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openEHR in China 2019-06

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The overview of openEHR in China, 2019.

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openEHR in China 2019-06

  1. 1. openEHR in China 2019-06 Prof. Xudong Lu / Zhejiang University Management Board Member of openEHR Foundation General-Secretary of China Medical Software Association
  2. 2. China Medical Software Association/中国医疗器械行业协会医用软件分会 Early Researches of openEHR in China l 2009, Jiye An(ZJU PhD Thesis),《Research on Healthcare Information Framework and Information Model》 l 2010, Zhihong Yao,Lei Liu , 《Introduction of openEHR and its difference with CDA and DICOM》 l 2012, Bin Li , 《Research on the Integration of SNOMED CT and OpenEHR》 l 2013, Zhihong Yao , 《Modelling Personal Health Record Based on openEHR》
  3. 3. China Medical Software Association/中国医疗器械行业协会医用软件分会 • 2015.08 , Xudong introduced a Case Study of openEHR-based CDR in Shangxi Dayi Hospital at Medinfo2015 in Brazil • 2016.04 , Prof. Huilong Duan was assigned ambassador of openEHR China “First-Contact”with openEHR Community
  4. 4. China Medical Software Association/中国医疗器械行业协会医用软件分会 openEHR TC of CMSA Started from 2016.04 Goal: Promoting openEHR Modeling and Implementation in China Activities:Seminars/workshops, Tutorials, Forums/conferences, Website Development,Modeling collaboration…… openEHR TC Modeling WG1 Modeling WG2 Modeling WG3 …… Secretariat
  5. 5. China Medical Software Association/中国医疗器械行业协会医用软件分会 openEHR Workshops • 2016.04, Shanghai, 1st openEHR workshop • 2016.11, Wuhan, 2nd openEHR workshop • 2017.08, Hangzhou, 3rd openEHR workshop • 2018.10, Shenzhen, 4th openEHR workshop 1-2 times/yearly, now we are having 5th openEHR workshop
  6. 6. China Medical Software Association/中国医疗器械行业协会医用软件分会 1-2 times/yearly, we will have 3rd openEHR tutorial tomorrow • 2018.05, Hanzhgou, 1st openEHR Tutorial, over 30 trainees from 6 companies/institutes • 2018.10, Shenzhen, 2st openEHR Tutorial, openEHR Tutorial
  7. 7. China Medical Software Association/中国医疗器械行业协会医用软件分会 • 2018.07, Guiyang, openEHR speech at CHIMA2018 • 2018.07, Heihe, openEHR speech at CODATA2018 • 2019.04, Chengdu, openEHR speech at 15th International Oral Medicine Medical Academic Conference • 2019.05, Shanghai, openEHR-based RDR at CMEF2019 openEHR in conferences recently
  8. 8. openEHR China Website www.openEHR.org.cn open to Chinese around 2016.08
  9. 9. openEHR International Connection Prof. Xudong Lu has been elected as openEHR Management Board Member in 2018
  10. 10. China Medical Software Association/中国医疗器械行业协会医用软件分会 Clinical Modelling in China
  11. 11. China Medical Software Association/中国医疗器械行业协会医用软件分会 HMC – Healthcare Modelling Collaborations http://openehr.org.cn/hmc/ A platform maintained by ZJU to support modeling collaborations
  12. 12. China Medical Software Association/中国医疗器械行业协会医用软件分会 openEHR Ecosystem CKM SYS-A Templates HMC SYS-B Templates SYS-C Templates Domain Experts Building the sharable archetypes End Users Defining the templates and building the applications Developers Building the enabling systems International Library of information Models
  13. 13. China Medical Software Association/中国医疗器械行业协会医用软件分会 China Medical Software Association / 中国医疗器械行业协会医用软件分会 HMC Management Experts User: Vendors User: Researchers Published Proposal Public Domain ACS Domain Obstetrics Domain Oral Domain Submit update Subdomain Subdomain Subdomain
  14. 14. China Medical Software Association/中国医疗器械行业协会医用软件分会 Relationship Between HMC and CKM Archetype Library Archetype Library International domestic China clinicians International clinicians
  15. 15. China Medical Software Association / 中国医疗器械行业协会医用软件分会 HMC Modeling Results 909 9archetypes ACS Oral Medicine Liver Cancer Stroke Heart Failure AD Invervention Liver Translation EMR Lung Cancer sub-domains 435 transferred from CKM and translated to Chinese 476 are new archetypes created according to requirements
  16. 16. Recent openEHR researches
  17. 17. openEHR-based persistence solution openEHR Archetypes/ templates Reference model Archetype& Template Domain Experts ARM Schema Rules + Database Schema • Wang, L., Min, L., Wang, R., Lu, X., & Duan, H. (2015). Archetype relational mapping-a practical openEHR persistence solution. BMC Medical Informatics and Decision Making, 15(1), 88.
