This document provides an overview of the openEHR CDR open source project called EHRbase. EHRbase aims to provide an open standard-compliant backend platform for electronic health records and clinical applications using the openEHR specification. It has a team of developers across multiple continents and uses modern development practices like Scrum and BDD. EHRbase provides a REST API and SDK for creating, querying, and managing openEHR objects in a clinical data repository, and also integrates with FHIR through a FHIR bridge. It is being used as the backend platform for a national COVID-19 system in Germany.
openEHR is an open specification for a health information model that supports an open platform ecosystem in a vendor-neutral and technology-neutral manner. It uses a two-level modeling approach with a stable reference model and separate clinical models defined through archetypes. Archetypes are shareable and computable models of discrete clinical concepts that can be aggregated into templates. openEHR supports vendor-neutral querying of health information through its AQL and various technical approaches have been used to implement openEHR-compliant clinical data repositories.
An introduction to openEHR, clinical information modelling, pragmatic standardisation and use of ontologies.
Presented by Erik Sundvall and Silje Ljosland Bakke in CRS4, Sardinia, on 11 october 2022, as part of InterHealth 2022.
Christian Chevalley discussed scaling up an openEHR CDR system to handle large volumes of EHR data. Some key points:
- The system was migrated to use EHRbase to handle over 10 million EHRs with over 10 billion compositions.
- Performance optimizations included performing all CRUD and query transactions in a single database transaction to minimize overhead.
- The system was benchmarked using a PostgreSQL cluster handling 650,000 EHRs with query response times under 1ms.
- For further scaling, distributing the transaction load across a "hyperscale" database cluster like Citus or YugabyteDB was recommended over a simple "dumb" database cluster.
openEHR is an open specification for a health information model that supports an open platform ecosystem in a vendor-neutral and technology-neutral manner. It uses open source clinical archetypes and content definitions to allow for substantially faster app development with lower barriers to market entry and no vendor/technology lock-in. openEHR utilizes a common information model with archetypes, a vendor-neutral querying language, and open-source content libraries to provide interoperable clinical data repositories for storing and querying health records.
The document provides an introduction to key concepts in the openEHR Reference Model (RM) including:
1) It describes several core RM classes - EHR, Composition, Section, and Entry - that define the structure of a patient health record in openEHR. Compositions contain patient data organized into Sections and Entries.
2) It explains key attributes for different types of Entries defined in the RM like Observations, Evaluations, Instructions, and Actions that support the "clinical investigator cycle".
3) It outlines important datatypes in the RM like Quantity, Text, and CodedText and their relevant attributes for modeling clinical data values and coded items.
4) It describes how archetypes are
Here are the steps to complete the tasks in the template designer walkthrough:
1. Open the template in the designer
2. Find the Problem/Diagnosis archetype and rename it to Main Diagnosis
3. Constrain the Main Diagnosis archetype to keep only the Problem/Diagnosis name node, removing all other nodes
4. Pull in the Adverse Reaction archetype
5. Constrain the Adverse Reaction archetype to keep only the Substance and Manifestation nodes, removing all other nodes
6. Rename the Manifestation node to Reaction Details and set it to mandatory (single occurrence required)
7. Find the Medication Order archetype
8. Clone the Specific
This document discusses clinical information modeling and interoperability. It introduces openEHR, a two-level modeling approach using archetypes and templates to define clinical information. OpenEHR aims to support app development through a shared information model and democratize healthcare standards development. The document also discusses challenges with mismatched clinical models, the need for a shared platform and information standard, and an evolutionary approach to standards development involving clinical stakeholders.
This document provides an overview of the openEHR CDR open source project called EHRbase. EHRbase aims to provide an open standard-compliant backend platform for electronic health records and clinical applications using the openEHR specification. It has a team of developers across multiple continents and uses modern development practices like Scrum and BDD. EHRbase provides a REST API and SDK for creating, querying, and managing openEHR objects in a clinical data repository, and also integrates with FHIR through a FHIR bridge. It is being used as the backend platform for a national COVID-19 system in Germany.
openEHR is an open specification for a health information model that supports an open platform ecosystem in a vendor-neutral and technology-neutral manner. It uses a two-level modeling approach with a stable reference model and separate clinical models defined through archetypes. Archetypes are shareable and computable models of discrete clinical concepts that can be aggregated into templates. openEHR supports vendor-neutral querying of health information through its AQL and various technical approaches have been used to implement openEHR-compliant clinical data repositories.
An introduction to openEHR, clinical information modelling, pragmatic standardisation and use of ontologies.
Presented by Erik Sundvall and Silje Ljosland Bakke in CRS4, Sardinia, on 11 october 2022, as part of InterHealth 2022.
Christian Chevalley discussed scaling up an openEHR CDR system to handle large volumes of EHR data. Some key points:
- The system was migrated to use EHRbase to handle over 10 million EHRs with over 10 billion compositions.
