smart data, smarter healthcare

SMART DATA, SMARTER HEALTHCAREDr Heather LeslieChief Clinical Informatician, Ocean InformaticsClinical Programme Lead, openEHR FoundationDirector, Global eHealth Collaborative

Journey to interoperability…

© Ocean Informatics 2016

paperHealth

eHealth: Connectivity

eHealth: Interoperability

The journey so far…


Maze of Monolith

ic Systems

Forest of Many Silos Swamp of

Incremental

Innovation

River of Fixed

Messages

Sea of Unsustainabil

ity

Semantic Cliffs

Quicksand

Heights of

Optimism

Bay of Never-ending

Negotiation


How to reach interoperability?


>30 YearsBridge of‘Smart Data’

Semantic Cliffs


What is smart health data? Shared clinical content specifications Clinically led

Represents how clinicians need their data Unambiguous & fit for purpose Implementable

Collaboratively developed & agreed Zero cost to use; free access Standards based Independent of any single technology

or software application© Ocean Informatics 2016

ALL CLINICAL CONTENT

openEHR Smart Data approach


Clinicians drive this process!

Templates

Archetypes

Terminology

SNOMED CTLOINCetc

openEHR information models

openEHR Smart Data approach


Templates

Archetypes

Terminology

SNOMED CTLOINCetc

openEHR information models

Software is built independently of the content

CLINICAL

TECHNICAL

What is openEHR?

‘openEHR’ = Open Electronic Health Record

Often pronounced as ‘open air’ or ‘open E-H-R’

Specification/schema for a complete electronic health record architecture Open source, freely available Managed by not for profit openEHR

Foundation at University College London www.openEHR.org


http://www.openehr.org/

The openEHR community

International community Email lists, online tools, teleconferences

5 operational areas Specification development Software development Clinical models Education Localisation


International openEHR clinical model community


1500 people 87 countries

• Clinicians• Informaticians• Software Engineers• Terminologists

Clinical Knowledge Manager Known as ‘CKM’ Online tool -

www.openEHR.org/CKM Library of information models –

‘Archetypes’ 500 archetypes = 6000 data points 23 languages, mostly English

Online collaboration portal Governance – publication, versioning,

distribution© Ocean Informatics 2016

http://www.openehr.org/CKM

Clinical Knowledge Manager

© Ocean Informatics 2016www.openEHR.org/CKM

http://www.openehr.org/CKM

International CKM collaboration

Clinical knowledgebase

CKM Library

CKM Archetype library

Time

Technology

Number of archetypes


‘ReferenceModel’= rules

‘Archetype’= Clinical concept

specification

‘Templates’ = datasets

Clinical Documents/Messages/Forms

CKM Library National resource

Health data patterns• Standardised• Clinically agreed• Centrally

governed

Aggregate & constrain clinical diversity:• clinical domain• profession• location

Smart data ecosystem


What is an archetype?

Archetype Building block Computable specification

for one single clinical concept Blood pressure Medication order Symptom Diagnosis Family History

Maximal data set Universal use-case Design once, re-use over

& over Strong governance critical© Ocean Informatics 2016

Blood Pressure Archetype

Archetype Definition Language (ADL)

ISO standard 13606


What is a template?

Archetype Template Building block Computable specification

for one single clinical concept Blood pressure Medication order Symptom Diagnosis Family History

Maximal data set Universal use-case Design once, re-use over

& over Governance is critical© Ocean Informatics 2016

Data set; multiple blocks Computable specification

for a specific clinical purpose: Message content Document Form Report

Flexible expression of clinical requirements

Constrain sensible for the specific clinical use-case

1-∞ archetypes per template

Governance NOT critical

Template?


Archetype Re-use


Project archetype re-use

1 jurisdiction 3 projects 14 unique templates

1 Antenatal 10 Hearing Health 3 RMP on-call

81 unique archetypes

Templates

Archetypes

Data Sets

Decision Support

Acknowledgements: Hugh Leslie, Thomas Beale

SchemasSemantic

QueriesOne recordPopulation health

Messages

Terminology

SNOMED CTLOINC

Forms

Documents

openEHR smart data ecosystem


Guideline Definition Language (GDL)

Archetype Query Language (AQL)

Smart data, smarter healthcareIts. All. About. The. Data.

Change the viewpoint Universal Health Record (data) vs EHR/EMR

(app) Independent of Application/Technology/Vendor

Platform data shared between applications Change the approach

Archetypes = building blocks Clinician-driven, collaborative Foundation for data storage, exchange, decision support,

aggregation & analysis Templates = clinical data sets

Aggregate & constrain – cater for clinician diversity © Ocean Informatics 2016

Final thought…


smart data, smarter healthcare

Data & Analytics