  18. 18. Trusted personal health record access architecture • Challenges: • Medical institutions do not share patient data for safety reasons • Medical information is fragmented and cannot effectively provide health services Build PHR EMPI data structure according to openEHR • 姚俊明,邢丹,李庆玲. 基于区块链的个人健康记录分布式框架研究[J].医学信息学杂 志,2019,40(3):31-35,43. DOI:10.3969/j.issn.1673-6036.2019.03.005.
  19. 19. Discovering clinical information models online • To discover clinical information models from an open repository online Archetype Features Clinical Resources Network A1 A2 A3 Suggest edges Concept| Concept | Probability medication order | medication order | 0.2872 medication order | dosage| 0.2331 medication order | therapeutic direction | 0.2219 …… address | address | 0.5257 address | healthcare provider address | 0.2056 …… healthcare provider address | healthcare provider address | 0.1922 healthcare provider address | address | 0.1008 …… …… Information element layer Archetype layer Concept subnetwork …… ……C1’ A1 A2 A3 C2’ C3’ C1 C2 C3 T1 T2 T3 T4 T5 • Yang, Lin, Xiaoshuo Huang, and Jiao Li. "Discovering Clinical Information Models Online to Promote Interoperability of Electronic Health Records: A Feasibility Study of OpenEHR." Journal of medical Internet research 21.5 (2019): e13504.
  20. 20. openEHR Related research conducted by ZJU • Lingtong Min, Qi Tian, Xudong Lu, Huilong Duan. Modeling EHR with the openEHR approach: an exploratory study in China. BMC Med Inform Decis Mak. 2018; 18: 75. • Min L, Tian Q, Lu X, et al. An openEHR based approach to improve the semantic interoperability of clinical data registry[J]. BMC medical informatics and decision making, 2018, 18(1): 15. • Medinfo 2019 posters • Extending CQL with openEHR to express clinical quality indicators • Representing rules for clinical data quality assessment based on openEHR Guideline Definition Language • Using openEHR’s Guideline Definition Language for representing Percutaneous Coronary Intervention Patient Safety Rules in a Dynamic Checklist System
  21. 21. Implementations in China
  22. 22. China Medical Software Association/中国医疗器械行业协会医用软件分会 Active Enterprise & institutions ü United Care Technologies(Beijing) ü ZTE-ICT(Shenzhen) ü Suhai technology(Suzhou) ü Zhuojian Technology(Hangzhou) ü Ternal Health(Shanghai) ü INFINITT China(Shanghai) ü Ming zhihui technology (Zhejiang) ü Vico Software(Zhejiang) ü Choice Technology(Hangzhou) ü … ü China Stroke Data Center ü Zhejiang University ü Academy of Military Sciences PLA China ü PLA General Hospital & Hainan branch ü ShanXi Dayi Hospital ü General Hospital of Ningxia medical University ü Wuhan General Hospital of Guangzhou Military ü Wuzhou Hospital of Traditional Chinese Medicine 22 companies 47 institutions
  23. 23. China Medical Software Association/中国医疗器械行业协会医用软件分会 1st Case– CLEVER CDR by ZJU • Archetype/ Template Editor • Archetype – relational mapping • AQL-based Data Access Interfaces • Archetype driven UI configuration Developed by ZJU
  24. 24. China Medical Software Association/中国医疗器械行业协会医用软件分会 CLEVER CDR – Upper Applications 病原体抗生素耐药性变化趋势图 Clinical Decision SupportTimeline view Clinical Research Support
  25. 25. China Medical Software Association/中国医疗器械行业协会医用软件分会 CLEVER CDR – Implemented in different scenarios City Level Wuzhou Chinese Medicine Hospital Research Collaboration Anzhen Hospital Ningxia General Hospital Group (33 hospitals) Cardiovascular Registry Provincial Level Shangxi Dayi Hospital (2600 beds) 301 Hospital National Level 301 hospital
  26. 26. China Medical Software Association/中国医疗器械行业协会医用软件分会 2nd Case – PHIP by ZTE-ICTApplicationsUsers Citizens Health Admin Medical staff Business partners Telemedicine Regional PACS Regional LISRegional HIS Decision Making Health Card RegionalHealthInformationPlatform Hospitals Platform IntegrationPrimary Health Centers Health Insurance Data Source Data Sharing EHR EMR LIS PACS Database Population Databse EMR EHR BI Data Comprehensive Management Medical Service Public Health Medical Insurance Drug System Medical resource … Public Health Regional HIS Regional PACS Regional LIS Maternal&Ch ild Sub-systems Medical Knowledge Health Card Mobile App Authority Security Quality Management Terminology Library Standard Management Health Portal Information Exchange & Sharing Platform Health Assessment Center EMPI HL7 CDA Registration • Population Health Information Platform (PHIP)based on openEHR • Developed by ZTE-ICT
