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  • No dependancy on others, so timing depends on you
  • No need to migrate
  • You are the expert
  • Transparency to you
  • No internet required
  • No benefit to the community
  • No advantages from community knowledge, clinical expertise, and medical terminology
  • You are the expert
  • You do all the maintanance
  • Limits for multiple servers and implementation
  • Gain expertise from others
  • Create a collection from the best and multiple sources
  • Flexible for multiple servers and implementation
  • Cloud-based
  • Many different mechanisms
  • Time consuming concept management process

CIEL with subscription
  • The community and experts are constantly improving and expanding concepts
  • Cloud-based

  • CIEL dictionary has too much (ie. clinician searches for "malignant" and finds more than 1000 concepts)
  • Requires internet for updates
Central curation
  • The community and experts are constantly improving and expanding concepts
  • Most flexible option for multiple servers and implementations
  • Cloud-based
  • OCL is not ready for collections

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Standalone:  This is could be quickly implemented when there's a single OpenMRS server and implementation, but difficult if it grows to multiple servers and implementations.  An example of this is the implementation at Partners In Health/Malawi (APZU).  The concept dictionary is based on a fork of the concept dictionary in 2008 (AMPATH/OpenMRS concept dictionary and later Partners In Health concept dictionary).  It is difficult to benefit from any maintanance and improvements that are done in the CIEL or "golden" PIH dictionary (ie.  ICD10 and SNOMED mappings, duplicate concept names in pre OpenMRS 1.7, etc.)  The one positive aspect is that concepts can be created quickly and without discussion or reliance.