- Performance optimizations included performing all CRUD and query transactions in a single database transaction to minimize overhead.
- The system was benchmarked using a PostgreSQL cluster handling 650,000 EHRs with query response times under 1ms.
- For further scaling, distributing the transaction load across a "hyperscale" database cluster like Citus or YugabyteDB was recommended over a simple "dumb" database cluster.
openEHR is an open specification for a health information model that supports an open platform ecosystem in a vendor-neutral and technology-neutral manner. It uses open source clinical archetypes and content definitions to allow for substantially faster app development with lower barriers to market entry and no vendor/technology lock-in. openEHR utilizes a common information model with archetypes, a vendor-neutral querying language, and open-source content libraries to provide interoperable clinical data repositories for storing and querying health records.
The document provides an introduction to key concepts in the openEHR Reference Model (RM) including:
1) It describes several core RM classes - EHR, Composition, Section, and Entry - that define the structure of a patient health record in openEHR. Compositions contain patient data organized into Sections and Entries.
2) It explains key attributes for different types of Entries defined in the RM like Observations, Evaluations, Instructions, and Actions that support the "clinical investigator cycle".
3) It outlines important datatypes in the RM like Quantity, Text, and CodedText and their relevant attributes for modeling clinical data values and coded items.
4) It describes how archetypes are
Here are the steps to complete the tasks in the template designer walkthrough:
1. Open the template in the designer
2. Find the Problem/Diagnosis archetype and rename it to Main Diagnosis
3. Constrain the Main Diagnosis archetype to keep only the Problem/Diagnosis name node, removing all other nodes
4. Pull in the Adverse Reaction archetype
5. Constrain the Adverse Reaction archetype to keep only the Substance and Manifestation nodes, removing all other nodes
6. Rename the Manifestation node to Reaction Details and set it to mandatory (single occurrence required)
7. Find the Medication Order archetype
8. Clone the Specific
This document discusses clinical information modeling and interoperability. It introduces openEHR, a two-level modeling approach using archetypes and templates to define clinical information. OpenEHR aims to support app development through a shared information model and democratize healthcare standards development. The document also discusses challenges with mismatched clinical models, the need for a shared platform and information standard, and an evolutionary approach to standards development involving clinical stakeholders.
openEHR is an open specification for a health information model that supports an open platform ecosystem. It uses two-level modeling with reference models representing health data and archetypes representing clinical concepts separately. Archetypes capture clinical concepts in an open source and computable format. Templates aggregate archetypes to deliver clinical datasets. AQL allows querying of the information model independent of the database. Building a high-quality openEHR system is challenging as it requires understanding and supporting archetypes, templates, information modeling querying, and being fast and flexible.
This document provides an overview of openEHR archetypes and their classes. It describes the main generic classes used in openEHR such as COMPOSITION, SECTION, ENTRY and ELEMENT. It then explains how archetypes act as recipes for defining clinical content using these classes. Key parts of archetypes like COMPOSITION, SECTION, ENTRY and their subclasses are defined. The roles of different ENTRY types like OBSERVATION, EVALUATION and INSTRUCTION are outlined. Examples of common archetypes are also referenced.
To view recording of this webinar please use the below link:
https://wso2.com/library/webinars/2015/02/connected-health-reference-architecture/
The key focus areas of this session are
Overview of healthcare IT landscape
Standards and protocols widely used in healthcare platforms
SOA is healthcare domain
Quality of services in healthcare platforms
A connected healthcare reference model
A seminar made to the Tennessee Department of Health in July 2015. An introduction to HL7 standards with a focus on HL7 v3 messaging and clinical document architecture standards.
This document provides an overview of the HL7 Clinical Document Architecture (CDA) standard for exchanging clinical documents. It describes what CDA is, the components of a CDA document, how CDA documents can be rendered and exchanged in messages, and examples of use cases for CDA. The key points are that CDA specifies an XML format for clinical documents to enable their structured exchange between systems, CDA documents have human-readable and machine-processable parts, and CDA relies on other HL7 standards for semantics.
The document provides an introduction to FHIR (Fast Healthcare Interoperability Resources). It outlines some of the limitations of previous HL7 standards like V3 being too complex and documents (CDA) not being sufficient. It notes the need for a transition path from V2 and something to address new markets. FHIR is presented as a new approach that is focused on implementers and uses resources as the basic building block. Each resource has its own model and unique ID. The goal is to make implementation easier compared to previous standards.
An overview of the interoperability standard - Health Level 7
In partial fulfillment of the requirements for
MI 224: Coding, Classification, and Terminology in Medicine
MS Health Informatics
UP Manila College of Medicine
Full lecture with narration: https://www.youtube.com/watch?v=hjUy6k328gk
The presentation talks about the components of FHIR, its distribution and use. Scenarios for the introduction of FHIR in the country using HL7 V3 are also offered.
