• Welcome - beware, this is a live reality show by nerds, not a slick marketing presentation… @Erik Sundvall (SLIDES)

• overview of openEHR features usable for this - @Ian McNicoll (SLIDES) & @Thomas Beale (SLIDES)

  • Very quick overview of openEHR (But we hope you have done your homework and read or looked at an intro online.)

  • How we got here by iterations of experimentation and standardisation. How the SEC works & How the clinical modelling is done.

• Cycle of knowledge / feedback (shown in Rong’s thesis) + Not doctors vs CDS, but rather doctors with CDS vs doctors without CDS… @Rong Chen

• Alan Rector “propeller” diagram - where is openEHR in the overall knowledge environment? @Rong Chen slides, https://drive.google.com/file/d/1_nH2ljbEpUSmGs2nuv0ie_hDX3qiR-uJ/view?usp=sharing

15 - 20?

• Intro page: https://www.openehr.org/about/what_is_openehr

• Intro videos:

  • https://www.youtube.com/watch?v=Y3dL1hS4XUQ&t=1s

  • https://www.youtube.com/watch?v=s0Vuno-iIIE&t=16s

• Deeper intro for techies: openEHR Architecture Overview

• History of openEHR:

• Cycle of knowledge etc:

• Rector’s “propeller” paper:

Demo/explanation of some already deployed and soon to be deployed examples
Users' point of view - what can be done in reality

Cambio @Rong Chen

• Stroke prevention in atrial fibrillation in Swedish regions deployed in COSMIC (since 2016)

• SVF prostate cancer referral support with RCC Stockholm and Gotland, deployed in TakeCare (pilot 2018)

• Decision / process support for pressure ulcer, fall, malnutrition and oral health (based Swedish QR Senior Alert), deployed in COSMIC

• Type-2 diabetes prescribing support for glucose and blood pressure management with GPs from Region South Denmark, deployed in CGM’s XMO (2020)

• Decision support for symptom monitoring in advanced breast cancer, integrated with Cemplicity’s ePRO product, New Zealand

• C3-Cloud - Personalized are plans for patients with type-2 diabetes, heart failure, kidney failure & depression in Sweden, Spain & UK. Deployed in three EHR systems.

• Scotland GP CDS pilot cases (2018), tested integration with EMIS and Vision’s GP products

   

• A clinical decision support tool for improving adherence to guidelines on anticoagulant therapy in patients with atrial fibrillation at risk of stroke: A cluster-randomized trial in a Swedish primary care setting (the CDS-AF study), https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002528

• Decision support for suspected prostate cancer (news in Swedish), https://www.cancercentrum.se/stockholm-gotland/om-oss/nyheter/2018/oktober/beslutsstod-prostata/

• A Collaborative Platform for Management of Chronic Diseases via Guideline-Driven Individualized Care Plans, https://doi.org/10.1016/j.csbj.2019.06.003

• Decision support for symptoms management in advanced breast cancer (news in Swedish), https://www.cambio.se/sv/inspiration/nyheter/2188

• Decision support for type-2 diabetes in Denmark, https://cambio.dk.loopiadns.com/index.php/2020/02/27/cambio-and-university-of-southern-denmark-collaborate-in-project-dicta-on-clinical-decision-support-for-gps/

• Video demo of GP decision support apps from Scotland National Decision Support GP pilot, https://rightdecision.scot.nhs.uk/video-library

• EU C3-Cloud project to support personalized care for multimorbidities, https://c3-cloud.eu/

DIPS @Bjørn Næss

• Intelligent entry forms and query based views - example from an acute ward using vital signs for scoring and decision support

• DIPS “on trace of Covid-19” as a timely application using the openEHR platform.

COVID-19 openEHR applications

• Different examples based on https://discourse.openehr.org/t/openehr-covid-19-project/448

• How the openEHR platform approach and international cooperation helped DIPS adapt faster to changed Norwegian Clinical needs in the face of COVID-19

Converting WHO guideline documents to executable task plans

• Brazil / Obstetric ++ Task Plans @Danielle Santos Alves (Backup; @Thomas Beale)

WHO guidlines
Models
Scientific publications

Tools & How to build

Building decision/process support systems using openEHR based tools.
Example themes:

• Low-hanging fruit:

  • the single-screen apps with decision- and process-support using interactive forms including calculations (with behaviour ranging from simple to advanced)

  • Simple use-cases: process support using Instruction+Activity+Action

• Manage overall process e.g. diabetic care, obstetrics (many screens & many systems) using “Task Planning”

• GDL based approaches

• Triggers (opening an EHR, opening a form, storing data, CDS Hooks etc)

• Output destinations (screen, EHR-composition, API calls to systems etc)

• Server side vs Client side logic and combinations

• integration with other systems (data, triggers etc) including using FHIR.

Better Tools

• @Matija Kejžar - 15 -20 mins
  Creating, maintaining and executing/instanciating task plans etc (SLIDES)

Cambio CDS Tools

• @Rong Chen

Possible content examples:

• Common clinical modelling project (Github repo) - GDL examples

• Cambio Clinical Knowledge Manager to support yearly CDS App Challenge

• Simple CDS Alert

• Single screen CDS App

• open source github project for common clinical modelling (open source github project for common clinical modelling (archetypes, GDL guidelines), ​
  archetypes, GDL guidelines), GitHub - gdl-lang/common-clinical-models: Common clinical models in the forms of openEHR archetypes and GDL guidelines

• CDS App Challenge & GDL tutorials, https://cds-apps.com/cds-app-challenge/

DIPS Tools

• @Bjørn Næss

• Form Designer - a tool to create advanced forms based on openEHR data.

  • Layout

  • Dependencies

  • Calculations with a syntax borrowed from Excel

  • Advanced script support

• EHR Flow - DIPS Taskplanning

  • Short introduction to the examples we will support initially

    • Outpatient visit to assess the need for hip replacement; details here

Combinations etc. (short discussion)

“Single screen apps” and GDL-rules can be parts within a “task plan” process structure

• CDS/TP-systems calling and being called by external (non-openEHR systems) via APIs, including FHIR. CDS hooks etc.

• COVID-applications are a combination

Wrapping up…

Roadmap for openEHR CDS/TP- convergence of guidelines, decision logic / algorithms, task plans (workflows), CDS hooks, data @Thomas Beale (SLIDES)

• decision module / guideline libraries & re-use of small algorithms

• integrated architecture

• making models like contsys ‘real’ (implementable & maintainable) ?

what it looks like today (slide 1) - where we are going (slide 2) - what is there now (slide 3)

(Brief) answers to some of the written questions submitted by the participants ahead of (and possibly during) the seminar.

SEC answers, moderated by @Erik Sundvall

See forum thread

Slide - Digital Twin

The End and another beginning
Thanks, goodbye and encouraging participants to continue discussion online in openEHR’s different discourse forums. @Erik Sundvall

open EHR web

International forum:
Swedish subsection: