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HANDI-HOPD:
Whats in the box?
Software apps to support health and care - Supporting the app paradigm
Creating a community of interest - That's HANDI
www.handi-hopd.orgDr Ian McNicoll
HANDIHealth
openEHR FoundationfreshEHR Clinical Informatics
HANDI-HOPD Planning meeting London Sept 2014
http://www.handihealth.org/http://www.handihealth.org/http://www.handihealth.org/http://www.handihealth.org/http://www.handihealth.org/8/11/2019 Handi-HANDI-HOPD Summit Ian McNicoll - 18 Sept 14 Ian London 18 Sept 2014
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INTRODUCTION
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Ian McNicoll
Clinician
Former Scottish GP
Health informatics
Director openEHR Foundation
freshEHR Clinical Informatics
Ocean Informatics UK
HANDIHealth
NHS Scotland SCIMP
Commercial software developer
GP Accounts
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SMARTPlatforms
Pluggable Webapp
API
HL7 FHIR
Clinical Content
Exchange NHS API
inVivo
Datastore API
Detailed
Clinical Content
Development
Clinical leadership PRSB
Terminology
CentreHSCIC
Non
openEHR
systems
Archetype+ SNOMED ClinicalContent definitions
Apps developers
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What is an API?
Application Programming interface
allows one application to talk
directly to another. The app world runs on APIs
how Gmail calendar talks to
Apple Calendar
how my Train app knows my
next train home
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What is in an API
Modern API restful requests look like web
page urlhttps://api.twitter.com/1.1/statuses/user_timelin
e.json?screen_name=twitterapi&count=2
and carries some
sort of
structured content
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https://api.twitter.com/1.1/statuses/user_timeline.json?screen_name=twitterapi&count=2https://api.twitter.com/1.1/statuses/user_timeline.json?screen_name=twitterapi&count=2https://api.twitter.com/1.1/statuses/user_timeline.json?screen_name=twitterapi&count=2https://api.twitter.com/1.1/statuses/user_timeline.json?screen_name=twitterapi&count=28/11/2019 Handi-HANDI-HOPD Summit Ian McNicoll - 18 Sept 14 Ian London 18 Sept 2014
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SMARTPlatforms API
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Scopes and permissions: OAuth2
Simple sign-in: OpenID Connect
Lightweight UI integration: HTML5
via Pluggable app framework
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SMARTPlatforms : Substitutable Apps
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SMART-on-FHIR
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HL7 FHIR
data model
replacing
SMARTPlatform
s
data model(RDF)
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HL7 FHIR API
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What is FHIR good at?
Communication of information between
systems with limited querying
Strengths
Developer friendly
Lightweight approach Great documentation / community
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Where might FHIR be weaker?
Not designed for persistence
can work but will it scale?
