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Clinical modelling with openEHR Archetypes
Koray Atalag, MD, PhD, FACHISenior Research Fellow (ABI & NIHI)[email protected]
Outline
• What is openEHR?• Multi-level Modelling• Archetypes & Templates• Setting Semantics• Tooling – modelling & repository/governance
Open source specs & software for representing health information and person-centric records– Based on 20 years of international research, including Good European
Health Record Project (GEHR)– Superset of ISO/CEN 13606 EHR standard
Not-for-profit organisation - established in 2001 www.openEHR.org
Extensively used in research
Separation of clinical and technical worlds
• Big international community
• Online models repositoryhttp://openehr.org/ckm
Also newly elected
got the power ;)
Multi-Level Modelling
Reference ModelLogical building blocks of EHR
Compositions
EHR
Folders
Sections
Clusters
Elements
Data values
Entries
Lifelong Longitudinal Versioned Comprehensive Computable Secure Sharable
RM: Text Data Type
7
RM: Quantity
Data Type
Units:
* Units part of RM not domain model
Archetypes?
• Formal constraints on Reference Model Classes– Structural constraints: List, table, tree– What labels can be used?– What data types can be used?– What values are allowed for these data types?– How many times a data item can exist?– Whether a particular data item is mandatory– Whether a selection is involved from a number of
items/values• Formal semantics via terminology bindings• Meta-data and language translations
Anatomy of an Archetype
11
12
Archetype EditorAll about tooling mate!
Example: NZ Cardiac Registry
14Screenshot of openEHR Template from a tool
Semantics in openEHR
• Whole-of-model meta-data:– Description, concept references (terminology/ontology), purpose,
use, misuse, provenance, translations
• Item level semantics– Trees/Clusters (Structure)– Leaf nodes (Data Elements)
Formally: different types of terminology bindings:1) linking an item to external terminology/ontology for the
purpose of defining its real-world meaning2) Linking data element values to external terminology (e.g. a
RefSet or terminology query)
• Instance level semantic annotations – applies to actual data collected
Blood Pressure Measurement
mindmap representation of openEHR Archetype
1) Linking items to SNOMED to define clinical meaning
NZ Cardiac Registry: Medication2) Linking data element values to external terminology (NZULM)
RM: Text Data Type Instance level semantic annotations
Onl
ine
Mod
el R
epos
itory