Christmas greetings from the CKM team - 2018

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Hi everyone,

What a year it has been, and great to be able to reflect back on achievements and the gathering momentum.

@Silje Ljosland Bakke (Unlicensed) and myself, as clinical program leads, would like to thank everyone for their contributions and efforts over the year.

Some stats to provide some insight into the current ‘state of the CKM’ and activity over the year:

• Archetypes

  • 443 archetypes available, distributed over 35 projects; and a further 102 ungoverned ones evolving in incubators

  • In projects: 322 are draft; 26 currently undergoing review; 79 are published for content

  • In the past 12 months, 16 archetypes were published; 203 archetypes were modified; 66 were created and added to CKM as new models

  • Archetypes for ECG report and alcohol consumption are just on the brink of publication – we can expect them to be published very early in the new year.

• Templates

  • 85 templates have been submitted, mostly as examples of modelling for specific scenarios; 77% are in ungoverned incubators

  • None have been reviewed to final publication status

• Translations

  • Over the years there have been many archetypes that have been translated. A huge amount of work by a very small number of volunteers and largely invisible and beneath the surface. We currently have representations in 24 languages, the top five (obviously excluding English as the default language of CKM) being:

    • Portuguese (Brazil) - 119 archetypes translated;

    • Norwegian Bokmål with 110;

    • Arabic (Syria) with 78

    • Spanish (Argentina) 51

    • Spanish (Spain) 42

• CKM users

  • As of today, 2106 registered users from 93 countries

  • Top five countries, by number of registered users: Brazil; UK; USA; Australia; Sweden

  • 278 new registrants signed up this year, purely by word of mouth. Imagine if we did some marketing!

• Reviews:

  • 749 registrants have volunteered to participate in reviews

  • This year:

    • 80 unique reviewers participated this year, 75 completing at least 1 content review and 5 reviewers participate only in translation reviews

    • 23 archetypes completed at least one review round this year

    • 414 archetype reviews were submitted - 375 content reviews in 39 review rounds; 34 Swedish translation reviews in 7 review rounds

  • Additionally, all reviewed and published archetypes have undergone parallel reviews in the Norwegian CKM

• We have 35 projects; 18 public incubators; 15 private incubators

• 44 archetypes are available on a ‘view only’ basis as they are ‘owned’ by other collaborating CKMs – 29 referenced from the UK Apperta CKM; and 5 from the Norwegian CKM

From an operations point of view it has been really pleasing to see activity increasing and new users actively engaging in reviews.

Silje and I particularly wish to thank all those who participated as Editors – the ongoing effort week by week, herding cats behind the scenes and teasing out the patterns that make each archetype implementable is easy to underestimate and should not be! And to Sebastian for crafting the CKM itself that powers this great collaborative effort.

We thank you all for your participation and encourage those who are not yet active to indicate your willingness by adopting archetypes that you’d like to participate in for review purposes. We value any and all input. There is no ‘stupid’ answers as everyone views the content from their own professional perspective and unique domain knowledge.

By volunteering your comments we have collectively created an extraordinary international resource, with no equal – there is no body of work in the public domain that is so broad and deep, and so transparent and freely available. And all crowd sourced from volunteer participants. Please pat yourselves on the back for an extraordinary effort as a community!!

The year has not been without it’s dramas and disagreements, but I am continuously amazed at the respect and collegiality by which people collaborate in meetings, on openEHR clinical Slack channels and of course, in the archetype reviews. Unfortunately the Slack channels are only available by invite only, so if you would like to be included please email me directly - heather.leslie@atomicainformatics.com - and I’ll add you in:

Some big topics have been ‘nailed’ this year – in particular the Medications family of archetypes, which has constituted a massive amount of work by editors and reviewers. Others that have finally been published include the tricksy archetypes for: Contraindication; Pulse oximetry; Problem/Diagnosis qualifier. Others like Hip circumference and Waist circumference were easier, low hanging fruit.

Also, undergoing what we hope might be their final review round, is the Laboratory test OBSERVATION and related CLUSTERs for haematology, biochem, serology etc – as you can imagine, achieving consensus has required a huge amount of work and checking with implementers around the world. Seriously ground breaking work, here. Micro and histopathology will need a little more work once these first core lab archetypes are published, and the Imaging family of archetypes will be reimagined by aligning them with the lab patterns and adjusting for their specific purpose.

There are a few that are providing headaches for Editors – particularly designing the patterns for fractal Physical examination findings; Social history, including housing, accommodation, living arrangements, occupation etc; and Communication capability, including language and translation requirements have been surprisingly elusive, but we are well advanced in all of these areas and we expect these patterns to be worked on in the new year again.

As well as the celebrations, we are also grieving for one of our colleagues, Hildegard McNicoll. Hildi passed away only weeks ago and we already miss her significant and enthusiastic contributions, and especially her friendship and wisdom. As Editors we are still working on facilitating on review rounds in which Hildi has made comments which we are still incorporating into archetypes as they evolve. Her presence is still actively being felt! Vale Hildi, and thank you! Our sincerest condolences to Ian and family.

Finally, as the year draws to a close, we wish you all a great celebration with family and friends, and especially a restful holiday break – we need you to be in good shape for all the work we anticipate for 2019.

Best regards

@Heather Leslie

December 21, 2018