Ian McNicoll

openEHR in context:Integration, terminology, querying

The bigger picture

openEHR and integrationMaking openEHR CDR connect to other systems …

Very easy to talk to other openEHR-based systems

Talking to non-openEHR systems

transforms, transforms, transforms

But do it once for the whole openEHR community

share the transforms as open-source and a reusable asset

Integration

National messages:referral, prescription emergency summary

Model-driven integration

TDS

Model-driven integration

Healthlink eReferral TDS template

Healthlink eReferral TDS template

TDSopenEHR template

APIs - HL7 FHIR

UK- Endeavour Health

What is FHIR good at?Communication of information between systems with limited querying

Strengths

Developer friendly

Lightweight approach

Great documentation / community

Where might FHIR be weaker?Not designed for storing data

can work but will it scale up?

limited, hard-wired querying only

FHIR ‘resources’ will not work ‘out of the box’ in the real world

Need local extensions and profiles

not a ‘weakness’ as such but often overlooked

SMARTPlatforms APIScopes and permissions: OAuth

Simple sign-in: OpenID Connect

App within an App integration:

HTML5-based pluggable app

SMARTPlatforms APIScopes and permissions: OAuth

Simple sign-in: OpenID Connect

App within an App integration:

HTML5-based pluggable app

SMART example

SELECT pulse FROM EHR[ehr_id/value=$ehruid] CONTAINS COMPOSITION c

CONTAINS OBSERVATION hr[openEHR-EHR-OBSERVATION.heart_rate_pulse-zn.v1]

WHERE c/name/value='Encounter‘AND c/context/start_time/value <= $endperiod

AND c/context/start_time/value >= $startPeriod

AND pulse/data[at0001]/events[at0006|Anyevent]/ data[at0003]/items[at0004|Rate]/value/value < 60

AQL: Archetype Query Language

Model-driven

querying

SELECT pulse FROM EHR[ehr_id/value=$ehruid] CONTAINS COMPOSITION c

CONTAINS OBSERVATION hr[openEHR-EHR-OBSERVATION.heart_rate_pulse-zn.v1]

WHERE c/name/value='Encounter‘AND c/context/start_time/value <= $endperiod

AND c/context/start_time/value >= $startPeriod

AND pulse/data[at0001]/events[at0006|Anyevent]/ data[at0003]/items[at0004|Rate]/value/value < 60

AQL: Archetype Query Language

Model-driven

querying

SELECT pulse FROM EHR[ehr_id/value=$ehruid] CONTAINS COMPOSITION c

CONTAINS OBSERVATION hr[openEHR-EHR-OBSERVATION.heart_rate_pulse-zn.v1]

WHERE c/name/value='Encounter‘AND c/context/start_time/value <= $endperiod

AND c/context/start_time/value >= $startPeriod

AND pulse/data[at0001]/events[at0006|Anyevent]/ data[at0003]/items[at0004|Rate]/value/value < 60

AQL: Archetype Query Language

Model-driven

querying

Archetypes and terminology

Internal terminology

External terminologiesMedications / drug allergies: dm+d, RxNorm, proprietary

Conditions, procedures:ICD-10, SNOMED-CT

Lab tests/ analytes:LOINC, SNOMED-CT

Organisation types, Sex / gender:Local/national admin terminologies

Ripple + Termlex

CDSS: GDL/Proforma

SMARTPlatforms Pluggable Webapp

API

HL7 FHIR Clinical Content

Exchange NHS API

Clinical Data Repository

Detailed Clinical Content

Development

Clinical leadership PRSB

Terminology CentreHSCIC

Non openEHR systems

Archetype+ SNOMED Clinical Content definitions

US - Healthcare Services Platform Consortium

Useful linksopenEHR-based Form building/querying: https://www.youtube.com/watch?v=pC6mUtqqK9U

HL7 FHIR: https://www.hl7.org/fhir

SMARTPlatforms: http://smarthealthit.org/

A clinical challenge: To lead or be led by health-IT? (Linköping Nov 2015)https://www.youtube.com/playlist?list=PLHFGvRPKSumvhCrMbDrAWi2Kc0MrTHi9M

Clinical Decision Support: https://www.youtube.com/watch?v=KgBtc19LXMk