Abstract

Databases for Clinical Information Systems are difficult to design and implement, specially especially when the design involves the implementation of a formal specification or standard. The openEHR specifications offer a very expressive an and generic model for clinical data structures, allowing semantic interoperability and compatibility with other standards like HL7 CDA, FHIR, and ASTM CCR. But openEHR is not only for data modeling, it specifies an EHR Computational Platform designed to create highly modifiable future-proof EHR systems, and to support long term economically viable projects, with a knowledge-oriented approach that is independent from specific technologies. Software Developers find a great complexity in designing openEHR compliant databases since the specifications do not include any guidelines in that area. The authors of this tutorials aer developers that had to tutorial are developers that have overcome these complexities. This tutorial will expose different requirements, design principles, technologies , techniques and main and techniques. The tutorial will also explain the main challenges of implementing an openEHR-based Clinical Database , with  examples and lessons learned to help designers and developers to overcome those challenges.

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Tutorial Description

The main motivation of motivation for this tutorial is to help reducing bridge the gap between the openEHR formal specifications and concrete database implementation. Considering that This tutorial is a good fit for the Medinfo 2015 conference because a) openEHR is an EHR standard adopted by the Brazilian government and by other countries [1], and b) it 's is gaining momentum at within the Latim Latin America eHealth community because of the dissemination and training activities created by the openEHR 'en Español' community [2]), and supported by ACHISA, we think this tutorial might be a good fit for the MedInfo conferencec) it is supported by ACHISA(? expand acronym).

This tutorial will expose the key challenges software developers have when designing and implementing Clinical Databases for Clinical Information Systems, including EHR data requirements, data organization, use, modification and evolution. Next, the tutorial will be centered on using the openEHR specifications [3] to tackle some of those challenges, adding other difficulties further complexities to the database design and implementation. The rest of the tutorial will be focused focus on giving proven solutions and lessons learned to create openEHR-based Clinical Databases.

We'll not only center on cover clinical data storage, but how that that is queried and used for to query the data and use it for healthcare (documentation, order management, Clinical Decision Support, healthcare plan follow-up for chronic diseases and other conditions, etc.) , and secondary uses (clinical research, education, public health, quality assurance, and complying with medico-legal requirements).

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We'll explain how to implement some functional requirements related to health record versioning (to support modifications, amendments and corrections at the database level), clinical data validation and indexing to improve query performance.

Will We will end with the conclusions about the different approaches to Clinical openEHR Database design and implementation.

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The main goal of this tutorial is to shorten narrow the gap between the openEHR specifications and real world Clinical Database design and implementation for software developers.

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Clinical Informatics Consultant at CaboLabs Medical Informatics and Standards, Lecturer at Chilean Association of Healthcare Informatics (ACHISA), Coordinator at the openEHR-ES community, Qualified member of the openEHR Foundation - Localization Programme Member for LatAm.

Luis Marco-Ruiz, M.Sc.; Norwegian Center for Integrated Care and Telemedicine, University Hospital of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø; Qualified member of the openEHR Foundation; Tromsø, Norway

Koray Atalag, MD, PhD, FACHI: Senior Research Fellow in Biomedical Informatics at Auckland Bioengineering Institute and National Institute for Health Innovation at the University of Auckland, New Zealand; openEHR Localisation Programme Leader

Erik Sundvall, MSc, PhD - Researcher, Department of Biomedical Engineering, Linköping University and information architect in Region Östergötland, Sweden. Erik coordinates the openEHR software program: 

PLEASE ADD A MINI BIO HERE!

 http://openehr.org/programs/software/

Sergio Miranda Freire, DSc, Associate Professor, Departament of Health Information Technology Education, State University of Rio de Janeiro, Brazil

Sergio and Erik have research interests in scalability and storage solutions for archetype-based EHR systems and have been testing and evaluating different noSQL storage and query approaches for openEHR data.

References

[1]   Who is using openEHR? http://www.openehr.org/who_is_using_openehr/healthcare_providers_and_authorities

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