This document provides information about HL7 standards and two experts, Dr. Supachai Parchariyanon and Dr. Nawanan Theera-Ampornpunt. It discusses Dr. Parchariyanon's background and interests in standards and interoperability. It then outlines the topics to be covered, including an introduction to standards and interoperability, what HL7 is, HL7 Version 2 and 3, the Reference Information Model, and Clinical Document Architecture.
Presentation given at HL7 Norway on april 1st, 2014. Subjects are: why a new standard? what are the basic building blocks of FHIR? What are profiles? How do we make documents out of resources? Also contains some example architectures.
This document provides an overview of FHIR (Fast Healthcare Interoperability Resources) and how it can be used to exchange healthcare data. It discusses key FHIR concepts like resources, references between resources, extensions, and how FHIR uses RESTful principles for interoperability. Resources are small units of exchange that can be composed of other resources or reference them. FHIR specifies a RESTful API where resources have URLs and can be retrieved, updated, deleted using HTTP verbs. This allows distributed, standards-based sharing of healthcare information.
OpenMRS Concept Management Tutorial presented on 9 Dec 2015 at the OpenMRS Worldwide Summit in Singapore. Presented by Andy Kanter and Ellen Ball. 4 hour presentation.
Pentaho is an open-source business intelligence (BI) suite that provides query and reporting, OLAP analysis, data integration, dashboards, and data mining capabilities. It was founded in 2004 and offers these features through an enterprise edition with professional support. The suite allows users to access and analyze data through tools like reporting, interactive analysis, data integration, and machine learning algorithms for pattern detection.
The document provides an overview of the Informatica PowerCenter 7.1 product, describing its major components for ETL development, how to build basic mappings and workflows, and available options for loading target data. It also outlines the course objectives to understand PowerCenter architecture and components, build mappings and workflows, and troubleshoot common problems. Resources available from Informatica like documentation, support, and certification programs are also summarized.
Este documento fornece uma visão geral de um workshop para DBAs que visa ensinar desde a instalação do sistema operacional até a configuração do banco de dados Oracle. A agenda inclui introdução ao papel de DBA, sistemas operacionais, armazenamento, instalação e configuração do Oracle database nas versões 10g, 11g e 12c. O workshop também aborda preparação do sistema operacional, gerenciamento e manutenção do banco de dados.
Elsevier Medical Graph – mit Machine Learning zu Precision MedicineRising Media Ltd.
Elsevier Health Analytics entwickelt den Medical Knowledge Graph, welcher Korrelationen zwischen Krankheiten und zwischen Krankheiten und Behandlungen darstellt. Auf einem Gesamtdatensatz von sechs Millionen anonymisierten Patienten, beobachtbar über sechs Jahre, haben wir über 2000 Modelle erstellt, welche die Entwicklung von Krankheiten prognostizieren. Jedes Modell ist adjustiert für mehr als 3000 Kovariablen. Dazu kam ein Boosting Algorithmus mit Variablenselektion zum Einsatz. Die Betas der selektierten Variablen wurden extrahiert, getestet hinsichtlich Kausalität und Signifikanz, und daraus wurde die erste Version des Medical Graphen mit über 2000 Krankheitsknoten und 25.000 Effekt-Kanten gebaut. Der Graph wird aktuell in der Praxis getestet, mit dem Ziel, dem Arzt eine patienten-individuelle Entscheidungsunterstützung für die Behandlung zu geben.
This document discusses pathology informatics and describes several key concepts:
- Pathology informatics involves using information technology to facilitate pathology practices like patient care, disease understanding, and education. It requires integrating diverse data sources and presenting data to support decisions.
- Key components of a pathology information system include managing specimens, acquiring and processing data, and generating integrated reports that can be accessed across hospital systems.
- Standards like SNOMED, ICD-10, and LOINC are important for representing and communicating information between different medical systems.
- A laboratory information system is a comprehensive software that manages the pathology laboratory workflow and reporting.
openEHR is an open specification for a health information model that supports an open platform ecosystem. It uses two-level modeling with reference models representing health data and archetypes representing clinical concepts separately. Archetypes capture clinical concepts in an open source and computable format. Templates aggregate archetypes to deliver clinical datasets. AQL allows querying of the information model independent of the database. Building a high-quality openEHR system is challenging as it requires understanding and supporting archetypes, templates, information modeling querying, and being fast and flexible.
This document provides an overview of openEHR archetypes and their classes. It describes the main generic classes used in openEHR such as COMPOSITION, SECTION, ENTRY and ELEMENT. It then explains how archetypes act as recipes for defining clinical content using these classes. Key parts of archetypes like COMPOSITION, SECTION, ENTRY and their subclasses are defined. The roles of different ENTRY types like OBSERVATION, EVALUATION and INSTRUCTION are outlined. Examples of common archetypes are also referenced.
