Healthcare Information
Models & Applications
Timothy W. Cook, MSc.Health Informatics Research &
Consulting
[email protected]
I hate quotations. Tell me what you know.
Ralph Waldo Emerson
Keep everything as simple as possible;but no simpler!
Holy Grail of Health Care
The Longitudinal, Patient Controlled, Future Proof Electronic
Healthcare Applications
= Golden Ratio
Healthcare Information Systems
Current Approach
Requirements gathering within a limited scope, build data
structures and write the software.
For more than 45 years we have shown that in healthcare this
approach is flawed.
Insanity: Doing the same thing over and over again, and
expecting a different result.
Multi-Level Modeling Components
Reference Model
Concept Constraint Definitions
Template Constraint Definitions
Relationship of openEHR & MLHIM
Words
Observation
Evaluation
Instruction
Action
Entry
Words are but symbols for the relations of things to one another
and to us; nowhere do they touch upon absolute truth.--Friedrich
Nietzsche
Observation
10 entries on dictionary.com
All nouns all very similar (exception:Navigation)
One specific to medicine
Evaluation
2 entries at dictionary.com
Noun
One specific to medicine
Instruction
6 entries on dictionary.com
Nouns
Action
19 Nouns
1 Adjective
Entry
13 Nouns
Semantic Context
Having all of the information about a piece of data; available
everywhere.
Linking Concepts
Healthcare DATA: 101
101
Is it a component of BP measured in mmMg?
Is it body temperature in degrees Fahrenheit?
Is it body weight measured in kg or lbs.?
Is it body length/height in cm?
New Approach
Create a complete information model that encapsulates that
information with the data.
Forever in time and space.
Experience without theory is blind, but theory without
experience is mere intellectual play. --Immanuel Kant
MLHIM Health Information Platform
QueriesXPathXQuery
TemplatesTCDs
CCDsCDOMXMLReference Model
What is in the Reference Model?
Compositions
Set of entries committed at one date/time
e.g. progress note, report, letter, test result
EHR
The electronic health record
for one person
Folders
High-level organisation of the EHR
e.g. per episode, per clinical speciality
Sections
Clinical headings reflecting the workflow
and consultation/reasoning process
Clusters
Compound entries
e.g. blood pressure, full blood count
Elements
Element entries
e.g. reason for encounter, body weight
Data values
e.g. Coded terms from term sets,
measurements with units
Entries
Clinical statements about Observations,Evaluations, and
Instructions
Common
Package Structure
Security Features
Separation
Principles
The components of the Reference Model are like LEGO brick
specificationsConstraint Definitions = instructions/designs
constraining the use of LEGO pieces to create meaningful
structures
Concept AConcept BRMInstances
Ordered(rm.support.assumed)
INTERVAL(rm.support.assumed)
DATA_VALUE(rm.data_types.basic)
OSHIP
Open Source Health Information Platform
OSHIP
A MLHIM implementation in Python
Provides a rapid application development environment for a
variety of healthcare applications
OSHIP
Heavy re-use of existing open source components
The Zope Tool Kit (ZTK)
OSHIP
Choice of HTTP servers
Possible GUI interfaces
Choice of RDBMs and OODBMs
Internationalization/localization (i18n/l10n)
Fine-grained security framework
XML based configuration files
Designer friendly templating language
OSHIP Current Status
Reference Model
Constraint Model
Proven Infrastructure
Complete Documentation
Label on a 500 piece, jigsaw puzzle box
500-piece puzzle:
Some assembly required.
Why MLHIM?
In order to fully embrace open source and open content ideals
and processes.
Thank You!
QUESTIONS?Timothy W. Cook, MSc.Health Informatics Research &
Consulting
[email protected]
http://www.linkedin.com/in/timothywaynecook
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June 28,2010
1st Workshop on Scientific Computing in Health Applications
