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Exchange Content Model (ECM): Getting there
 

Exchange Content Model (ECM): Getting there

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Koray Atalag

Koray Atalag
National Institute for Health Innovation
University of Auckland
(Wednesday, Interoperability Workshop)

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  • Published by HISO (2012); Part of the Reference Architecture for Interoperability“To create a uniform model of health information to be reused by different eHealth Projects involving HIE”Consistent, Extensible, Interoperable and Future-Proof Data
  • Content is ‘clinician’s stuff’ – not techy; yet most existing standards are meaningless for clinicians and vice versa for techiesopenEHR Archetypes are in ‘clinical’ space – easily understood and authored by themArchetypes can be transformed into numerous formats – including CDAArchetypes are ‘maximal datasets’ e.g. They are much more granular than other models when needed. Support more use cases – indeed almost anything to do with EHR (including some workflow). Scope not limited to HIE but whole EHR.One agreed way of expressing clinical concepts – as opposed to multiple ways of doing it with HL7 CDA (CCDA is a good first step though)ECM invest in information fulfilled completely – future proof technology today with ECM for tomorrow’s implementation technology (e.g. FHIR etc., distributed workflows etc.)

Exchange Content Model (ECM): Getting there Exchange Content Model (ECM): Getting there Presentation Transcript

  • Exchange Content Model (ECM) Getting there... Koray Atalag, MD, PhD, FACHI k.atalag@nihi.auckland.ac.nz koray.atalag@openehrfoundation.org
  • What is ECM?• IT IS A REFERENCE LIBRARY - for consistent HIE Payload (CDA)• Superset of all clinical dataset definitions – normalised using a standard EHR record organisation (aka DCM) – Expressed as reusable and computable models – Archetypes• Top level organisation follows CCR*• Further detail provided by: – Existing relevant sources (CCDA, Nehta, epSoS, FHIR etc.) – Extensions and new Archetypes (NZ specific)• Each HIE payload (CDA) will correspond to a subset (and conform)What’s the value proposition of ECM? Why not just build CDAs?* kind of – CCDA may be more appropriate
  • ECM > Payload
  • Creating Payload ?
  • Archetypes• The way to go for defining clinical content  CIMI (led by S. Huff @ Intermountain & Mayo)  In many nat’l programmes (eg. Sweden, Slovenia, Australia, Brazil, Scotland)• Smallest indivisible units of clinical information with clinical context• Brings together building blocks from Reference Model (eg. record organisation, data structures, types)• Puts constraints on them: – Structural constraints (List, table, tree, clusters) – What labels can be used – What data types can be used – What values are allowed for these data types – How many times a data item can exist? – Whether a particular data item is mandatory – Whether a selection is involved from a number of items/values
  • Logical building blocks of EHREHRFoldersCompositionsSectionsEntriesClustersElementsData values
  • BP Measurement Archetype
  • Extending ECM• Addition of new models• Making existing models more specific – powerful Archetype specialisation mechanism: – Lab result > HbA1C result, Lipid profiles etc. Problem First level specialisation Text or Coded Term Diagnosis Second level specialisation Clinical description Date of onset Coded Term Diabetes Date of resolution + diagnosis No of occurrences Grading + Diagnostic criteria Diagnostic criteria Stage  Fasting > 6.1  GTT 2hr > 11.1  Random > 11.1
  • Value Proposition• Content is ‘clinician’s stuff’ – not techy; yet most existing standards are meaningless for clinicians and vice versa for techies – Archetypes in ‘clinical’ space – easily understood & authored by them• Single source of truth for entire sector – One agreed way of expressing clinical concepts – as opposed to multiple ways of doing it with HL7 CDA (CCDA is a good first step)• Archetypes can be transformed into numerous formats – including CDA• Archetypes are ‘maximal datasets’ – Much easier to agree on• Scope not limited to HIE but whole EHR; workflow supported• ECM principle invest in information fulfilled completely – future proof content today for tomorrow’s implementation technology (e.g. FHIR etc., distributed workflows etc.)