To view recording of this webinar please use the below link:
https://wso2.com/library/webinars/2015/02/connected-health-reference-architecture/
The key focus areas of this session are
Overview of healthcare IT landscape
Standards and protocols widely used in healthcare platforms
SOA is healthcare domain
Quality of services in healthcare platforms
A connected healthcare reference model
A seminar made to the Tennessee Department of Health in July 2015. An introduction to HL7 standards with a focus on HL7 v3 messaging and clinical document architecture standards.
This document provides an overview of the HL7 Clinical Document Architecture (CDA) standard for exchanging clinical documents. It describes what CDA is, the components of a CDA document, how CDA documents can be rendered and exchanged in messages, and examples of use cases for CDA. The key points are that CDA specifies an XML format for clinical documents to enable their structured exchange between systems, CDA documents have human-readable and machine-processable parts, and CDA relies on other HL7 standards for semantics.
The document provides an introduction to FHIR (Fast Healthcare Interoperability Resources). It outlines some of the limitations of previous HL7 standards like V3 being too complex and documents (CDA) not being sufficient. It notes the need for a transition path from V2 and something to address new markets. FHIR is presented as a new approach that is focused on implementers and uses resources as the basic building block. Each resource has its own model and unique ID. The goal is to make implementation easier compared to previous standards.
An overview of the interoperability standard - Health Level 7
In partial fulfillment of the requirements for
MI 224: Coding, Classification, and Terminology in Medicine
MS Health Informatics
UP Manila College of Medicine
Full lecture with narration: https://www.youtube.com/watch?v=hjUy6k328gk
The presentation talks about the components of FHIR, its distribution and use. Scenarios for the introduction of FHIR in the country using HL7 V3 are also offered.
This document provides information about HL7 standards and two experts, Dr. Supachai Parchariyanon and Dr. Nawanan Theera-Ampornpunt. It discusses Dr. Parchariyanon's background and interests in standards and interoperability. It then outlines the topics to be covered, including an introduction to standards and interoperability, what HL7 is, HL7 Version 2 and 3, the Reference Information Model, and Clinical Document Architecture.
Presentation given at HL7 Norway on april 1st, 2014. Subjects are: why a new standard? what are the basic building blocks of FHIR? What are profiles? How do we make documents out of resources? Also contains some example architectures.
This document provides an overview of FHIR (Fast Healthcare Interoperability Resources) and how it can be used to exchange healthcare data. It discusses key FHIR concepts like resources, references between resources, extensions, and how FHIR uses RESTful principles for interoperability. Resources are small units of exchange that can be composed of other resources or reference them. FHIR specifies a RESTful API where resources have URLs and can be retrieved, updated, deleted using HTTP verbs. This allows distributed, standards-based sharing of healthcare information.
OpenMRS Concept Management Tutorial presented on 9 Dec 2015 at the OpenMRS Worldwide Summit in Singapore. Presented by Andy Kanter and Ellen Ball. 4 hour presentation.
Pentaho is an open-source business intelligence (BI) suite that provides query and reporting, OLAP analysis, data integration, dashboards, and data mining capabilities. It was founded in 2004 and offers these features through an enterprise edition with professional support. The suite allows users to access and analyze data through tools like reporting, interactive analysis, data integration, and machine learning algorithms for pattern detection.
The document provides an overview of the Informatica PowerCenter 7.1 product, describing its major components for ETL development, how to build basic mappings and workflows, and available options for loading target data. It also outlines the course objectives to understand PowerCenter architecture and components, build mappings and workflows, and troubleshoot common problems. Resources available from Informatica like documentation, support, and certification programs are also summarized.
Este documento fornece uma visão geral de um workshop para DBAs que visa ensinar desde a instalação do sistema operacional até a configuração do banco de dados Oracle. A agenda inclui introdução ao papel de DBA, sistemas operacionais, armazenamento, instalação e configuração do Oracle database nas versões 10g, 11g e 12c. O workshop também aborda preparação do sistema operacional, gerenciamento e manutenção do banco de dados.
Elsevier Medical Graph – mit Machine Learning zu Precision MedicineRising Media Ltd.
Elsevier Health Analytics entwickelt den Medical Knowledge Graph, welcher Korrelationen zwischen Krankheiten und zwischen Krankheiten und Behandlungen darstellt. Auf einem Gesamtdatensatz von sechs Millionen anonymisierten Patienten, beobachtbar über sechs Jahre, haben wir über 2000 Modelle erstellt, welche die Entwicklung von Krankheiten prognostizieren. Jedes Modell ist adjustiert für mehr als 3000 Kovariablen. Dazu kam ein Boosting Algorithmus mit Variablenselektion zum Einsatz. Die Betas der selektierten Variablen wurden extrahiert, getestet hinsichtlich Kausalität und Signifikanz, und daraus wurde die erste Version des Medical Graphen mit über 2000 Krankheitsknoten und 25.000 Effekt-Kanten gebaut. Der Graph wird aktuell in der Praxis getestet, mit dem Ziel, dem Arzt eine patienten-individuelle Entscheidungsunterstützung für die Behandlung zu geben.
