Now Here Is A Blog I Really Agree With - I Have Been Saying Something Like This For Ages.

This appeared a few days ago.

Question: FHIR and un-semantic interoperability

Posted on March 12, 2013 by Grahame Grieve
Question:
 I did not understand the blog post about un-semantic interoperability.  Can you elaborate?  Will FHIR provide any of this un-semantic interoperability?
Answer:
Well, the original post on unsemantic interoperability is just pointing out that many people mis-understand the nature of what semantic interoperability is trying to achieve:
We’ve had semantic interoperability in healthcare since we started having healthcare. Since the beginning of healthcare (by whatever definition you can use), healthcare practitioners have exchanged data using spoken and written words, and the semantic meaning has been clear (well, as clear as it can be given that human knowledge is limited).
So whatever it is that we are doing, it’s not introducing semantic interoperability. In fact, what we are doing is introducing a new player into the mix: computers. And not, in actual fact, computers, but the notion that there is something to be gained by processing healthcare information by persons or devices who don’t properly understand it. So, in fact, what we are actually doing is seeking for unsemantic interoperability.
It’s a matter of perspective. Perhaps, one day, we’ll really be working on true semantic inteoperability. But right now, we can afford to chase a lesser goal, which is exchanging data that can be used usefully in some limited pre-ordained ways.
More here:
The second comment - as italicised - is a ripper.
Karim Keshavjee
Unfortunately in all the discussion about semantic and/or non-semantic interoperability, we keep forgetting the purpose of achieving them. If we really took time to understand the purpose of interoperability, we’d have achieved a lot more than we have to date.
Sometimes I think we’re pursuing a Holy Grail when a plain chalice would do fine, or even a cup.
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Essentially what is being recognised here is that complexity is something that takes so long to address that we need to approach solutions incrementally and not in a big bang.
Electronic semantic interoperability is really as hard and complex as it gets and doing what we can to while we address the possible is really smart.
Here are a couple of blogs where I and others have explored this especially the complexity issue.
Here are a couple of  more detailed discussions of some of the issues.
See here:
and here:
and here:
and here:
and here:
The bottom line here is that we should have work what can be made to work while continuing to work on improvement and better coverage.
David.

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