Standardised and Flexible Health Data Management with an Archetype Driven EHR System (EHRflex)
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Standardised and Flexible Health Data Management with an Archetype Driven EHR System (EHRflex)

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The semantically interoperable Electronic Health Record is one of the most challenging research fields in health informatics. Reaching this objective, the use of EHR standards that formally describe ...

The semantically interoperable Electronic Health Record is one of the most challenging research fields in health informatics. Reaching this objective, the use of EHR standards that formally describe health data structures cannot be waived. CEN EN13606 is one of the most promising approaches to solve this problem since it covers the technical needs for semantic interoperability and, at the same time, it incorporates a mechanism (archetype model) for clinical domain experts’ participation in building an EHR system. In this paper we present EHRflex, a generic system based on archetypes. It empowers the clinician and allows him to manage his own EHR system in a simple and generic way, assuring that the user works with underlying standardized data structures. They can be exchanged with other people and systems when needed. EHRflex introduces EHR standards into the clinical routine delivering a technical platform which works directly on archetype based data.

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Anton Brass, David Moner, Claudia Hildebrand, Montserrat Robles. "Standardized and flexible health data Management with an archetype driven EHR system (EHRflex)". Seamless care – Safe care: The Challenges of Interoperability and Patient Safety in Health Care. Proceedings of the EFMI Special Topic Conference, pp. 212-218. IOS Press BV, Amsterdam. ISBN: 978-1-60750-562-4, 2010.

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Standardised and Flexible Health Data Management with an Archetype Driven EHR System (EHRflex) Standardised and Flexible Health Data Management with an Archetype Driven EHR System (EHRflex) Presentation Transcript

  • Standardised and Flexible Health Data Management with an Archetype Driven EHR System (EHRflex) Anton Brass1, David Moner2, Claudia Hildebrand1, Montserrat Robles2 1 Helmholtz Zentrum München, Germany 2 Universidad Politécnica de Valencia, Spain
  • Content • Dual model and CEN EN13606 • The EHRflex system • Operational Template Model • System by example • Conclusion and future work 2EHRflex
  • Dual model and CEN EN13606 • The Dual Model approach is a methodology for building Information Systems based on the separation of information and knowledge. – Information – statements about specific entities Eg. Blood pressure measurement: 120/80, patient was sitting – Knowledge – statements which apply to all entities of a class Eg. Blood pressure is composed by Systolic and Diastolic measurements in mmHg, possible positions are: Lying, Sitting and Standing. • A dual model system can thus incorporate knowledge from a specific domain and evolve seamlessly. EHRflex 3
  • Dual model and CEN EN13606 • ISO/CEN EN13606 is an international standard for the semantic interoperability of electronic health records. – Based on a dual model approach. • Reference model (information model) – Provides the generic structures or building blocks to build an EHR. • Archetype model (knowledge model) – Constrains the reference model building blocks in order to define high-level semantic concept definitions. EHRflex 4
  • Dual model and CEN EN13606 • An archetype… – Defines the specific structure for data. – Defines other data constraints such as cardinalities, existence, occurrences, default values… – Binds data structures to terminologies. – Is a shareable definition of knowledge. – Can be defined by domain specialists (health professionals). – Can be used to generate user interfaces. EHRflex 5
  • Archetype “Blood pressure” Created with LinkEHR Archetype Editor: www.linkehr.com 6EHRflex
  • The EHRflex system • EHRflex: An archetype-based EHR system. • Main goals: – Definition and implementation of a generic model for user interaction and visualization of health data. – Clear and self-explanatory screen forms. – Empower clinicians to design their own content. – Introduce the dual model and archetypes into the daily practice. EHRflex 7
  • The EHRflex system The problem • How can we represent an EN13606 ENTRY? – Or an OpenEHR INSTRUCTION? – Or a HL7 CDA PROCEDURE? • In essence they all represent the same “business concept” – They should be represented in the same way. – They must be transformed into usable graphic interfaces. – And they should incorporate specific user needs or preferences (templates). EHRflex 8
  • The EHRflex system The solution • Operational Template Model (OTM) – A generic model for representing graphical user interfaces. – Independent of a particular reference model. – Also holds and transmits the associated health data instances. EHRflex 9 Medical Data Reference Model Archetype Model OTM List Data 1 Data 2 Data 3
  • Operational Template Model • The OTM is an object oriented model which includes: – Generic data structures: • StructureObject, List, Alternative. – Generic data types: • FieldList, Boolean, Integer, Real, CodedText, SimpleText. • Classes and data types from any reference model can be mapped and transformed into an OTM instance and vice versa. EHRflex 10
  • Operational Template Model • Step 1: transform archetypes into an OTM instance. EHRflex 11 Archetype Parser
  • Operational Template Model • Step 2: transform the OTM into a form to be filled with data. EHRflex 12 Data 1List1 Data 2 Data 5
  • Operational Template Model • Step 3: transform the OTM into an XML of any reference model. EHRflex 13 XML Data
  • 14EHRflex System by example http://www.ehrflex.eu
  • 15 System by example Google Health medication EHRflex
  • System by example Google Health medication 16EHRflex
  • Conclusions • Clinicians can define and use their own clinical concepts through archetypes. • Graphical representations are usable despite the generic reference models. • Data can be stored as standard XML documents. • EHRflex is generic and can be used with any standard. EHRflex 17
  • Future work • Support of additional archetype properties: – Alternatives, multiple languages, use of terminologies… • Support of templates for specific uses or domains. • Support for other reference models such as OpenEHR, CCR and HL7 CDA. EHRflex 18
  • Thank you for your attention! Standardised and Flexible Health Data Management with an Archetype Driven EHR System (EHRflex) David Moner damoca@upv.es EHRflex 19