This document discusses pathology informatics and describes several key concepts:
- Pathology informatics involves using information technology to facilitate pathology practices like patient care, disease understanding, and education. It requires integrating diverse data sources and presenting data to support decisions.
- Key components of a pathology information system include managing specimens, acquiring and processing data, and generating integrated reports that can be accessed across hospital systems.
- Standards like SNOMED, ICD-10, and LOINC are important for representing and communicating information between different medical systems.
- A laboratory information system is a comprehensive software that manages the pathology laboratory workflow and reporting.
This document provides an overview of RELMA (Regenstrief LOINC Mapping Assistant), a software tool for mapping local laboratory test names and codes to standardized LOINC codes. It discusses installing and using RELMA to facilitate mapping of a local observation file to LOINC codes. The goals are to improve data quality, interoperability and comparability by implementing standardized terminology.
Planning And Development Of The Iss Ise Webinar FinalJay1818mar
This document provides a summary of a presentation on planning and developing integrated summaries of safety and efficacy data from multiple clinical trials. It discusses the purpose and requirements of integrated summaries, the planning process, special analysis considerations, and guidance documents. Key points covered include defining analysis populations and treatment groups, handling adverse events and laboratory data consistently across studies, and obtaining regulatory agency input on analysis plans.
Using NLP and curation to make clinical data available for researchWarren Kibbe
While at Northwestern we developed a chart abstraction tool using a data mart to present EHR data to research personnel without double entry. Used in the Brain Tumor Institute. Mike Gurley did the majority of the development.
What happens when cardiologists have had enough with general EHRs that know nothing about cardiology? They formulate a plan to treat those issues, and here is how they did it with a system they designed from the ground up.
Discover the Cardiovascular Suite, including Cardiology EHR & Diagnostics, developed by the heart specialists at Objective Medical Systems.
[BBBtech] elemark for chronic disease care brochureKyongsik Yun
The elemark mobile blood testing device can test multiple parameters for managing chronic diseases like diabetes and cardiovascular disease. It tests glucose, ketone bodies, and cholesterol and stores the results, which can be viewed graphically over time. The data and risk scores can be shared with family and doctors through the elemark care monitoring service. Hospitals can also integrate elemark to sync results to electronic medical records.
The document provides an introduction and overview of the Logical Observation Identifiers Names and Codes (LOINC) system. It describes LOINC's structure using a six-axis model to systematically name clinical observations. It also gives examples of LOINC codes and discusses how LOINC aims to standardize clinical terminology to facilitate health information exchange.
Revised electronic medical record data modeleyetech
1. The document proposes a revised electronic medical record data model consisting of assessment objects, management objects, and encounters as the central class.
2. Encounters would contain assessment and management objects and stack together to form episodes of care and disease courses.
3. The model simplifies previous structures and provides a common format for sharing data between different software languages, while allowing flexibility for individual software providers.
The document provides an overview of an "Electronic Medical Regulation System" project. It includes sections on the introduction, objectives, modules, features, feasibility analysis, need and significance, system model, methodology, and required facilities and bibliography. The main goal is to build a management tool to easily track patient, staff, treatment, and billing information to analyze reports. It aims to reduce time compared to a manual system by accurately maintaining inpatient and outpatient records.
Presentation from the 3rd Joint Meeting of the Antimicrobial Resistance and Healthcare-Associated Infections (ARHAI) Networks, organised by the European Centre of Disease Prevention and Control - Stockholm, 11-13 February 2015
MLSC-382A INSTRUCTOR: BETH RAWSON
1
Results Interp Wksht Updated: 8/20/2020
RESULTS INTERPRETATION Worksheet STUDENT NAME: __________________
SECTIONS 1 AND 2:
Given the following results, identify the abnormal or questionable results, and provide at least one
explanation for them (there may be multiple explanations possible). The first thing you have to decide is
whether the values presented are valid or spurious (i.e. inaccurate due to either specimen quality or
handling). The second consideration is what could explain the abnormalities you are seeing (what kind
of clinical situation OR specimen problem is suspected).
The time listed in the “Previous” column refers to the interval between the current results and the most
recent previous values. If no values are listed in the “Previous” column, assume there is no known
history. Generic reference ranges are provided.
NOTE: A key ability for any laboratory professional is to be able to distinguish spurious results (those
due to improper specimen collection methods) from true clinical variation due to a pathological
condition.