partial querying only
Resources will not work out of the box in
the real world
Need local extensions and profiles Version control / governance of the profiles
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openEHR API
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Designed for storing and querying
rich clinical dataset
New content is defined directly
by clinicians and can be immediately
uploaded into the clinical data repository
Vendor-neutral data models
Technology-neutral data models
Vendor-neutral data querying
Technology-neutral data querying
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openEHR
Weaknesses
Complex technology
but new simplifying APIs appearing
Strengths
clinically-led data modelling
sharing archetypes= interoperability
Enterprise strength performance Mature versioning/governance
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dev.ehrscape.com
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http://dev.ehrscape.com/http://dev.ehrscape.com/http://dev.ehrscape.com/8/11/2019 Handi-HANDI-HOPD Summit Ian McNicoll - 18 Sept 14 Ian London 18 Sept 2014
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Vendor-neutral querying
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Vendor-neutral querying
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Vendor/technology-neutral platform
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Building out the platform
SMART and HL7 FHIR support
BlackPear , Marand
More openEHR providers
Lockheed Martin - OceanEHR
Medvision360
Code24 More demo apps
LiveCode mobile App demo
Knowledge resources
FirstDataBank
Indizen cloud terminology service
CDS resources
openClinical - PROFORMA
Cambio GDL
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SMARTPlatforms
Pluggable Webapp
API
HL7 FHIR
Clinical Content
Exchange NHS API
inVivo
Datastore API
Detailed
Clinical Content
Development
Clinical leadership PRSB
Terminology
CentreHSCIC
Non
openEHR
systems
Archetype+ SNOMED Clinical
Content definitions
Apps developers
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Interoperability is not a tech problem
The real barriers to practical interoperability are
cultural and clinical
Diverse recording practice (sometimes arbitrary)
Diverse recording requirements
Complexity / contextual nature of health data
Lack of clinical involvement in standards development
Too technical, too philosophical
Too time-consuming, too slow
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Traditional Standards Process
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Clinical stakeholders
engage through top-down
governance
Committee-based
Late vendor engagement
Fixed review cycles
Unclear / unresponsivechange request
mechanism
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Formal standards process is a barrier
Standards can be a barrier to progress
Ewan Davis, HANDI
http://www.woodcote-consulting.com/farwell-to-ruthless-standardisation/
Technical (ISO / SCCI)
Still largely a paper and committee-bound process
No clear problem report/changerequest mechanism
Slow review cycles
Professional (PRSB)
Valuable clinical requirements input
but distant from implementation
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open, shared data models: Archetypes
Clinically-led + collaboratively authored open-source crowd-sourcing methodology
Shared open repository CC-BY-SA licence
Agility in response to continually changing clinical
demand Clear ownership, change request mechanism
Tight version control
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GP2GP medication archetype
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Web-based clinical review
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FHIR + openEHR joint resource/archetype
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Clinically-led Content Service
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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
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Evolutionary standardisation
distributed Governance
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Implementers
Secondaryendorsement
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Publication and Secondary Endorsement
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Project editors decide on
formal publication, acting as
Benign Dictators
Professional bodies, vendorsand PRSB may Endorsea
resource as a secondary
exercise
this does not restrain the
formal publication process
By Royal Appointment
PRSB hires and fires Editors
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Blogs
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http://www.woodcote-
consulting.com/farwell-
to-ruthless-
standardisation/
http://coiera.com/201
3/11/01/are-
standards-necessary/ That the fraction of standards
produced that are actually complied with,will with time asymptote toward zero
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Links
twitter: @ianmcnicoll
HANDI-HOPD: handi-hopd.org
http://diy-hopd.rhcloud.com/
hopdscape-hopd.rhcloud.com
minimal-hopd.rhcloud.com
Marand Ehrscape API: dev.ehrscape.com
Leeds Innovation Lab Health Platform : http://leedslabplatform.com
openEHR Foundation : www.openehr.org
SMARTPlatforms: smartplatforms.org
HL7 FHIR: hl7.org/implement/standards/fhir/
International archetype repository: www.openehr.org/ckm
UK archetype repository: www.clinicalmodels.org.uk
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http://handi-hopd.org/http://diy-hopd.rhcloud.com/http://hopdscape-hopd.rhcloud.com/http://leedslabplatform.com/http://www.openehr.org/http://smartplatforms.org/http://www.openehr.org/ckmhttp://www.clinicalmodels.org.uk/http://www.clinicalmodels.org.uk/http://www.clinicalmodels.org.uk/http://www.openehr.org/ckmhttp://smartplatforms.org/http://www.openehr.org/http://leedslabplatform.com/http://hopdscape-hopd.rhcloud.com/http://hopdscape-hopd.rhcloud.com/http://hopdscape-hopd.rhcloud.com/http://diy-hopd.rhcloud.com/http://diy-hopd.rhcloud.com/http://diy-hopd.rhcloud.com/http://handi-hopd.org/http://handi-hopd.org/http://handi-hopd.org/Top Related