  27. 27. China Medical Software Association/中国医疗器械行业协会医用软件分会 PHIP – Installations in China Shenzhen PHIP, Primary Healthcare, Telemedicine, AIO,H8, Health Management Platform PHIP, AIO, Mobile Healthcare, H8 National health and family planning commission International cooperation division (Residents mobile health management、China-Africa cooperation center) Beijing Bureau of traditional Chinese medicine (TCM Healthcare provided for the aged) PHIP, AIO, Mobile Healthcare, FDA Shanxi All-in-One Health Terminal Shaanxi All-in-one Health Terminal PHIP, AIO, Mobile Healthcare, Telemedicine Shi Jiazhuang E-health&Network Hospital First Hospital Cooperation case, build Shi Jiazhuang Chest Hospital Telemedicine Center, Family Doctor Service and Remote Clinics etc franchise rights Suzhou E-Health Grade-A hospital of second class license obtained Nantong E-Health Shenzhen Luohu Family Doctor Project
  28. 28. China Medical Software Association/中国医疗器械行业协会医用软件分会 PHIP – Interconnect Test by MOH 门诊摘要 住院摘要 会诊记录 产后访视服务 糖尿病患者随访服务 预防接种报告服务 转诊(院)记录 个人基本健康信息登记 儿童健康体检 高血压患者随访服务 产前随访服务 成人健康体检服务 新生儿家庭访视 成人健康体检 2型糖尿病随访服务 预防接种报告 产后访视 产后访视 病历概要 检查报告 治疗记录 急诊留观病历 麻醉记录 门(急)诊病历 检验报告 西药处方 手术护理记录 入院记录 入院评估 中药处方 一般手术记录 一般护理记录 住院病案首页 住院病程记录会诊记录 住院病程记录抢救记录 住院病案首页 中医住院病案首页病历 出院小结 住院病程记录术前小结 2016卫生信息共享文档标准&2016电子病历共享文档标准 Standard Documents defined by NHC 公共卫 生服务 原型 OPENEHR CORE DB EMR Archetypes (96) Public Health Archetypes (152) Interconnect Assess
  29. 29. China Medical Software Association/中国医疗器械行业协会医用软件分会 Funded by National Project, covering 16 big hospitals in 13 provinces. Targeting for 100,000 clinical and imaging data of coronary heart diseases 3rd Case – Coronary Heart Registry 大连 医科 大学 附属 院 大附属 一院四院 Beijing huairou hopital Renji hospital, shanghai Jinan military general hospital Sir run run shaw hospital zhejiang university School of medicine The second affiliated hospital of zhejiang university school of medicine Shanghai chest hospital Ruijin hospital,shanghai The first affiliated hospital of xinjiang medical university West china hosppital, sichuan unieversity The first affiliated hopstial Of dalian medical university The first affiliated hosptal of zhengzhou university Tongji medical college of hust tongji medical The first affiliated hospital, sun yat-sen University Qilu hospital of Shandong Unversity Chinese PLA general hospital Beijing Anzhen hospital
  30. 30. China Medical Software Association/中国医疗器械行业协会医用软件分会 CHR – System Concept Design US MRA ECG Meication Lab EMR Datasets from system in hospital … … CRF designed by clinicians Mid-term Follow-up Baseline Adverse Events Final Follow-up Coronary Heart Registry based on openEHR Data QC Data Verify 数据集成 CRF Entry Data Processing Integartion … extraction • openEHR is used for modeling both from clinicians and existing databases • The data extraction is facilitated through linking to openEHR-based CDR
  31. 31. China Medical Software Association/中国医疗器械行业协会医用软件分会 CHR – International Collaboration All of New Zealand Acute Coronary Syndrome – Quality Improvement (Registry) 急性冠脉综合征 风险预测 Ø Research on the benefit of improving interoperability through openEHR Ø Data Analytics such as Disease Risk Predication Models on dual Registries to compare the results between two countries,
  32. 32. China Medical Software Association/中国医疗器械行业协会医用软件分会 4th Case – Chinese Army EHR-S l Switching technical framework to openEHR since 2018, by Academy of Military Sciences PLA China and ZJU l Collecting data from over 200 hospitals and 1400 clinics, and provide EHR data services for improving management and medical services
