Thursday, October 22, 2009

A bad day for the German finance minister - a good day for human rights

Today was another bad day for the German finance minister, and a good day for human rights for gay people in Germany.
The constitutional court ruled that gay partners that have a registered partnership (just like a marriage - but with another name) have the right on a survival pension when one the partners dies. Until now, the state had refused such a pension to these people, because "they were not married".
To my surprise the argument of the state during the court trial was that the constitution has a paragraph about the "special protection of the family", so married people are entitled to the pension when one of the partners dies, but as gay partners are officially not a "family", they must be excluded.
The judges however ruled that this paragraph in the constitution may not be used (or abused) to discriminate people that choose (deliberately or not) for another form of living together. Furthermore (and that is important for other areas) they stated that "the only difference between a registered partnership and a marriage is that the latter is explicitely named in the constitution".
Another interesting case about human rights has just started for the constitutional court: families that live of social security get about 8 Euros for a child to live from per day. This amount has been calculated "scientifically", but does not include things like doing sports, reading (!), dipers, and many other things children need. As the German constitution states that the government is responsible that noone in Germany must live in a state of undignity, this "scientific calculation" has now been questioned and gone to the highest court.
It will take a number of months before the court judges, but at the opening session the president of the court already stated that he also wants to test the daily rates for adults.

Tuesday, October 6, 2009

interfacing or a super-model ?

Yesterday, I forgot to mention another blog, on which prof. Smith's blog was based.
It can be found at: http://wolandscat.net/2009/10/01/the-crisis-in-e-health-standards-ii/

The latter brings me to an interesting question I am asking my self often: should we (in healthcare) try to build "supermodels" that try to encompass almost everything (as HL7 does with the RIM), or should we allow for more "isolated" models (in CDISC: SDTM, CDASH, ODM, ...) and have them use elements of each other, and build interfaces between them, as IHE does with its profiles?
I haven't got the full answer yet, but observing the immense problems e.g. HL7 encounters with the RIM (some ontologists say the RIM is basically incorrect, and there are currently already over 80 versions of it), and the monsters it produces when it comes to implementation, I am more and more thinking that the IHE approach is currently the better one. Of course it is more work (the n-to-n problem), but at least it leads to implementable systems.

Monday, October 5, 2009

HL7-v3-XML messages and ontologists

As I am not a great supporter of HL7-v3-XML messages (overcomplicated, probably based on an incorrect model, nearly impossible to implement), I am following the blog at http://hl7-watch.blogspot.com/.
Barry Smith, a professor in philosophy at the university of Buffalo, and a well-known ontologist in the biopharma world, regularly attacks HL7 for it's way it develops "standards".
His two latest posts, are very interesting. First, he published a very challenging blog with the title "should an organization like HL7 be engaged in building standards?". Only two days later, there was a similar entry, but this time on Microsoft Healthvault.
But the latest post also contained a positive contribution: Smith proposes to start a new organization, with contributions from (at least) ontologists (of course), software engineers, domain specialists, and "persons with experience of and a track-record of success in implementing and brutally testing healthcare IT systems in real-world environments".
I think this is not a bad idea at all. Also in CDISC we see that some teams are nearly only consisting of domain experts, others nearly only of terminology experts, others have an overrepresentation of XML and software experts. But none of them has ontologists in its ranks, nor specialists in "brutally testing real-life IT systems" (although I am doing my best in the latter).
So I wonder whether the new SHARE initiative will have ontologists involved (I think it should), and later software specialists and testers. I think that within CDISC, we should not make the same error as HL7 did by generating standards which later proved to be nearly impossible to implement.

Friday, October 2, 2009

This will become an occasional blog about myself, CDISC, XML, German politics (sometimes in German), European integration, phylosophy, and much more.