Clinical modelling with openEHR Archetypes

Koray Atalag, MD, PhD, FACHISenior Research Fellow (ABI & NIHI)k.atalag@auckland.ac.nz

Outline

• What is openEHR?• Multi-level Modelling• Archetypes & Templates• Setting Semantics• Tooling – modelling & repository/governance

Open source specs & software for representing health information and person-centric records– Based on 20 years of international research, including Good European

Health Record Project (GEHR)– Superset of ISO/CEN 13606 EHR standard

Not-for-profit organisation - established in 2001 www.openEHR.org

Extensively used in research

Separation of clinical and technical worlds

• Big international community

• Online models repositoryhttp://openehr.org/ckm

Also newly elected

got the power ;)

Multi-Level Modelling

Reference ModelLogical building blocks of EHR

Compositions

EHR

Folders

Sections

Clusters

Elements

Data values

Entries

Lifelong Longitudinal Versioned Comprehensive Computable Secure Sharable

RM: Text Data Type

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RM: Quantity

Data Type

Units:

* Units part of RM not domain model

Archetypes?

• Formal constraints on Reference Model Classes– Structural constraints: List, table, tree– What labels can be used?– What data types can be used?– What values are allowed for these data types?– How many times a data item can exist?– Whether a particular data item is mandatory– Whether a selection is involved from a number of

items/values• Formal semantics via terminology bindings• Meta-data and language translations

Anatomy of an Archetype

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Archetype EditorAll about tooling mate!

Example: NZ Cardiac Registry

14Screenshot of openEHR Template from a tool

Semantics in openEHR

• Whole-of-model meta-data:– Description, concept references (terminology/ontology), purpose,

use, misuse, provenance, translations

• Item level semantics– Trees/Clusters (Structure)– Leaf nodes (Data Elements)

Formally: different types of terminology bindings:1) linking an item to external terminology/ontology for the

purpose of defining its real-world meaning2) Linking data element values to external terminology (e.g. a

RefSet or terminology query)

• Instance level semantic annotations – applies to actual data collected

Blood Pressure Measurement

mindmap representation of openEHR Archetype

1) Linking items to SNOMED to define clinical meaning

NZ Cardiac Registry: Medication2) Linking data element values to external terminology (NZULM)

RM: Text Data Type Instance level semantic annotations

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