The openEHR Developers' workshop
Shinji Kobayashia, Pablo Pazosb, Koray Atalag (Deactivated)c, Sebastian Garded, Ian McNicolle, Erik Sundvall f,g, Christian Chevalleyh
aThe EHR Research Unit, Kyoto University, Japan, bCaboLabs, cUniversity of Auckland, dOcean Informatics, eHandiHealth, fLinköping University, gRegion Östergötland, hADOC Software
Abstract and Objective
The openEHR project is well-known as a set of specifications to build future-proof and semantically interoperable electronic health record systems and is related to the family of ISO 13606 standards. This workshop will discuss implementations of the openEHR specifications with the following contents.
Learning objectives
- What archetypes are and how to operate standardized clinical models to assure semantic interoperability between EHR systems and why healthcare needs a mix of people, process and technology change and the role of the openEHR project.
- The openEHR implementation technologies with various development communities.
- State of the Art of the openEHR specifications
- Current software engineering technologies around the openEHR implementations
Expected outcomes
- Further understanding of the openEHR specification and its implementation technologies
- Evaluation the conformance to the specifications and more features of each technology.
- Sharing experience and passion with speakers and participants.
Keywords:
openEHR, archetype, open-source software, clinical standard
Workshop description
1. Overview of the openEHR project
The openEHR project(1) is well known as a development source for the ISO 13606 standards(2). These standards are considered the technology basis of clinical information models which enable the interoperability for electronic healthcare applications. A number of projects have been implementing the openEHR specifications with various approaches. Development projects related to the openEHR are spreading worldwide. The core reference implementation has been implemented using Eiffel and is recognized as a reference implementation of the openEHR specifications. Java and C# are also being used in a number of reference implementations. These core implementations are provided as open-source software. This momentum provided an evidence that the openEHR specification are being widely accepted and gaining worldwide interest. On this steady international growth, we are taking this opportunity to introduce these specifications to a wider audience and explain their features. Even though these projects are still ongoing and have not yet completed their missions, developers, whether they are involved in openEHR or not, will benefit from the sharing of experiences and discussions about the implementation of the openEHR specifications.
2 The workshop structure and arguments
Initially, we will provide an overview of the openEHR architecture. This is followed by a number of presentations introducing various - quite different - openEHR projects.
2.1 The openEHR architecture overview
The core technology of openEHR specification features a two-level modeling system, named as ‘archetype-based systems’. With regards to this archetype-based technology, technological implementation is clearly isolated from clinical concern and assures future-proof semantic interoperability. In this workshop, we will overview this archetype-based technology.
- What archetype is.
- Why archetypes assures semantic interoperability in future.
- How to implement archetype-based systems.
- Upcoming ADL(ARchetype Definition Language) 2.0 and AOM(Archetype Object Model) 2.0.
2.2 Overview of each implementation project
Clinical Knowledge Manager (Sebastian Garde)
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.
HL7 FHIR and openEHR: perspectives on coexistence and collaboration (Erik Sundvall, Ian McNicoll and Koray Atalag)
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.
Development of an openEHR-based Open Source EHR Platform and openEHR EMR frameworks (Pablo Pazos Guiterez)
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.
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.
EtherCIS a new Open Source 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.
2.3 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
3 Specific Educational Goals
The educational goal of this workshop is not only to learn openEHR technology, but implementation technology of standardized clinical models for semantic interoperability.
4 Expected Attendees
Expected attendees of this workshop are mainly developers who are interested in openEHR archetype technology, implementation of clinical models or open-source software projects in medical domain. The knowledge of the openEHR specification/technology is helpful to understand, but not required.
Because the workshop will present the state-of-the-art of implementation technologies in health care, attendees can learn the cutting edge of EHR system and software technology.