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openEHR sll-2015final

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Presentation of openEHR Foundation to Stockholm County Council and Karolinska Institute on the use of open platforms and openEHR in e-health.

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openEHR sll-2015final

  1. 1. Rong Chen, MD, PhD openEHR Management Board Co-lead, openEHR Specification Program CMIO, Cambio Healthcare Systems Copyright 2015 openEHR Foundation Thomas Beale openEHR Management Board Co-lead, openEHR Specification Program CTO, Ocean Informatics
  2. 2.  "eHealth is just healthcare management of the 21st century. It's not an ICT project.” ◦ Madis Tiik, CEO, Estonian E-Health Foundation Copyright 2014 openEHR FoundationCopyright 2014 openEHR Foundation
  3. 3. Copyright 2014 openEHR Foundation
  4. 4. Open or closed? Retain or cede control? Copyright 2014 openEHR FoundationCopyright 2014 openEHR Foundation
  5. 5. Copyright 2014 openEHR FoundationCopyright 2014 openEHR Foundation gov payers vendors provider institutionssolutions build deploy care SDOs ? Q:How much influence does the buyer really have? A: control points are usually limited to Function points, limited standards conformance
  6. 6. Copyright 2014 openEHR FoundationCopyright 2014 openEHR Foundation gov payers vendors provider institutionssolutions build deploy care SDOs ? How much influence Government?
  7. 7. Copyright 2014 openEHR FoundationCopyright 2014 openEHR Foundation gov payers vendors provider institutionssolutions build deploy care SDOs e-health programme ? Technical requirements based on?
  8. 8. Copyright 2014 openEHR FoundationCopyright 2014 openEHR Foundation e-health programme gov payers vendors provider institutionssolutions build deploy care SDOs ? integrate PLATFORM Now procurement has a means of requiring conformance – a fully defined set of specifications
  9. 9. Copyright 2015 openEHR 1. Standard Information model 2. Standard content definitions Service API B2B Service API Service API Service API B2B Service API B2B Service API Service API Service API Service API Service API 4. Standard interfaces 3. Open terminologies 5. Semantic Querying app app other system
  10. 10. Copyright 2014 openEHR FoundationCopyright 2014 openEHR Foundation e-health programme gov payers vendors provider institutionssolutions build deploy care SDOs ? integrate PLATFORM Except the buyer side has no means of influence
  11. 11. Copyright 2014 openEHR FoundationCopyright 2014 openEHR Foundation e-health programme gov payers vendor provider institutions build deploy care SDOs ? solution PLATFORM And no visibility
  12. 12.  Primarily the Patient data (EHR/CDR) ◦ Want to use as needed, including unplanned uses ◦ Value of data relies on its computability Copyright 2014 openEHR FoundationCopyright 2014 openEHR Foundation
  13. 13.  And ways of interacting with it ◦ Open application APIs - Enable new apps to be added at any time in a known way, e.g. care planning ◦ B2B service interfaces - e.g. lab data, EHR extract to DW, quality registers  And open knowledge engineering – develop microbiology result definition and terminology subsets…. Once, for the whole jurisdiction Copyright 2014 openEHR FoundationCopyright 2014 openEHR Foundation
  14. 14.  Environment with (un-?)controlled cost characteristic  Cost characteristic is based on ability to modify the environment in a relatively fine- grained way, with the price relating to the true underlying cost of the component in question ◦ Add / remove apps ◦ Change / add back-ends ◦ Add / modify connection points ◦ Reprocess data at will Copyright 2014 openEHR FoundationCopyright 2014 openEHR Foundation
  15. 15.  With monolithic supplier, not only are the technical details outsourced, so too is the ability to control costs of incremental change ◦ The cost of a change is what the supplier says it is  You are now invested in the supplier’s development path, not your own Copyright 2014 openEHR FoundationCopyright 2014 openEHR Foundation
  16. 16.  No vendor lock-in  Free access to, use & reuse of data… forever  Incremental deployment of components according to customer timeline  Direct clinical engagement (ask Norway!)  Control over costs Copyright 2014 openEHR FoundationCopyright 2014 openEHR Foundation
