observations Interoperability Telcon November 20, Tuesday 11:00am - 12:00pm US EST

Hi Vipul,

Thanks for the clarification on the notes.

See below for comments:


Kashyap, Vipul wrote:

> Dan,
> Thanks for pointing this out. Would like to clarify that these notes 
> are taken by a scribe in a telcon and sometimes the context of the 
> statement is not captured accurately.
>     To correct the mis-statement: The HL7 Observation standards for
>     EMR's have been in use since the 1990's in both HL7 2.x standards
>     and the new HL7 RIM-based standards found in CDA documents and
>     other RIM-based standards. These RIM-based standards are now
>     chosen by national government bodies including US (ONC contracts),
>     Canada (Infoway), Australia (NEHTA), and the UK (NHS). Therefore,
>     there are widely used standards for observations in EMR design.
>     [VK]  The specific context in which this  comment was made was
>     that of clinical decision support and clinical research protocols.
>     For the most part HL7 standards used for interoperability and storage.
>             Specifically Detailed Clinical Models have been developed
>     by Stan Huff et. al. for clinical decision support and
>     documentation, use cases for which HL7 2.x standards are typically
>     not used (correct me if I am wrong).
>             At the same time, DCMs are HL7 compliantl and I believe
>     are going through the standards process within HL7. So in some
>     sense they might be "future HL7 standards".  
>     <dan> Clinical decision support has long been implemented with HL7
>     Arden in commercial products that describequeries against
>     databases populated with HL7 2.x observations. These queries could
>     not be standardized in the HL7 2.x environment, but the
>     observations themselves often were standardized in OBX segments
>     utilizing LOINC codes. That is not to argue that 2.x observation
>     models or Arden decision support models are optimum in today's
>     environment. We just need to recognize the history before
>     inventing something new. Regarding Detailed Clinical Models...The
>     current standards in HL7 CCD use templateID's to specify templated
>     clinical structures. These are the standards today for composite
>     observations that need to be taken into account.. As you suggest,
>     Detailed Clinical Model work may have some impact on future HL7
>     standards, but most DCM are compositions of observations. Not
>     quite the same as the simple observation itself. One might look at
>     HL7 Care Record Query messages for standards on querying composite
>     observations. </dan>
>     Hope the work of the Clinical Observation Interoperability group
>     makes sure that an effort is made to harmonize clinical trial
>     observation standards with both of these older, widely-used HL7
>     standards for patient care....Dan
>     [VK] Absolutely, our goal is to re-use and incorporate widely
>     used standards such as HL7/DCM and SDTM using Semantic Web
>     specifications.
>             Will be great if some folks from the Clinical side of
>     Oracle could participate in this activity.
<dan> I'll forward to the Oracle Clinicals crowd />

>     Cheers,
>     ---Vipul 
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Received on Monday, 26 November 2007 00:44:03 UTC