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Handi open standards platform

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Given at EHI Live 6th Nov 2013 HANDIHealth Presentation Stage.

Given at EHI Live 6th Nov 2013 HANDIHealth Presentation Stage.

Published in: Health & Medicine, Technology
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  • 1. TIME FOR AN OPEN STANDARDS HEALTHCARE PLATFORM? DR IAN MCNICOLL CLINICAL MODELLING CONSULTANT, OCEAN INFORMATICS DIRECTOR, OPENEHR FOUNDATION
  • 2. INTRODUCTION Dr Ian McNicoll  Former Glasgow GP  Director openEHR Foundation  Health informatics consultancy     Ocean Informatics UK Clinical Modelling Consultant NHS Scotland, CfH, GP2GP, RCP health informatics consultancy HANDIHealth , BCS PHCSG Commercial software development
  • 3. TIME FOR ‘OPEN PLATFORMS’? • USA • • SMARTPlatforms UK • GP Systems of Choice (GPSOC) refresh • Phase 1 GP systems open APIs • Phase 2 GP systems Common APIs • De-facto ‘open platform’
  • 4. ‘SUBSTITUTABLE’ APPS
  • 5. ‘small and agile’ • Resurgence in SME sector • Role of Intellect • Adaptable platforms • IMS Maxims • Black Pear Software • Digital Spark • MS Healthvault • ‘Apps’ paradigm • HANDIHealth
  • 6. ‘open’ • Open data • • Analytics, quality monitoring Open APIs / standards • • GPSOC-R • • ITK, GP2GP SMARTPlatform, FHIR Open source • openEyes, Wardware • Leeds Care Record • Spine2 • “Safer Wards” Fund
  • 7. ‘clinical engagement’ • Formal clinical ownership • Joint GP IT Committee (RCGP / BMA) • RCP ITU / Professional Records Standards Body • UK – increasing 4-countries engagement • Guerilla activity • ‘Clinicians who code’, DigiDocs • NHS Hackday, openGPSOC • DIY • Renal PatientView • Multiple MS Access/ Excel databases
  • 8. THE ‘HANDI VISION’ Apps EPR CDS Service PHR Meds Repository EHR Terminology Server EMR PHR Drug KB Pathways KB Service Directory Services/Repositories PDS/Record Discovery EWS ESB/Spine Infrastructural Services Security Broker
  • 9. ‘CLOSED’ EHEALTH PLATFORM ITK Integration component ESB/Spine Terminology Server Pathways KB Proprietary value-add components Proprietary Clinical Content / API Proprietary Querying and Persistence
  • 10. ‘OPEN SOURCE’ SILOED EHR ‘PLATFORM ITK Integration component ESB/Spine Terminology Server Pathways KB OSS Value-add components Siloed Clinical Content / API Siloed Querying and Persistence
  • 11. MULTIPLE CLOSED SILOS
  • 12. NHS OPEN STANDARDS PLATFORM ITK Integration component ESB/Spine OSS components API and messaging content based on open source clinical content definitions Terminology Server Pathways KB Commit Retrieve OSS Closed OSS Closed Vendor A Vendor B Vendor C Vendor D Vendor solutions
  • 13. OPENEHR DRIVEN STANDARDS PLATFORM ITK Integration component ESB/Spine OSS Value-add components Terminology Services Open source Archetype-based clinical content information / querying model Pathways KB Commit Retrieve Query openEHR CDR Closed source Open source Open source Vendor A Vendor B Vendor C Vendor D Vendor solutions
  • 14. GPSOC - OPENEHR www.openehr.org
  • 15. INTEROPERABILITY IS NOT A TECH PROBLEM • Interoperability is a clinical problem • Diverse recording practice (sometimes arbitrary) • Diverse recording requirements • Complexity / contextual nature of health data • Lack of clinical involvement in standards development • Too technical, too philosophical • Too time-consuming, too slow
  • 16. OPENEHR ARCHETYPES: OPEN SOURCE CLINICAL INFORMATION COMPONENTS • Clinically-led + collaboratively authored • open-source ‘crowd-sourcing’ methodology • democratised clinical content development • Shared open repository CC-BY-SA licence • Agility to respond to continually changing clinical demand • Clear ownership, change request mechanism • Tight version control
  • 17. INDUSTRY/PROFESSION-DRIVEN STANDARDISATION ‘OPEN GOVERNANCE’ Implementation Clinical Knowledge Administrators Blood pressure Archetype Editors Secondary endorsement Opthalmology Project Editors Archetype Reviewer Visual fields archetype Archetype Reviewer Visual acuity archetype Reviewer Review
  • 18. OPENEYES GLAUCOMA : INITIAL AUTHORING Gather evidence First draft mindmap Refine mindmap (inclusive dataset) Create /Upload Initial archetype
  • 19. OPENEYES GLAUCOMA : IMPLEMENTATION Template Data Schema
  • 20. Professional oversight [1] Clinical content LCR apps (Leeds) NHSvista Care API [3a] openENT (UCLP) Wardware2 (Kings) OpenEyes (Moorfields) NHSvista Reporting API [3b] ESB / ITK / Spine components [2] NHS vistaopenEHR Adaptors [8] openEHR API integration [7] Local SQL DB EHRPaaS [9] openEHR API openEHR API openEHR Repository (vendor #1) openEHR Repository (vendor #2) openEHR API openEHR Repository [10] (open source)
  • 21. LEEDS NHS CARE RECORD: OPEN PLATFORM OpenEHR Clinical Content “Archetypes”: • • • • Medication, allergies (GP2GP/ RCP/NHSS) Problems, procedures (international) End of Life content (ISB) Vital Signs, NEWS (international) Open APIs: ESB/Spine ITK Integration component openEHR Foundation accredited Open Standards CDR Service layer SMARTPlatforms Commit Retrieve Query Leeds Clinical Portal N3 hosted Clinical data repository
  • 22. LEEDS INNOVATION LAB: OPEN PLATFORM DEMONSTRATOR OpenEHR open source Clinical Content : “Archetypes”: • • • • Medication, allergies (GP2GP/ RCP/NHSS) Problems, procedures (international) End of Life content (ISB) Vital Signs, NEWS (international) Open APIs: FHIR ITK Integration component openEHR Foundation accredited Open Standards CDR Service layer SMARTPlatforms Commit Retrieve Query Leeds Clinical Portal N3 hosted Clinical data repository
  • 23. OPENEHR CLOUD ‘PLATFORM AS A SERVICE’ ITK Integration component N3 hosted ESB/Spine Value-add components openEHR Foundation accredited Terminology Server Pathways KB Commit Retrieve Implementation-agnostic CDR Service layer Query Oracle Marand SQL Server Ocean NHS OSS? Postgres SQL openEyes Code24 CDR Solutions
  • 24. TIME FOR AN NHS OPEN STANDARDS EHEALTH PLATFORM? • Provide commoditised eHealth application services • persistence/querying/audit/ connectivity • Can handle rich, complex clinical information • Vendor/technology stack neutral • Add-on common services • ITK, N3, Spine , APIs • DSS, terminology services • EHR PaaS model • Platform as a Service • Cloud-based ‘pay as you go’ • Choice of provider • Solves the ‘MSAccess’ problem
  • 25. LINKS • twitter: @ianmcnicoll • Leeds Health Innovation Lab : www.leedsinnovation.com • openEHR Foundation : www.openehr.org • International archetype repository: www.openehr.org/ckm • UK archetype repository: www.clinicalmodels.org.uk
  • 26. openEHR Solutions

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