wscha2010 cook
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1st Workshop on Scientific Computing in Health ApplicationsTRANSCRIPT
June 28,2010 1st Workshop on Scientific Computing in Health Applications
Healthcare InformationModels & Applications
Timothy W. Cook, MSc.Health Informatics Research & Consulting
June 28,2010 1st Workshop on Scientific Computing in Health Applications
I hate quotations. Tell me what you know.
Ralph Waldo Emerson
June 28,2010 1st Workshop on Scientific Computing in Health Applications
Keep everything as simple as possible;but no simpler!
1st Workshop on Scientific Computing in Health Applications
Holy Grail of Health CareHoly Grail of Health Care
The Longitudinal, Patient Controlled, Future Proof Electronic Healthcare Applications
June 28,2010 1st Workshop on Scientific Computing in Health Applications
Φ = Golden Ratio
Healthcare Information Systems
June 28,2010 1st Workshop on Scientific Computing in Health Applications
Current Approach
Requirements gathering within a limited scope, build data structures and write the software.
For more than 45 years we have shown that in healthcare this approach is flawed.
June 28,2010 1st Workshop on Scientific Computing in Health Applications
Insanity: Doing the same thing over and over again, and expecting a different result.
June 28,2010 1st Workshop on Scientific Computing in Health Applications
Multi-Level Modeling Components
Reference Model Concept Constraint Definitions Template Constraint Definitions Relationship of openEHR & MLHIM
June 28,2010 1st Workshop on Scientific Computing in Health Applications
Words
Observation Evaluation Instruction Action Entry
June 28,2010 1st Workshop on Scientific Computing in Health Applications
Words are but symbols for the relations of things to one another and to us; nowhere do they touch upon absolute truth.--Friedrich Nietzsche
June 28,2010 1st Workshop on Scientific Computing in Health Applications
Observation
10 entries on dictionary.com All nouns – all very similar
(exception:Navigation) One specific to medicine
June 28,2010 1st Workshop on Scientific Computing in Health Applications
Evaluation
2 entries at dictionary.com Noun One specific to medicine
June 28,2010 1st Workshop on Scientific Computing in Health Applications
Instruction
6 entries on dictionary.com Nouns
June 28,2010 1st Workshop on Scientific Computing in Health Applications
Action
19 Nouns 1 Adjective
June 28,2010 1st Workshop on Scientific Computing in Health Applications
Entry
13 Nouns
June 28,2010 1st Workshop on Scientific Computing in Health Applications
Semantic Context
Having all of the information about a piece of data; available everywhere.
Linking Concepts Healthcare DATA: 101
June 28,2010 1st Workshop on Scientific Computing in Health Applications
101
Is it a component of BP measured in mmMg? Is it body temperature in degrees Fahrenheit? Is it body weight measured in kg or lbs.? Is it body length/height in cm?
June 28,2010 1st Workshop on Scientific Computing in Health Applications
New Approach
Create a complete “information” model that encapsulates that information with the data.
Forever in time and space.
June 28,2010 1st Workshop on Scientific Computing in Health Applications
Experience without theory is blind, but theory without experience is mere intellectual play. --Immanuel Kant
June 28,2010 1st Workshop on Scientific Computing in Health Applications
MLHIM Health Information Platform
XPathXQuery
TCDs
CCDs
CDOM XML
Reference Model
What is in the Reference Model?
CompositionsSet of entries committed at one date/timee.g. progress note, report, letter, test result
EHRThe electronic health record for one person
FoldersHigh-level organisation of the EHRe.g. per episode, per clinical speciality
SectionsClinical headings reflecting the workflowand consultation/reasoning process
ClustersCompound entriese.g. blood pressure, full blood count
ElementsElement entriese.g. reason for encounter, body weight
Data valuese.g. Coded terms from term sets, measurements with units
EntriesClinical “statements” about Observations,Evaluations, and Instructions
Co
mm
on
June 28,2010 1st Workshop on Scientific Computing in Health Applications
June 28,2010 1st Workshop on Scientific Computing in Health Applications
Package Structure
June 28,2010 1st Workshop on Scientific Computing in Health Applications
June 28,2010 1st Workshop on Scientific Computing in Health Applications
Security Features
Separation
June 28,2010 1st Workshop on Scientific Computing in Health Applications
Principles
The components of the Reference Model are like LEGO brick specifications
Constraint Definitions = instructions/designs constraining the use of LEGO pieces to create meaningful structures
Concept A Concept B
RMInstances
June 28,2010 1st Workshop on Scientific Computing in Health Applications
June 28,2010 1st Workshop on Scientific Computing in Health Applications
June 28,2010 1st Workshop on Scientific Computing in Health Applications
Ordered(rm.support.assumed)
INTERVAL<T>(rm.support.assumed)
DATA_VALUE(rm.data_types.basic)
June 28,2010 1st Workshop on Scientific Computing in Health Applications
June 28,2010 1st Workshop on Scientific Computing in Health Applications
June 28,2010 1st Workshop on Scientific Computing in Health Applications
June 28,2010 1st Workshop on Scientific Computing in Health Applications
OSHIP
Open Source Health Information
Platform
June 28,2010 1st Workshop on Scientific Computing in Health Applications
OSHIP
➔A MLHIM implementation in Python➔Provides a rapid application
development environment for a variety of healthcare applications
June 28,2010 1st Workshop on Scientific Computing in Health Applications
OSHIP
➔Heavy re-use of existing open source components➔The Zope Tool Kit (ZTK)
June 28,2010 1st Workshop on Scientific Computing in Health Applications
OSHIP
➔Choice of HTTP servers➔Possible GUI interfaces
➔Choice of RDBMs and OODBMs➔Internationalization/localization (i18n/l10n)
➔Fine-grained security framework➔XML based configuration files
➔Designer friendly templating language
June 28,2010 1st Workshop on Scientific Computing in Health Applications
OSHIP – Current Status
➔Reference Model➔Constraint Model
➔Proven Infrastructure➔Complete Documentation
June 28,2010 1st Workshop on Scientific Computing in Health Applications
Label on a 500 piece, jigsaw puzzle box
500piece puzzle: Some assembly
required.
June 28,2010 1st Workshop on Scientific Computing in Health Applications
Why MLHIM?
In order to fully embrace open source and open content ideals
and processes.
June 28,2010 1st Workshop on Scientific Computing in Health Applications
Thank You!
Timothy W. Cook, MSc.Health Informatics Research & Consulting
http://www.linkedin.com/in/timothywaynecook