SECTION 1: CBC Testing
For each example, note which parameter(s) are pertinent to your explanation. An asterisk next
to a value indicates that it has been flagged by the instrument. Delta flags are indicated by [%D]
next to the value.
CBC #1: 57-year old Caucasian male, presented to the ED with chest pain, diagnosed with myocardial
infarction and admitted to the ICU 2 days earlier.
CURRENT PREVIOUS
(8 hours)
REFERENCE
RANGE
UNIT
WBC 4.8 5.4 4.5 – 11.5 103/uL
RBC 2.87 4.65 4.60 – 6.00 (m) 106/uL
HGB 10.1 [%D] 14.2 14.0 – 18.0 (m) g/dL
HCT 29.1 [%D] 42.4 40.0 – 54.0 (m) %
MCV 101 [%D] 91 80 – 98 fL
MCH 35.1 30.5 26 – 32 pg
MCHC 34.7 33.4 32 – 36 g/dL
RDW 12.5 13.3 11.5 – 14.5 %
PLT 224 292 150 – 450 103/uL
MPV 7.9 8.1 6.8 – 10.2 fL
MLSC-382A INSTRUCTOR: BETH RAWSON
2
Results Interp Wksht Updated: 8/20/2020
CBC #2: 27-year old Greek female, presented for prenatal evaluation (20 weeks pregnant).
CURRENT PREVIOUS REFERENCE
RANGE
UNIT
WBC 6.6 4.5 – 11.5 103/uL
RBC 5.13 4.00 – 5.40 (f) 106/uL
HGB 10.7 12.0 – 15.0 (f) g/dL
HCT 34.9 35.0 – 49.0 (f) %
MCV 68 80 – 98 fL
MCH 20.9 26 – 32 pg
MCHC 30.7 32 – 36 g/dL
RDW 27.3 11.5 – 14.5 %
PLT 309 150 – 450 103/uL
MPV 7.4 6.8 – 10.2 fL
CBC #3: 19-year old African American male, presented to the outpatient draw station subsequent to his
yearly physical examination; he did not have any complaints.
CURRENT PREVIOUS REFERENCE
RANGE
UNIT
WBC 5.6 4.5 – 11.5 103/uL
RBC 3.58 4.60 – 6.00 (m) 106/uL
HGB 11.0 14.0 – 18.0 (m) g/dL
HCT 46.4* 40.0 – 54.0 (m) %
MCV 130 80 – 98 fL
MCH 30.7 26 – 32 pg
MCHC 23.7* 32 – 36 g/dL
RDW 22.4 11.5 – 14.5 %
PLT 8* 150 – 450 103/uL
MPV 9.7 6.8 – 10.2 fL
MLSC-382A INSTRUCTOR: BETH RAWSON
3
Results Interp Wksht ...
Keynote address by Brent James at the 2013 Saskatchewan Health Care Quality Summit. For more information about the summit, visit www.qualitysummit.ca. Follow @QualitySummit on Twitter.
Dr. Brent James describes how Intermountain Healthcare is systematically, and successfully, bringing together clinicians, patients and leaders to: establish best practices; drive out waste in their system; and ultimately deliver better, safer care. Dr. James will share insights about the structures, strategies and relationships that have been pivotal in transforming their health system.
Developing New Drug Antagonist for Alpha Adrenergic Receptors for Hypertensio...rahulmonikasharma
Alpha-adrenergic receptors play a vital role in the regulation of blood pressure(BP). Hypertension referred as blood pressure above the normal range. hyper tension can cause severe complications such as stroke, coronary heart disease and kidney failure. Phentolamine is a potential antagonist for a. Alpha-adrenergic receptor. New phentolamine derivatives will be developed through FEP (Free Energy perturbation) methods. AMBER Force fields will apply for energy Calculation. Molecular modeling includes energy minimization, molecular dynamics, mounte-carlo simulations and QSAR properties will be performed for all phentolamine analogs. The interactions studies between alpha - adrenergic Receptor and Phentolamine analogs in solvent mode and protein complex mode will be performed. The best antagonist for alpha-Adrenergic Receptor will be identified.
The document discusses a project to analyze and predict sepsis early using clinical data. It aims to predict sepsis 6 hours before clinical diagnosis to allow for earlier treatment. The author handles missing data and class imbalance in a large dataset. Features are engineered and selected. Decision trees and XGBoost models are used for prediction, achieving partial success. Further research is needed on time-series modeling, feature importance, and model performance with a domain expert.
Purple and white modern advertising presentationAnjuPremy
The document summarizes a study that used machine learning models to predict patient survival from heart failure and identify important risk factors. [1] The study analyzed data from 299 heart failure patients, applying classifiers to predict survival and rank risk factors. [2] The models identified serum creatinine and ejection fraction as the most important predictors of survival. [3] Using only these two factors resulted in more accurate predictions than using all available data, suggesting these metrics could help doctors predict patient outcomes.