  33. 33. China Medical Software Association/中国医疗器械行业协会医用软件分会 5th Case - China Stroke Data Center • Nearly 7 million patients, covering 360 hospitals • openEHR data standardization is on-going and the implementation has been planned
  34. 34. China Medical Software Association/中国医疗器械行业协会医用软件分会 6th Case – image CDR by Suhai Co. Ltd. - Compliance with ACR RADs, RSNA SR template, DICOM SR & RadLex - Fast Reporting Templates by openEHR - Image Labeling - Deep Learning - Segmentation & Analysis - Data archive - Search & Statistics - Study Management Radiology Structured Reporting System 影像结构化报告系统 Radiology AIaaS System (AI Lab) 影像AI研究支持系统 Radiology Research System 影像科研管理系统 openEHR image- CDR 基于openEHR影像数据平台 影像医生诊断辅助、高效发表高质量研究成果、创新探索的工作平台
  35. 35. • Scope: 1. Accumulate 10000+ liver transplant studies 2. 50000+ structured EMR+Followup data including Labelled images 3. To support research and clinical CDS • Current Research: 1. openEHR modelling for Liver Transplant 2. Liver transplant Ultrasound Hemodynamics CDSS #Grant by Tianjin Government in 2018 as Key Science Project 1600beds, the No.1 Liver Transplant Center in Asia Liver Transplant Ultrasound image-CDR Dental image-CDR 200+Chair & 200beds, one of the best dental hospitals in China. • Scope: 1. Oral & Maxillofacial image structure reporting system 2. CBCT and Panoramic image labelling of children dental caries 3. Dental big data repository including labelled images • Current Research: 1. openEHR modelling for Oral and Maxillofacial Image 2. Children dental caries evaluation • Scope: 1. Radiology structure reporting system 2. MDCT, DR image labelling of Chest Image 3. Radiology big data repository including labelled images • Current Research: 1. openEHR modelling for Chest (Lung, Cardiac) Radiology 2. Five decease CDSS of Chest DR by Deep Learning 3. Lung RADs for Lung Cancer Score classification Installations of iCDR Radiology image-CDR
  36. 36. China Medical Software Association/中国医疗器械行业协会医用软件分会 7th Case – EHR.care by PROSPECTWELLNESS l Open Care Solution to provide rapid development for healthcare enterprise information platform, which is powered by openEHR- based EHR.care l Use case 1(implemented in 2017.12): Building information platform for High-end Health Management Corporations covering four cities in China, l Use case 2(On-going): Building information platform for Private Hospital Alliance Corporation, integrating all the heterogeneous systems.
  37. 37. China Medical Software Association/中国医疗器械行业协会医用软件分会 openEHR Industrial Alliance openEHR产业化联盟
  38. 38. China Medical Software Association/中国医疗器械行业协会医用软件分会 Requirements & Motivations Ø Enforce the Strength of openEHR in the domain Ø Localization of Archetypes/Templates Ø Linkage with the standardization efforts of MOH Ø Training and Educations Ø International Communication Ø Collaborations both in technology and in market
  39. 39. China Medical Software Association/中国医疗器械行业协会医用软件分会 Proposal for COIA Ø China openEHR Industrial Alliance – COIA • Non-profit Organization CMSA/ openEHR TC COIA Management Board Industrial Members Individual Members Modeling/Specification/ Development WGs
  40. 40. China Medical Software Association/中国医疗器械行业协会医用软件分会 What COIA can do for members ? • Development and Maintenance of openEHR.org.cn • Development and Maintenance of openEHR.org.cn/hmc • openEHR Specification Translation and Development • openEHR localization and Modeling services • Standardization and linkage with other standardizing efforts • Connection with openEHR Foundation • Training and Workshops • openEHR Certification • ……
  41. 41. China Medical Software Association/中国医疗器械行业协会医用软件分会 openEHR国际:www.openEHR.org openEHR中国:www.openEHR.org.cn openEHR模型库: www.openEHR.org/ckm openEHR中国模型库: www.openEHR.org.cn/hmc openEHR技术交流微信群 Welcome to join in openEHR community
  • mandi5

    Jun. 18, 2019

The overview of openEHR in China, 2019.

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