Dr Ian McNicollSCIMP

NHS England Code4HealthCo-chair openEHRHANDIHealth CIC

openEHR:the wider picture

openEHR Foundation openehr.org

HSCIChave adopted openEHR as primary ‘clinical content standards methodology’

acquiring a separate ‘English CKM’

developing archetypes for

PRSB Discharge summary

GPOC-R / GP2GP

Allergies, Blood pressure, Document metadata

http://www.infostandards.org/

documents/data-structures-v1-0-richard-

kavanagh-pptx.pptx

HSCIC

Professional Records Standards Body

Professional Records Standard Body (4-country)

adopting NHS Scotland / GP2GP medication archetypes

Relationship with HSCIC

HSCIC (largely) fund PRSB

PRSB commission work from HSCIC

NHS England NHS Code4Health/Open source program

Using EHRScape engine for SME / clinical training

Supporting openEHR-based ‘Open platform’ approach

OPENeP

HANDIHealth / Integration Pioneers

part share ‘UK CKM’ licence

SMARTPlatformsPluggable Webapp

API

HL7 FHIR Clinical Content

Exchange NHS API

‘inVivo’Datastore

API

Detailed Clinical Content Development

Clinical leadership PRSB

Terminology Centre

HSCIC

NonopenEHR systems

Archetype+ SNOMED Clinical Content definitions

Apps developers

OPENePopen-source HEPMA solution built on openEHR back-end

will use NHS Scotland medication archetypes for discharge and reconciliation

considering tendering for Scottish HEPMA framework

Archetypes into production

Archetypes are computable

can define clinical aspects of message / interface structures

SCI-XML - ECS, SCI-GW

openEHR

HL7 FHIR (clinical content)

can define data storage schema for openEHR systems

new content can be stored and queried immediately

open standard -> multiple providers

How is it used:underpins App development

How is it used : National standards development

arketyper.no/ckm

Traditional standards development

Clinical stakeholders engage through top-down governance

Committee-based

Late vendor engagement

Fixed review cycles

Unclear / unresponsive change request mechanism

Are ‘Standards’ necessary?

http://www.woodcote-consulting.com/

farwell-to-ruthless-standardisation/

http://coiera.com/

2013/11/01/are-standards-necessary/

Clinically-led standards development

Clinical content service

Clinical stakeholders, vendors engage directly with clinically-led content service

Continual dialogue with all stakeholders via web-based collaborative tooling

No fixed review cycles

On-demand change request directly to clinical content service

PRSB has high-level governance role

Web-based clinical review

Web-based clinical collaboration

Implementers

Secondary endorsemen

t

Evolutionary standardisation‘distributed Governance’