Clinical Trials Powered By Electronic Health RecordsJuan Bru
The development of Electronic Health Record (EHR) systems containing valuable clinical information is an opportunity not only for health care but also for clinical research. Clinical Trial (CT) management systems would improve their processes by accessing this EHR data in a straightforward way.
Nevertheless, there are still many problems to be solved in order to facilitate the reuse of information, including the lack of common formats for the representation of data, or a limited definition of the meaning of that data. The use of standards and clinical terminologies, together with a clear definition of clinical information models becomes essential in order to enable the semantic interoperability of EHR and clinical trials by means of a standardized definition of the data to be exchanged.
The document is a technical supplement from the WHO on temperature and humidity monitoring systems for transport operations. It discusses requirements for monitoring devices used to track temperature and humidity during transport of pharmaceuticals. It covers different types of monitoring devices including electronic data loggers and indicators. It provides guidance on selecting appropriate monitoring devices and ensuring proper data collection, storage and retrieval.
Hdbs15, phụ lục 9 gmp who, hệ thống theo dõi nhiệt độ độ ẩm trong khi vận chuyểnTư vấn GMP, cGMP, ISO
The document is a technical supplement from the WHO on temperature and humidity monitoring systems for transport operations. It discusses requirements for monitoring devices, including device types like electronic data loggers and indicators. It also covers data collection, storage and retrieval from these monitoring devices. The target readership are those involved in the transport and distribution of time- and temperature-sensitive pharmaceutical products.
This document outlines the requirements for an electronic health record (EHR) system, including an overall description, specific requirements, diagrams, and a prototype demonstration. It discusses the problem-oriented medical record model and how problem lists have evolved in EHRs. The document also provides details on the proposed project timeline, technology requirements, basic EHR concepts and terminology, and a literature review on EHR adoption.
Similar to openEHR Composition category - persistent vs. event (20)
Interoperability is impossible... Discuss ...Ian McNicoll
The document discusses interoperability challenges in health records and proposes an alternative approach. It suggests building systems that minimize the need for interoperability by baking in data fluidity and using open, vendor-neutral platforms. Rather than assuming interoperability will solve problems, it questions if separate best-of-breed applications could integrate tightly as a single system through coherent information modeling and open standards. The goal is citizen-centric records not tied to any single vendor or technology.
The document discusses openEHR, an open specification for a health information model that supports an open platform ecosystem. It is vendor neutral, technology neutral, and allows both open and closed source business models. The document outlines openEHR's archetypes and templates, which allow reusable clinical concepts and datasets to be shared across applications independently of the underlying database or technology. It provides examples of openEHR's use in various NHS and clinical projects. Finally, it discusses how an openEHR-based platform could profoundly change health IT by making apps and data independent and enabling data services as a commodity.
The openEHR Revolution Heidelberg 2018Ian McNicoll
This document provides an overview of Ian McNicoll's background and roles related to openEHR, as well as the current state and future potential of openEHR in the UK. It discusses openEHR adoption by various NHS organizations, the Genomics England project, and efforts to establish an open platform architecture and bridge openEHR to FHIR through the INTEROpen and Apperta groups. The vision is for openEHR to expand commercially and help enable an interoperable health system through open standards and APIs.
This document discusses the challenge of interoperability between health systems and the role open source can play in addressing this challenge. It notes that open source software and specifications allow systems to avoid vendor lock-in, but that open source applications alone do not ensure interoperability unless everyone uses the same system. It argues that the strength of open source lies in open infrastructure components, not just applications. An open platform based on common open standards and information models could substantially accelerate app development and lower barriers to the market while avoiding lock-in.
openEHR: NHS Code4Health RippleOSI and EtherCisIan McNicoll
Christian Chevalley has over 30 years of experience in software development and has been developing platforms based on openEHR since 2010. He has delivered a first release of EtherCIS, an open source openEHR server. EtherCIS takes advantage of PostgreSQL's mixed support for relational and JSON datatypes in a single table structure. It uses the jOOQ library extensively for SQL coding in Java and allows easy migration between database backends like Oracle or DB2. EtherCIS is fully compliant with the Ehrscape API and its development includes adding validation handling and common provisioning tools.