  17. 17. Copyright 2014 openEHR Foundation
  18. 18. Copyright 2015 openEHR 1. Standard Information model 2. Standard content definitions Service API B2B Service API Service API Service API B2B Service API B2B Service API Service API Service API Service API Service API 4. Standard interfaces 3. Open terminologies 5. Semantic Querying app app other system
  19. 19.  We don’t propose a ‘bag of standards’  Instead we propose a coherent platform definition, managed by a single .org entity ◦ That defines many key elements – information models, content models, guidelines, ◦ And sources others from elsewhere, and integrates them properly  IHE.net with openEHR profiles  IHTSDO, WHO, WONCA, LOINC etc  HL7 FHIR? CDA?  OMG RLUS, EIS  etc Copyright 2015 openEHR
  20. 20.  Most of the semantics come from clinical models (‘archetypes’ and ‘templates’) and terminology  These are built by clinical people (e.g. Norway MoH / Bergen…) in a crowd-sourced fashion  They ultimately define data-sets & value-sets  Which can be used to generate usable software artefacts   we no longer wait for some SDO to produce a standard for ‘discharge summary’ Copyright 2015 openEHR
  21. 21. Copyright 2014 openEHR Foundation
  22. 22.  Non-profit organisation based at UCL  1300+ Members from 71 countries  All specifications & schemas publicly available  Software open source (GPL, LGPL, Apache2)
  23. 23. Copyright 2013 Ocean Informatics
  24. 24. Copyright 2015 openEHR
  25. 25. Copyright 2015 openEHR
  26. 26. Copyright 2015 openEHR
  27. 27. Copyright 2013 Ocean Informatics
  28. 28. Copyright 2015 openEHR
  29. 29. Copyright 2014 openEHR Foundation
  30. 30. Copyright 2013 Ocean Informatics
  31. 31. Copyright 2013 Ocean Informatics
  32. 32. Copyright 2013 Ocean Informatics
  33. 33. Copyright 2013 Ocean Informatics
  34. 34. Copyright 2013 Ocean Informatics
  35. 35. Copyright 2013 Ocean Informatics
  36. 36. Copyright 2013 Ocean Informatics
  37. 37. Copyright 2013 Ocean Informatics
  38. 38. Copyright 2014 openEHR Foundation
  39. 39.  Is to define (parts of) a health computing ‘platform’ that addresses these challenges: ◦ Information and workflow complexity ◦ Constantlychanging clinical requirements ◦ A long-lived patient-centric EHR ◦ Enables diverse e-health vendor components and products to work together Copyright 2014 openEHR FoundationCopyright 2014 openEHR Foundation
  40. 40. Copyright 2014 openEHR FoundationCopyright 2014 openEHR Foundation
  41. 41.  The clinical domain generates most of the requirements ◦ And is changing all the time  We therefore need to model the clinical domain to do sustainable ICT ◦ Terminology models the ‘facts’ ◦ We still need to model the information & workflow  openEHR enables a model-based tool chain for building sustainable software solutions Copyright 2014 openEHR FoundationCopyright 2014 openEHR Foundation
  42. 42.  Nr semantic definitions huge and constantly growing – O(1E6)  Nearly all semantic definitions only doable by domain professionals ◦ Not IT people  Number of technical expressions substantial and always changing – O(1E2) ◦ Prog langs, various XSD, JSON, UI, … Copyright 2014 openEHR Foundation
  43. 43.  We need to enable domain professionals to do the semantic modelling directly ◦  special tools and formalisms  We need to do the models upstream of the technical representations ◦  requires model  software transform tools  We need to build systems that accept generated model artefacts… forever Copyright 2014 openEHR Foundation
  44. 44. Copyright 2012 Ocean Informatics Deployed system consumes new content definitions ... forever Forms and messages formally based on content models
  45. 45. Copyright 2014 openEHR Foundation
  46. 46. Copyright 2015 openEHR 1. Standard Information model 2. Standard content definitions Service API B2B Service API Service API Service API B2B Service API B2B Service API Service API Service API Service API Service API 4. Standard interfaces 3. Open terminologies 5. Semantic Querying app app other system
  47. 47.  The road ahead is a process not a product  It’s an ecosystem not a monoculture Copyright 2014 openEHR Foundation
  48. 48.  http://www.openEHR.org  http://www.openEHR.org/ckm Copyright 2014 openEHR Foundation

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