Code versus Id

Why is it so difficult to see the difference between code and id?
Even in standards they mix the two. RFC3881, a standard for Audit Messages in Healthcare Applications used in NEN7513 and IHE ATNA, uses it wrong. Specificaly on EventID were the attributes are CodeSystem, etc, so it should be called EventCode.
In the ISO Datatypes used in HL7 there are two datatypes, namely II (Instance Identifier) and CD (Concept Descriptor).
I think the distinction is clear. There are codes for kinds of animals, and each animal has its own id in the form of a name. So my cat(==code) her name(==id) is Michi.
That's all folks.

Livescribe Podcast Recorder

This pen also works great as a podcasts recorder! You can use the internal microphone or the 3D microphone/earphone.
The audio is in aac format and can be saved as wav from the sessions view in Livescribe Desktop or you can just search for the aac file and convert it.
Here is how using the aTunes 1.13.1 (== great audio player/manager) command line tools in the win_tools directory:

• Convert the aac to a "audiodump.wav" file:
  mplayer c:\My Lifescribe\Library\...\Sessions\audio-#.aac -ao pcm:fast -vc null -vo null


• Encode to mp3:
  lame audiodump.wav audiodump.mp3 --tl [album name] --tt [title] --ta [artist] --ty [year]

Et voila. You got the audio as a mp3 file ready for publishing and listening on your mp3 player!
On to my first Healthcare IT podcast ;-) Don't even know if anyone is interested in healthcare standards news as a podcast... but I sure want it. There is so much happening on and so little time to read all the news...

Livescribe Talking Pen First Contact

Finally, almost half a year of searching for a way to get the pen in the Netherlands further; I got it on my desk!
Installing the software was easy, but then came the message "There is an important firmware upgrade...". I decided to just install it at once. Waiting, waiting, waiting.... the pen reboots and.... nothing :-(
When I used the pen, it just said "install the software..." or something like that.
Now here is why: After installing the firmware "System file" you see the pen reboot, the Livescribe logo appears and after that the time is displayed. The Livescribe Desktop now emulates a remove/reinsert of the USB device and waits for a signal that never comes on my laptop/USBport. The fix is easy, just take the pen of the cradle and put it back on again. Then Livescribe Desktop will finish the upgrade!

Up to the next challanges: writing a penlet and creating my own paper!

Paperless EHR in 1961!

Great to see how far we have come. In almost 50 years of development we still want the same: "Paperless healthcare". And we still have miles and miles of paper archives... Something is very wrong here.

Services are brewing @ HL7 v3 2.0

During the last few HL7 Work Group Meetings I noticed something is brewing. Specifically there are a lot of discussions on the Services (SOA) paradigm. At the last WGM in Kyoto (may 2009) someone even said "Messaging is dead, long live messaging". Originally HL7 was focused on messages and documents. The current Service idea synapse was not firing yet. The current state of technology has changed enormously since then. Most of the current ISVs are moving toward Services, even in healthcare IT. But where is HL7 in this? HL7 v3 is a perfect Common Information Model for an SOA! But HL7 v3 needs to accept and embrace the WS-* standards. The Architecture Review Board Workgroup of HL7 is working on this. They are creating the Service Aware Enterprise Architecture Framework (SAEAF) which will take HL7 v3 into the Services era.

See also: Joint OMG/HL7 Project.

XMI, UML, EMF

I was trying to figure out the relationship between XMI, UML, EMF and Enterprise Architect (EA) XMI export. How was it possible that Eclipse was unable to read an EA UML XMI export. Now I know. EMF Ecore uses XMI to store the model. EA uses XMI to store the UML. The UML XMI is something completely different than Ecore XMI. The picture made it all clearer for me. If I want Eclipse to read the UML models from EA, I need the UML2 plugin from the Eclipse Modeling Framework. XMI and UML XMI are from OMG and Ecore is from Eclipse. UML2 is an implementation of UML XMI.

Clinician Desktop - New Software Paradigm?

I often ask myself the question if it is the time for a new kind of software for healthcare. America and others are investigating if Open Source software is an option for EHR Systems. I think the question should be different.
In the Netherlands hospitals are doubting if they should develop their own software or if they should buy a complete solution like McKesson Horizon, Alert, Epic, iSoft Lorenzo, Microsoft Amalga or Siemens Sorian.
They should not be looking for a complete EHR system in the commercial nor the open source space. They should ask/look for framework software that delivers all the basic functionality that healthcare providers need. They should not be forced in processes that happen to be implemented in the software. The software should support their own processes and way of work. The software should be flexible and help them.
I think you will always be developing your own solutions, so you need more than just a programming language or framework like Java or .Net. You will need a healthcare framework that understands the basis healthcare information concepts like Detailed Clinical Models, Care Pathways, Clinical Research Queries, etc.
It should be a Clinician Desktop.

Yes I Can ... CDA R2!

At the HL7 Work Group Meeting in Orlando, FL January 15, 2009 I did the CDA R2 exam and now I may call myself a "Certified CDA R2 Specialist" (the list)!
It is a confirmation that I know CDA R2. The Monday after the WGM I got a mail telling me I had passed the exam. And 2 weeks later, just as I was told, I received the certificate and the pin. I think HL7 does a good job on this.
Some may think a certificate is not saying much, but I really think the exam tests your knowledge to use the CDA R2 and not just that you can learn well. Furthermore it is not just a test of CDA, but also of the RIM and interpreting the DMIM diagrams.
Just to be sure I was prepared I also followed the excellent CDA Advanced tutorial by Bob Dolin and later the CCD tutorial. In my hospital I created a CDA Implementation Guide for archiving and sending clinical documents. At the moment we are working on a SemanticSOA which uses something similar to the CDA R3 Model as it's Common Information Model. See also this great blog entry about the future roadmap of CDA R3/CCD by Rene Spronk.