The openEHR Developers' workshop
Shinji Kobayashia, Pablo Pazosb, Koray Atalag (Deactivated)b, Erik Sundvall c,d ,Christian Chevalleye , Samar El Heloua, Sebastian Garded, Ian McNicolle, Erik Sundvall f,g, Christian Chevalleyh
aThe EHR Research Unit, Kyoto University, Japan, bCaboLabs, cUniversity of Auckland, dOcean Informatics, eHandiHealth, f cLinköping University, g dRegion Östergötland, h eADOC Software, fOcean Informatics, gHandiHealth
Abstract
The openEHR project is well-known for publishing and updating a set of open specifications to build maintinable and semantically interoperable (and even intraoperable) electronic health record systems that stay agile in a changing clinical reality. It is closely related to the family of ISO 13606 standards and to CIMI (now an HL7 WG). The detailed openEHR clinical models (archetypes and templates) are authored by global and regional clinical communities in an online environment where the authoring and review process gathers views and concensus from a breadth of clinical specialities. The openEHR archetypes are often used as a source of clinical requirements gathering also in non-archetype-based systems and interoperability standards (e.g.HL7 FHIR).
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Electronic Health Records, openEHR, archetype, interoperability, intraoperability, open-source software, clinical standards, HL7 FHIR, IHE
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Introduction
Initially, we will provide an overview of the openEHR architecture and the clinical+technical usage contexts. This is followed by a number of presentations introducing various openEHR projects and related integrations. After the introduction and between each subtopic presentation there will be Q&A and open discussions with the workshop participants.
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2.1. Short presentations:
2.1.1 HL7 FHIR, openEHR and IHE: perspectives on coexistence and collaboration (Erik Sundvall, Ian McNicoll, Koray Atalag and Borut Fabjan) [Info: not sure if Koray and Borut will attend physically or not (perhaps virtually?) anyway they will co-author the presenation material]
The HL7 FHIR standard has many benefits over some previous HL7 approaches and is gaining a lot of attention and implementation. There is also FHIR-hype, usually not from the core team behind FHIR, but from others hoping that FHIR will solve (almost) all healthcare information interoperability needs. We will highlight some differences and commonalities between the FHIR and openEHR approaches and exemplify how context of use and political/business views influences the short- and long-term benefits of different options and combinations. Some systems based on openEHR are succesfully used in IHE profiled exchange environments and some are IHE-certified, we'll also discuss such options and combinations.
Working with openEHR Semantically (Koray Atalag)
We have used openEHR to model and persist experimental data that underpins computational physiology models (e.g. VPH, Human Physiome). The idea is then to link both experimental and real-world clinical information to these quantitative and predictive models to create a new breed of decision support tools that can deliver highly personalised and precision medicine. We have had some key important learnings while representing such models and especially when semantically annotating them - which in openEHR world corresponds to term and constraint bindings and data instance level term mappings. We will explain our methodology and discuss lessons learned which we hope will facilitate the use of openEHR in Semantic Web environments.
(Update:Slides of this part attached - sorry we did not have time to cover IHE in these.)
2.2.2 EtherCIS a new Open Source OpenEhr OpenEHR backend server (Christian Chevalley)
EtherCIS is a DB centric openEHR compliant SOA platform. It exposes a RESTful API handling OpenEhr entities under three formats (Flat json, AQLPath json and XML). The motivation of EtherCIS has been to provide an open, scalable yet secure clinical data repository that can be queried using different languages (AQL and SQL). SQL querying is performed using standard tools, as recent progresses in DB developments now allow combinations of relational and schema-less data structures. We will discuss our experiences (and failures) with previous persistence approaches, pros and cons of the current one and future perspectives in line with major DB engines developments.
2.2.3 Implementation of an openEHR repository using a Graph Database (Samar El Helou)
Building openEHR repositories is challenging since it requires a thorough grasp and implementation of the openEHR Reference Model (RM) that has numerous classes in a tree-structure with deep hierarchy. Moreover, a mismatch between the database model and the RM can lead to high development time and cost. The graph model shares many semantic similarities with the definitions of the openEHR RM making it a potential fit for its representation and implementation. We will propose a method for implementing an openEHR repository by a graph database employing the labeled property graph model. We will also discuss some limitations and opportunities of persisting openEHR data with Neo4j.
- - - - Unconfrimed participations/sessions below this line - - - -
2.2.4 Clinical Knowledge Manager (Sebastian Garde) [Question: has Sebastian confirmed attendence or is this a cut & paste from Medinfo 2015?]
To be able to exchange clinical information in a semantically safe way across different openEHR-based systems, it is important to agree on the clinical concepts used in these systems. In openEHR, such concepts are formally expressed in archetypes and developed in regional, national and international collaboration. It is crucial that clinicians - even without any knowledge of openEHR - are inherently involved in this process by being able to review and comment as required. Only this can ensure that the clinical content models are clinically valid and comprehensive. To enable this collaboration, the Clinical Knowledge Manager (CKM) has been developed as a web-based system for collaborative development, management, validation, review and publishing of openEHR archetypes and other clinical knowledge resources. CKM is used internationally by the openEHR foundation as well as in several regional and national programmes. CKM supports the 'federation' of archetypes, so that the various programmes can work independently and to their own timelines, while sharing archetypes with each other where possible.
Development of an openEHR-based Open Source EHR Platform and openEHR EMR frameworks (Pablo Pazos Guiterez) [Question: has Pablo confirmed attendence or is this a cut & paste from Medinfo 2015?]
Since 2009 we have developed several Clinical Information System projects based on openEHR. We started focusing on R&D, and now reusing that experience (and code) to build a service oriented (REST and SOAP), open source, and general purpose EHR platform to help developers to create shared EHRs that will be standard-compliant from scratch. That platform will support many EMR applications and devices. We are also creating tools to help on the application development itself, providing frameworks, libraries and tools.
Will there be anything from the Japanese national project?
3. Workshop speakers
- Shinji Kobayashi, MD, PhD - Kyoto University, Japan
- Pablo Pazos, Ingeniero en Computación, openEHR en español, CaboLabs, ACHISA
Koray Atalag (Deactivated), MD, PhD, FACHI - University of Auckland, New Zealand
- Sebastian Garde, Dr. sc. hum., Dipl.-Inform. Med., FACHI - Ocean Informatics, Germany
- Erik Sundvall, MSc, PhD - Linköping University and Region Östergötland, Sweden
- Christian Chevalley, Founder and Technical Director, ADOC Software, Thailand
- Samar El Helou - Kyoto University, Japan
- Borut Fabjan, Marand, Slovenia
4. References
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