HL7 CDA, Clinical Modelling and openEHR · Data Structures Data Types EHR Demographic Security EHR...

HL7 CDA, Clinical Modelling

and openEHR Thomas Beale

NHS Scotland, February 2007

IntroductionsThomas Beale

Chief Technology Officer Ocean InformaticsSenior Researcher, Centre for Health Informatics, UCLChair ARB openEHR Foundation5 years’ int’l standards work20 years’ experience in software engineering12 years working with clinical people

© Ocean Informatics 2007

openEHR Health Computing Platform


Integrated Care

Pathway MgtDecisionSupport

KnowledgeDiscovery

Health Information Platform

Application Development

Platform

Health Integration

Platform

Knowledge Management

Platform

openEHR Health Information Platform



Platform

Health Integration

Platform


Platform

Queries

EQL

Templates

TOM

Archetypes

AOM ADL

Reference Model

(data types, …secure EHR)

Data Retrieval

Data Entry & validation

Data Viewing




Data Structures

Data Types

DemographicEHR

Security

EHR Extract

virtual EHR

Archetype OM

Support (identifiers, terminology access)

AM

RM

SM EHRservice

archetypeservice

demographicservice

terminologyservice

{core

Common{patterns

{domain }Integration

Composition openEHR Archetype Profile

Template OM

EN13606

?

CDA Rel 2


Observation

SubstanceAdministration

Supply

Procedure

Encounter

Act

Organiser

ActReference

opinions

observations

instructions

actions

patient

investigatoragents

investigator

administrativeeventspublished

knowledgebase

personalexperience

Standard state machine


ArchetypesThe components of the Reference Model are

like LEGO brick specificationsArchetypes = instructions/designs constraining

the use of LEGO pieces to create meaningful structures

Archetype A Archetype B

Information modelInstances


Archetypes and Templates

Antenatal visitDiabetic checkup Archetypes

Weight

FH

HbA1c

BP

Issues

Assess

Tingling feetFeeling tired

76 kg

124/92

7.5%

Excellent control

66 kg

102/64 mmHg

142/min

NAD, see 4/52

Back pain

Template Template



Integrated Care Pathways

INSTRcelebrex

INSTRCor bypass

INSTRACE inhib

GP

Specialist

Hospital

ACTIONstart

ACTIONstartPatient

ACTION↓ dose

ACTIONschedule

ACTIONperform

ADMINadmission

ADMINdischarge

ACTIONsuspend

ACTION∆ freq

ACTIONresume

Reporting on Instructions

INSTRCelebrex

(GP)

INSTRHip repl.

(specialist)

INSTRACE inhib

(GP)

ACTIONStart

(patient)

ACTIONStart

(patient)

ACTION↓ dose(GP)

ACTIONSchedule

(specialist)

ACTIONPerform

(hospital)

ADMINAdmission(hospital)

ADMINDischarge(hospital)

ACTIONSuspend(hospital)

ACTION∆ freq(GP)

ACTIONResume

(GP)



The openEHR EHR

openEHREHR

openEHRExtract

ArchetypesTemplates

Queries

Comprehensive Entry modelLINKingDistributed VersioningState model of Instruction & ActionsArchetype-based QueryingFormal Terminology integrationopenPGP digital signing

Virtual EHRweb service

Queries from Archetypes

openEHREHR

Archetype-pathBased Queries


QueriesSELECT

o/data[at0001]/events[at0002]/time,o/data[at0001]/events[at0002]/data[at0003]/items[at0013.1]/value

FROM

Ehr[uid=@EhrUid] CONTAINS Compositionc[openEHR-EHR-COMPOSITION.encounter.v1]CONTAINS Observation o[openEHR-EHR-OBSERVATION.laboratory-lipids.v1]



openEHR Application Development Platform



Platform

Health Integration

Platform


Platform


Platform

Query BuilderTemplateDesigner

openEHR EQL

Virtual EHR API

openEHR TemplateObject Model

openEHR VirtualEHR API

openEHR Knowledge Management Platform



Platform

Health Integration

Platform


Platform


Platform

ArchetypeEditor

TerminologySubsetting tool

ArchetypeRepository

openEHR ADL(CEN, ISO)

openEHR OWLArchetype Ontology

TerminologySubsettingLanguage


openEHR Health Integration Platform



Platform

Health Integration

Platform


Platform

Health Integration

Platform


A Universal EHR

openEHREHR

HL7v2 msg

HL7v2 (archetyped)

openEHRExtract

CDAr2(text)

CDAr2(struct)

13606Extract

CDAr2(copied)

CDAr2(generated)

13606Extract

openEHRExtract

IntegrationArchetypes

ClinicalArchetypes

ClinicalArchetypes

ClinicalArchetypes

mappings


Conclusions

openEHR is a fully integrated, knowledge-enabled platform, EN13606-capableCan accommodate textual and structural CDA documentsArchetypes and templates provide control over data entry, querying and terminology binding


Questions

http://www.openEHR.org

Release 1.0.1 – March 2007


HL7 CDA, Clinical Modelling and openEHR · Data Structures Data Types EHR Demographic Security EHR...

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