smart data, smarter healthcare
TRANSCRIPT
SMART DATA, SMARTER HEALTHCAREDr Heather LeslieChief Clinical Informatician, Ocean InformaticsClinical Programme Lead, openEHR FoundationDirector, Global eHealth Collaborative
Journey to interoperability…
© Ocean Informatics 2016
paperHealth
eHealth: Connectivity
eHealth: Interoperability
The journey so far…
© Ocean Informatics 2016
Maze of Monolith
ic Systems
Forest of Many Silos Swamp of
Incremental
Innovation
River of Fixed
Messages
Sea of Unsustainabil
ity
Semantic Cliffs
Quicksand
Heights of
Optimism
Bay of Never-ending
Negotiation
eHealth: Interoperability
How to reach interoperability?
© Ocean Informatics 2016
>30 YearsBridge of‘Smart Data’
Semantic Cliffs
eHealth: Interoperability
What is smart health data? Shared clinical content specifications Clinically led
Represents how clinicians need their data Unambiguous & fit for purpose Implementable
Collaboratively developed & agreed Zero cost to use; free access Standards based Independent of any single technology
or software application© Ocean Informatics 2016
ALL CLINICAL CONTENT
openEHR Smart Data approach
© Ocean Informatics 2016
Clinicians drive this process!
Templates
Archetypes
Terminology
SNOMED CTLOINCetc
openEHR information models
openEHR Smart Data approach
© Ocean Informatics 2016
Templates
Archetypes
Terminology
SNOMED CTLOINCetc
openEHR information models
Software is built independently of the content
CLINICAL
TECHNICAL
What is openEHR?
‘openEHR’ = Open Electronic Health Record
Often pronounced as ‘open air’ or ‘open E-H-R’
Specification/schema for a complete electronic health record architecture Open source, freely available Managed by not for profit openEHR
Foundation at University College London www.openEHR.org
© Ocean Informatics 2016
The openEHR community
International community Email lists, online tools, teleconferences
5 operational areas Specification development Software development Clinical models Education Localisation
© Ocean Informatics 2016
International openEHR clinical model community
© Ocean Informatics 2016
1500 people 87 countries
• Clinicians• Informaticians• Software Engineers• Terminologists
Clinical Knowledge Manager Known as ‘CKM’ Online tool -
www.openEHR.org/CKM Library of information models –
‘Archetypes’ 500 archetypes = 6000 data points 23 languages, mostly English
Online collaboration portal Governance – publication, versioning,
distribution© Ocean Informatics 2016
International CKM collaboration
© Ocean Informatics 2016
Clinical knowledgebase
CKM Library
CKM Archetype library
Time
Technology
Number of archetypes
© Ocean Informatics 2016
© Ocean Informatics 2016
‘ReferenceModel’= rules
‘Archetype’= Clinical concept
specification
‘Templates’ = datasets
Clinical Documents/Messages/Forms
CKM Library National resource
Health data patterns• Standardised• Clinically agreed• Centrally
governed
Aggregate & constrain clinical diversity:• clinical domain• profession• location
Smart data ecosystem
© Ocean Informatics 2016
What is an archetype?
Archetype Building block Computable specification
for one single clinical concept Blood pressure Medication order Symptom Diagnosis Family History
Maximal data set Universal use-case Design once, re-use over
& over Strong governance critical© Ocean Informatics 2016
Blood Pressure Archetype
Archetype Definition Language (ADL)
ISO standard 13606
© Ocean Informatics 2016
© Ocean Informatics 2016
What is a template?
Archetype Template Building block Computable specification
for one single clinical concept Blood pressure Medication order Symptom Diagnosis Family History
Maximal data set Universal use-case Design once, re-use over
& over Governance is critical© Ocean Informatics 2016
Data set; multiple blocks Computable specification
for a specific clinical purpose: Message content Document Form Report
Flexible expression of clinical requirements
Constrain sensible for the specific clinical use-case
1-∞ archetypes per template
Governance NOT critical
Template?
© Ocean Informatics 2016
© Ocean Informatics 2016
Archetype Re-use
© Ocean Informatics 2016
Project archetype re-use
1 jurisdiction 3 projects 14 unique templates
1 Antenatal 10 Hearing Health 3 RMP on-call
81 unique archetypes
Templates
Archetypes
Data Sets
Decision Support
Acknowledgements: Hugh Leslie, Thomas Beale
SchemasSemantic
QueriesOne recordPopulation health
Messages
Terminology
SNOMED CTLOINC
Forms
Documents
openEHR smart data ecosystem
© Ocean Informatics 2016
Guideline Definition Language (GDL)
Archetype Query Language (AQL)
© Ocean Informatics 2016
Smart data, smarter healthcareIts. All. About. The. Data.
Change the viewpoint Universal Health Record (data) vs EHR/EMR
(app) Independent of Application/Technology/Vendor
Platform data shared between applications Change the approach
Archetypes = building blocks Clinician-driven, collaborative Foundation for data storage, exchange, decision support,
aggregation & analysis Templates = clinical data sets
Aggregate & constrain – cater for clinician diversity © Ocean Informatics 2016
Final thought…
© Ocean Informatics 2016