From the Meeting Floor

Norway (Silje)

Silje presentation (PPT).
Norway CKM http://arketyper.no now live.
100 CKM users now; Do-ocracy (who does, decides); 35 active current clinicians
CKM essential to the process
good quality clinical input so far

Sweden

Some previous national experiments with openEHR not very successful.
Erik Sundvall reporting from the perspective of the County Council of Östergötland:
- Cambio plans to start using archetypes more (in other things than CDS) in version 8.1 of their product (Cambio Cosmic) and then in version 8.2 user/customer-configurable archetypes will be possible. We have estimated that version 8.2 might appear in use among several Swedish customers sometime around 2017. That means we will have to start building local/national competence now.
  During fall/winter we’d like to get some demo environments and use-cases going in the county council of Östergötland of that we can explain well enough to get more support and budget to scale up education and preparations during 2015-2017.
- I would like our county council to arrange a course in Sweden some time during 2015. Collaboration with Norway regarding educational efforts and archetyping is also interesting.
- Our local modeling needs are for practical clinical use, things that need to work for real in clinical practice around 2017. That might be a different kind of start than some previous Swedish national projects. Our needs are likely very similar to the other Swedish Cambio customers, so I think we’ll be very open with collaborations and invitations to educations. We and two other county councils (Kalmar and Jönköping, both Cambio customers) collaborate as a healthcare region (~1m population coverage). In this region there at least is good hope that we’ll do a lot of informatics-related things together.
- 2 county council information modellers attended clinical modelling course in London.

Gunnar Klein: SKL doing some activity again; official activity mostly unknown due to new govt.

Brazil / Sweden (via Erik Sundvall)

Sergio Freire - was guest Post-doc at Linköping University in Sweden parts of 2012-2013. (Paper links coming...)
- Explored different NoSQL-approaches to persisting openEHR data, has load-tested querying in borh XML- and JSON-based persistence solutions. This has continued in Brazil after the time in Sweden.
- Large epidemiology DB published yearly in Brazil - Sergio et.al. devised archetypes and method to convert data to openEHR format that can be used for clinical querying, load testing etc. studies.

Japan (Shinji)

Seminars every 2 - 3 months; including vendor attendees
2 national projects: Medical Markup Language - being applied / re-engineered using archetypes.
Ruby implementation

Asia:

ASEAN unification program starts 2015 - opportunities in health information network.
Huge advantage - mostly green field technology wise

Australia (Heather Leslie)

NEHTA using CKM for 3-4y to generate their models underlying CDA and other end-use (non-openEHR) PCEHR artefacts; PCEHR archetype development currently on hold. Archetypes are basis for PCEHR CDA messages from GP systems.
Northern Territory currently main user and driver of modelling, due to indigenous health needs. Using a state-based atomised openEHR data repository. Archetypes developed for:
- Hearing Health program
- Antenatal Shared Care
- Remote Medical Practioner On Call
NEHTA archetypes being used natively in Ocean openEHR solutions
Ocean solutions, based on archetypes and openEHR platform include:
- Community care planning system used in Medicare Locals
- Infection Control system across Queensland Health and now into NT.

New Zealand (email from Koray Atalag - by Ian McNicoll)

National Interoperability Reference Architecture underpinned by openEHR Archetypes - but no CKM in action as the government is keen to see what comes out of FHIR & openEHR joint modelling initiative.
Just deployed a new clinical registry: gestational diabetes using full openEHR front and backends (using OceanEHR Framework)
Also using archetype modelling for national cardiac registry
Koray joining theresearch team involved in Virtual Physiological Human initiative (EU based) and will look at to applying openEHR to bridge various physiological, anatomical and clinical models.
openEHR is also planned to underpin a new Centre of Research Network Excellence (MedTech CoRE) platform idea to create an interoperable 'ecosystem' for medical devices. Funded by NZ govt ($26m)
Also started research collaboration with the State University of Amazon in Brazil and shortly kicking off a project to develop an openEHR based diabetic foot management system (a clinical system + app)

Spain (David Moner)

slides PPT; list of archetypes
Main government priority on interoperability / data sharing between 17 regions
10 clinical documents defined by MOH in form of 13606 archetypes
MOH review of archetypes currently underway
13606 will be long term direction for data interop between regions; archetype based
MOH is funding training activities in Snomed, 13606.
Pilots / projects in 5 regions - main ones - Madrid, Valencia

Slovenia (Tomaž Gornik)

Gov will procure national openEHR-based EHR server
CKM running but engagement of clinicians very difficult; progress is slow
New projects have to conform to archetype-based openEHR data.
PARENT FP7 registries project being run from Slovenia
Marand / Critical won Unimed (private health insurance) contract; 6m patients
Saudi Arabia tender for CKM and archetype and training services
some openEHR modelling activity in IRAN
Moscow city project - rolling out to 12m patients, following pilot with 2m patients

Netherlands

Gov - HL7v3 as basis for interop; not interested in how data are stored
Code24 implems in mental institutions at this stage; mostly using international CKM archetypes + some new archetypes.
somme DCM model development

UK (Ian McNicoll)

national project (NPfIT) lessons: top-down approach didn't work; no more HL7v3; possibly some CDA
NHS likely to move to FHIR;
GP systems are contractually required their APIs - will be FHIR