Handi open standards platform

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

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Handi open standards platform

  1. 1. TIME FOR AN OPEN STANDARDS HEALTHCARE PLATFORM? DR IAN MCNICOLL CLINICAL MODELLING CONSULTANT, OCEAN INFORMATICS DIRECTOR, OPENEHR FOUNDATION
  2. 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. 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. 4. ‘SUBSTITUTABLE’ APPS
  5. 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. 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. 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. 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. 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. 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. 11. MULTIPLE CLOSED SILOS
  12. 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. 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. 14. GPSOC - OPENEHR www.openehr.org
  15. 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. 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. 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. 18. OPENEYES GLAUCOMA : INITIAL AUTHORING Gather evidence First draft mindmap Refine mindmap (inclusive dataset) Create /Upload Initial archetype
  19. 19. OPENEYES GLAUCOMA : IMPLEMENTATION Template Data Schema
  20. 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. 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. 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. 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. 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. 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. 26. openEHR Solutions

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