openEHR Clinical modelling workshop
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Silje Ljosland Bakke a, Ian McNicoll b,c, Hildegard Franked
a Nasjonal IKT HF, b openEHR Foundation, c CHIME UCL, d freshEHR Clinical Informatics Ltd.
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
(speakers)
Ian McNicoll
Workshop structure
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2.1 Workshop speakers
- Silje Ljosland Bakke, RN BSN, Nasjonal IKT HF, Bergen, Norway
- Ian McNicoll, MSc, MbChB, openEHR, CHIME UCL London, UK
- Hildegard Franke, BA (Psych), MBA, freshEHR Clinical Informatics Ltd., Kettering, UK
2.2 Workshop structure
Three short presentations will be followed by a practical modelling session demonstrating clinical modelling thought processes, methods and tool use, where all workshop participants are encouraged to reflect on what has been presentedparticipate, and introduce questions or reflections from their experience.
2.3 Introduction to openEHR clinical modelling methodology and vendor engagement (Ian McNicoll)
openEHR is an open-source specification for a clinical information model with a specific aim of enabling the direct design input and quality assurance of detailed clinical models via the use of 'archetypes' and 'templates' These models can be consumed immediately in openEHR-compliant systems and used to define persistence and querying schema without any need for re-engineering but are also used as part of national and international standardisation efforts to help define the detailed clinical content of interfaces and messages.
The openEHR clinical modelling approach,
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and associated tooling, has evolved with experience
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The international perspective: the potential for, and challenges, of international clinical modelling collaboration
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but remains true to it's open-source philosophy, with a focus on collaborative and distributed governance.
2.4 International and national perspectives: managing international clinical modelling collaboration and governing national clinical model standardisation (Silje Ljosland Bakke)
The collaborative and largely voluntary development of a library of open source clinical content models ‘archetypes’ with is one of the core programs of openEHR. The clinical program is built on 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 chosen approach adopted and highlight the practical implications, touching on both successes and ongoing challenges.
Developing and governing national clinical model development in a vendor-rich environment
Norway is in almost a unique position in having both a vibrant openEHR vendor community, an active Norway's situation is unusual in that it has both an active community of openEHR vendors, a national clinical modelling program, and a commitment an aspiration to use reuse 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’leads to both opportunities and challenges, especially related to combining national and international governance, and doing modelling as fast as implementers require. We will present methods, experiences and progress to date.
2.5 Managing the diversity of operational and research requirements in a real life project (Hildegard Franke)
Genomics Medicine Centres in the UK face the diverse and sometimes conflicting requirements of creating and managing a rich dataset which can be used for the dual purpose of day-to-day operational use and of creating standardised reports for research and population analysis. We will present the methodology for managing and attempting to reconcile this diversity and report on progress to data working with one of the Genomics Medicine Centres.
2.6 Practical modelling
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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