Introduction to openEHR Clinical Workshop MIE2016Ian McNicoll
The document discusses the complexity of healthcare data and the challenges of capturing requirements from clinicians. It introduces openEHR as an open specification for a health information model that supports an open platform ecosystem in a vendor and technology neutral manner. The specification includes an open information model, REST API, and query language to allow multiple applications to access the shared openEHR clinical record in an open platform architecture. The workshop aims to provide perspectives on openEHR from international, national, and implementation views.
openEHR and DIPS Arena: the 'Best of Breed 3.0' revolutionIan McNicoll
Dr. Ian McNicoll introduces openEHR and discusses health information systems. OpenEHR aims to create an open platform where clinical data can be exchanged between any system regardless of programming language, human language, or database technology. OpenEHR uses archetypes, which are computable models of clinical concepts, to define clinical content in a standard way that is not locked into any one application. This "Best of Breed 3.0" open platform architecture allows different applications to access a shared set of clinical models and data, offering more flexibility and clinician control over clinical content.
UK Dose syntax and medication archetypes apr 2015Ian McNicoll
This document discusses developing a standardized computable "dose syntax" for representing community medication information across different healthcare systems. It proposes a solution that combines an openEHR archetype structural model with a parsable syntax to capture dose amounts and timings. Examples of the syntax are provided to represent prescriptions like "10mg twice daily" in a way that is computable. The goal is to improve medication reconciliation at care transitions by making prescription data electronically exchangeable and analyzable across primary, community, and secondary care settings. Feedback is sought on implementing this approach.
Digital assembly 2015 Cardiff HANDI-HOPD workshopIan McNicoll
1) The document discusses a workshop on digital health interoperability standards hosted by Dr. Ian McNicoll and several organizations.
2) It covers different approaches to digital health interoperability such as closed platforms, best of breed systems, and open ecosystems. The openEHR standard and FHIR API are discussed in detail.
3) The workshop promotes openEHR and FHIR as clinical content standards that can enable rapid app development, national standards, and a clinically-led content service to facilitate interoperability.
This document discusses the potential benefits of an open standards healthcare platform. It notes efforts in the US and UK to develop open APIs for healthcare systems. It argues that interoperability issues are primarily clinical rather than technical problems. The document outlines openEHR's approach of developing clinically-led and collaboratively authored archetypes as reusable clinical content components. It provides examples of open source projects implementing openEHR archetypes and notes the potential for an NHS open standards platform to provide common application services and a cloud-based electronic health record platform as a service model.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
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Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
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Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
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Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
2. openEHR data objects
EHR
COMPOSITION = ‘Nursing Observations
SECTION Vital signs
ENTRY Blood P.
Systolic
Diastolic
ENTRY Pulse
Rate
Rhythm
General appearance
Skin colour
Behaviour
Skin turgor
Capillary
Return
Hydration
SECTION = ‘Other obs’
ehr_id = 5c8a8636-bc98-4441-abd5-e9cf396e8833
134 mmHg
86 mmHg
134 mmHg
Irregular
Jaundiced
Normal
Reduced
30s
3. Composition - the document container
Root ‘document’ for clinical data
Carries most key medico-legal metadata
composer (clinical_author), start_time, end_time
organisation, clinical setting
All recorded patient data saved inside a Composition
Carries unique ID
UID::serverID::Version_Suffix
5c8a8636-bc98-4441-abd5-e9cf396e8833::ripple_osi.ehrscape.c4h::1
Versioned
All changes will create a new version
4. ‘Event’ category
Each time new data is committed, a completely new
composition instance is created
Lab reports, nursing observations, doctor encounter
5c8a8636-bc98-4441-abd5-e9cf396e8833::ripple_osi.ehrscape.c4h::1
77a-bc98b345-4421-ba6d5-fc89f396e8855::ripple_osi.ehrscape.c4h::1
Ehrscape POST /composition
5. ‘Persistent’ Category
Each time new data is committed, the original instance
is overwritten
Problem list, End of Life Summary
77a-bc98b345-4421-ba6d5-fc89f396e8855::ripple_osi.ehrscape.c4h::1
77a-bc98b345-4421-ba6d5-fc89f396e8855::ripple_osi.ehrscape.c4h::2
Ehrscape PUT /composition
6. Episode vs Longitudinal persistence
Longitudinal Persistence
Some persistent summaries should exist and be updated throughout
the patient’s lifetime
End of Life summary, GP problem list
Episodic Persistence
Most outpatient and hospital summaries e.g Allergy lists, Problem
lists need to be re-created at admission, then maintained for the
period of admission.
A new Problem list may need ot be created for each episode of care
8. but - always use ‘event’ !!!
We recommend always setting category
to ‘event’
Setting category to ‘persistent’ currently
removes the context of the Composition,
making it unsuitable for episodic care
i.e loses capacity to record start_time,
setting, location
will be changed soon in RM specification
Use documentation to tell developers
whether to save the composition as an
event, episodic persistent or longitudinal
persistent composition.
12. Links
Most of the relationships between different Entries
and Elements is defined in archetypes and
templates, generally in the same Composition
Links allow the system developer to connect
different Entries which do not have a ‘pre-cooked’
association, and where the Entries live in different
Compositions