Hi Vipul,
Thanks for the clarification on the notes.
See below for comments:
Dan
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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