time for an open standards platform?

Dr Ian McNicollCo-Chair openEHR Foundation

HANDIHealthHon. Research Associate UCL

Oxford AHSN CIO Forum

Time for an open Standards Platform?

Interop:Towards an Open Digital Care

Ecosystem

Megasuite

Best of Breed

Platform

Open Ecosystem

“One system to rule them all”• NPfIT• Enterprise/GP Systems• Limited external integrations

Many systems ~ 100• Portals• Integration engines• Bespoke integrations

“Own the Platform”• Health Vault, Apple, Lorenzo, etc• ~1000 apps• Partner interfaces (Woodcote L3)

The “Internet “of Digital Health• HANDI-HOPD• The Healthcare Services Platform

Consortium

Megasuite architecture

‘Best of breed’ architecture

‘Closed platform’ architecture

‘open platform’ architecture

SMARTPlatformsPluggable Webapp

API

HL7 FHIR Clinical Content

Exchange NHS API

‘inVivo’Datastore

API

Detailed Clinical Content Development

Clinical leadership PRSB

Terminology Centre

HSCIC

NonopenEHR systems

Archetype+ SNOMED Clinical Content definitions

HSPC: SMART on FHIR on Clinical Models

What is openEHR?An open specification for a health information model

capable of supporting an open ecosystem

vendor neutral

technology neutral

licensed with Apache to allow open and closed source business models

www.openehr.org

openEHR - key goalProvide specifications that allow a system developer to meet the very difficult requirements of health system building

but keep the data in any openEHR system completely interoperable and queryable

regardless of programming language

regardless of human language

regardless of internal database technology

openEHR - SpecificationsNormal technical specifications with UML diagrams etc

openEHR Reference model

how the health data is represented in a patient record

openEHR Archetype object model

how the clinical content definitions are represented separately from the Reference model

openEHR: Archetypes• open source computable

models of discrete clinical concepts

• Familiar components of a health record• Blood pressure, Body weight• Symptom,Medication order, Family

history• Urea, Creatinine results

• ‘Maximal dataset’

• Capture as many clinical perspectives as possible

• A Universal use case

openEHR: Templates• Templates deliver the datasets

by aggregating archetypes together

• Key clinical endpoint and starting point for generation of technical artefacts

• i.e. openEHR archetypes and templates can be used directly

• Class libraries• GUI skeletons• Message schema• Define API Profiles

National ‘standards’ development

Web-based ‘democratised’ collaborative review

HSCIC

openEHR in practice: Clinical Data Repositories

App development

NHS England NHS Code4Health/Open source program

Using EHRScape engine for SME / clinical training

Supporting openEHR-based ‘Open platform’ approach

OPENeP

HANDIHealth / Integration Pioneers

part share ‘UK CKM’ licence

SMARTPlatformsPluggable Webapp

API

HL7 FHIR Clinical Content

Exchange NHS API

‘inVivo’Datastore

API

Detailed Clinical Content Development

Clinical leadership PRSB

Terminology Centre

HSCIC

NonopenEHR systems

Archetype+ SNOMED Clinical Content definitions

From Russia with Love?

http://www.woodcote-consulting.com/moscow-ehealth-a-model-for-the-uk/

openEHR summary

• Designed for storing and querying rich clinical dataset

• New content is defined directlyby clinicians and can be immediately uploaded into the clinical data repository

• Vendor-neutral data modelsTechnology-neutral data models

• Vendor-neutral data queryingTechnology-neutral data querying