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Clinical Models - What Are They Good For?

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Dr Hugh Leslie
CMO, Ocean Informatics Ltd

Published in: Health & Medicine
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Clinical Models - What Are They Good For?

  1. 1. Clinical Models What are they? What are they good for?Dr Hugh Leslie MDCMO Ocean Informatics
  2. 2. data phenomena001101010010101001011110101011010010101010100 “We are analog beings111101001100101001 trapped in a digital world…100010011001010011 We are010101011000000000 compliant, flexible, tolerant.000000000 Yet we have constructed000000001111111111 a world of machines that111100100000000000 requires us to be000000000 rigid, fixed, intolerant.” Norman Donald 4.2
  3. 3. CDA
  4. 4. ClinicalDAClinicaDA ClinicDA CliniDA ClinDA CliDA ClDA CDA
  5. 5. The clinical content dilemma Clinical System CDA Message
  6. 6. Who needs standardised content?• Sophisticated solutions• Vendors• National Programs
  7. 7. A fresh approach... Clinical System CDA Message
  8. 8. ConsistencyQuality/Safety Governance
  9. 9. What about terminology?
  10. 10. ePatient Dave(http://epatientdave.com/)
  11. 11. Aortic Aneurysm
  12. 12. Diagnosis of: Risk of: Family History of: No history of: Age/Date of onset: Date of diagnosis: Diagnosed by: Diagnostic criteria: 44054006|Diabetes mellitus type 2Age/Date of remission: Severity of:Clinical significance of: Aetiology: Exacerbation of: Related problems: Terminology always requires context to make sense
  13. 13. Another thing about context…
  14. 14. Data elements• 11179• HL7 DAMs• Minimum data sets
  15. 15. COLD
  16. 16. Its quite COLDin Auckland today
  17. 17. I have a really bad COLDwith a runny nose and fever.
  18. 18. The diagnosis is: COLD(Chronic obstructive lung disease)
  19. 19. The patient had a very COLD emotional response
  20. 20. Definitions of single data elementsrarely survive outside a particular context
  21. 21. So reallyWhat is a clinical model? Detailed Clinical Model (DCM) CIMI model HL7 template/IHE profile Archetype
  22. 22. To a clinician, an archetype is:A definition of an atomic health concept thatas much as possible completely expresseseverything that you would ever want torecord about that particular thing in anysituation.
  23. 23. To a clinician, an archetype is:A definition of an atomic health concept thatas much as possible completely expresseseverything that you would ever want torecord about that particular thing in anysituation.
  24. 24. To a clinician, an archetype is:A definition of an atomic health concept thatas much as possible completely expresseseverything that you would ever want torecord about that particular thing in anysituation.
  25. 25. To a clinician, an archetype is:A definition of an atomic health concept thatas much as possible completely expresseseverything that you would ever want torecord about that particular thing in anysituation.
  26. 26. To a clinician, an archetype is:A definition of an atomic health concept thatas much as possible completely expresseseverything that you would ever want torecord about that particular thing in anysituation.
  27. 27. To a technician, an archetype is:A computable expression of a domain contentmodel in the form of structured constraintstatements, based on the openEHR referencemodel.A logical information modelReuseable
  28. 28. To a technician, an archetype is:A computable expression of a domain contentmodel in the form of structured constraintstatements, based on the openEHR referencemodel.A logical information modelReuseable
  29. 29. To a technician, an archetype is:A computable expression of a domain contentmodel in the form of structured constraintstatements, based on the openEHR referencemodel.A logical information modelReuseable
  30. 30. To a technician, an archetype is:A computable expression of a domain contentmodel in the form of structured constraintstatements, based on the openEHR referencemodel.A logical information modelReuseable
  31. 31. To a technician, an archetype is:A computable expression of a domain contentmodel in the form of structured constraintstatements, based on the openEHR referencemodel.A logical information modelReuseable
  32. 32. CKM – introductionDr Heather Leslie MDDirector Modelling - Ocean Informatics
  33. 33. So we have some archetypes… where do we go from here?
  34. 34. A single tool chain… Code Skeletons UI Forms DataReference Archetypes Templates Sets Model XML Messages Schemas etc Terminology Semantic HTML Mappings/ Subsets Queries Display
  35. 35. openEHR TemplatesTemplates are a use case specific constraint andaggregation of one or more archetypes to createany clinical specification.Templates have less need for governance as longas the archetypes that make them up are tightlygoverned.
  36. 36. openEHR TemplatesTemplates are a use case specific constraint andaggregation of one or more archetypes to createany clinical specification.Templates have less need for governance as longas the archetypes that make them up are tightlygoverned.
  37. 37. openEHR TemplatesTemplates are a use case specific constraint andaggregation of one or more archetypes to createany clinical specification.Templates have less need for governance as longas the archetypes that make them up are tightlygoverned.
  38. 38. openEHR TemplatesTemplates are a use case specific constraint andaggregation of one or more archetypes to createany clinical specification.Templates have less need for governance as longas the archetypes that make them up are tightlygoverned.
  39. 39. openEHR TemplatesTemplates are a use case specific constraint andaggregation of one or more archetypes to createany clinical specification.Templates have less need for governance as longas the archetypes that make them up are tightlygoverned.
  40. 40. Archetypes• Blood pressure• Weight• Height• Medication• Apgar score• Adverse reaction• Problem/Diagnosis
  41. 41. Templates• Discharge summary• Antenatal visit• Specialist letter• Shared health summary• eReferral• CCR• Prescription
  42. 42. Semantic architecture • Clinician and stakeholder input Semantic KeyArchetypes • Agreement based on requirements • Jurisdiction, Users, Vendor inputTemplates • Agreement through standardisation • Standard transformation per archetypeCommun- ication • Variety of formats
  43. 43. Demo

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