a standards-based approach to development of clinical registries - nz gestational diabetes registry...
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A Standards-based Approach to Development of Clinical Registries -
NZ Gestational Diabetes Registry Pilot
Dr. Koray Atalag MD, PhD, FACHI (National Institute for Health Innovation)
Aleksandar Zivaljevic, PhD candidate (Univ. Of Auckland)
Dr. Carl Eagleton MBChB, FRACP (Counties Manukau District Health Board)
Karen Pickering (Diabetes Projects Trust)
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Aims of the Registry
100% successful screening of women for type 2 diabetes (T2DM) within 3 months after a pregnancy with GDM
Annual screening of all women for new onset T2DM
Early warning to healthcare providers (GPs, Maori/Pacific Health, others) about GDM history in subsequent pregnancies
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GDM Registry Pathway
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GDM Registry Development• Used OceanEHR Framework
– Academic license from Ocean Informatics– Simplifies persistence and querying plus more!– Supports openEHR Demographic IM– Supports AQL
• Extended MultiPrac App (Source provided on academic license)– MVC Application (VS 2010 w/ SQL Server)– Handles user management, basic admin etc.– Supports reference sets, provider/organisation
etc.4
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The Dataset
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ate
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Automatic code generation – C# Class
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Further Development• Model-View-Controller (MVC)
– Model openEHR > C#– View written in html / forms– Controller written bindings and business
rules• Front-end (Javascript / Angular JS)• Back-end: OceanEHR & MultiPrac• Extended Demographics
– Added patient’s GP, LMC and Obstetrician– Added Provider organisation
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Interventions• Search due tests• Automatic annual screening• Send SMS to patients & providers for
due tests
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Evidence: Software Maintainability using openEHR
12Atalag K, Yang HY, Tempero E, Warren JR. Evaluation of software maintainability with openEHR – a comparison of architectures. International Journal of Medical Informatics. 2014 Nov;83(11):849–59.
VB6 / Access
Same Function & GUI
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Conclusions• Using an openEHR framework makes
implementation a heck of a lot easier!• Demographics model is challenging• Identifiers can be confusing• Getting data out is difficult
– Unit of openEHR committal is Compositions– Need Extract model to come to life
• There’s really no real incentive to use standards
• We need scientific evidence that proposed benefits are realised
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