openEHR Clinical modelling workshop: Embracing clinical diversity and complexity
Dr Ian MCNICOLLa, Dr Heather LESLIEab, Silje LJOSLAND BAKKEac
aopenEHR Foundation ,bGlobal eHealth Collaborative, cNasjonal IKT HF
(authors)
Abstract. openEHR is an open specification for the information model required to underpin an open digital care record platform. A key feature in openEHR architecture is the direct, collaborative involvement of clinicians in the design, review, curation and governance of open source clinical content definitions ‘archetypes’. This workshop will discuss the implications of this evolutionary approach to shared content development based on international, national and vendor-level experience as a means of maximizing benefit within a highly dynamic, culturally-mediated complex system.
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The emergent methodology draws heavily on the paradigms of open source distributed development5 and ‘crowd-sourcing’. It expects organic and evolutionary development6, anticipates and accepts speciation and ‘forking’ of assets. It tolerates and includes local, national7 and international perspectives to have to be supported, and that full international alignment/ adoption will not be a smooth journey8, understanding that short-term imperatives will always trump longer-term aspirations9. Nevertheless, steady progress is being made, largely due to considerable voluntary commitment from the community with the output of openEHR clinical modelling becoming apparent through implemented national and international standards, as well as significant system implementations.
2. Workshop
Speakers
Dr Ian McNicoll: Co-chair openEHR Foundation
Dr Heather Leslie: openEHR Clinical program joint lead
Silje Ljosland Bakke: openEHR Clinical program joint lead
(speakers)
Workshop structure
3 * 20 minute presentations will be followed by an extended discussion where all workshop participants are encouraged to reflect on what has been presented, and introduce questions or reflections from their experience.
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Introduction to openEHR clinical modelling methodology and vendor engagement (Ian McNicoll)
The openEHR clinical modelling approach, originally based on academic research and solid requirements statements, has evolved with experience, particularly driven by international vendor/implementer experience. openEHR introduces some novel paradigms, which can be challenging to those used to more traditional approaches. We will introduce the philosophical and methodological basis for openEHR with reference to real-world vendor experience.
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The international perspective: the potential for, and challenges, of international clinical modelling collaboration (Heather Leslie)
One of the core programs of openEHR is the collaborative and largely voluntary development of a library of open source clinical content models ‘archetypes’ with clinical informatics leadership and clinical assurance/review from using web-based tools and broad, democratized clinical input. We will give a a background to the approach adopted and highlight the practical implications, touching on both successes and ongoing challenges.
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Developing and governing national clinical model development in a vendor-rich environment. (Silje Ljosland Bakke)
Norway is in almost a unique position in having both a vibrant openEHR vendor community, an active national clinical modelling program and a commitment to use international models where possible This presents clear opportunities but other challenges, particularly around both local and distributed governance and maximising throughput of content production at ‘implementer speed’. We will present experiences and progress to date.
Practical clinical modelling
Practical clinical modelling involving the workshop participants.
3. Target audience
This session is directed at students, clinicians, clinical informaticians and system implementers who are interested in the clinical modelling methodologies used by the openEHR community, and how these are reflected in clinical requirements gathering/ clinical content development/governance at implementer, national and international levels.
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