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Ian McNicoll
openEHR in context:Integration, terminology, querying
The bigger picture
openEHR and integrationMaking openEHR CDR connect to other systems …
Very easy to talk to other openEHR-based systems
Talking to non-openEHR systems
transforms, transforms, transforms
But do it once for the whole openEHR community
share the transforms as open-source and a reusable asset
Integration
National messages:referral, prescription emergency summary
Model-driven integration
TDS
Model-driven integration
Healthlink eReferral TDS template
Healthlink eReferral TDS template
TDSopenEHR template
APIs - HL7 FHIR
UK- Endeavour Health
What is FHIR good at?Communication of information between systems with limited querying
Strengths
Developer friendly
Lightweight approach
Great documentation / community
Where might FHIR be weaker?Not designed for storing data
can work but will it scale up?
limited, hard-wired querying only
FHIR ‘resources’ will not work ‘out of the box’ in the real world
Need local extensions and profiles
not a ‘weakness’ as such but often overlooked
SMARTPlatforms APIScopes and permissions: OAuth
Simple sign-in: OpenID Connect
App within an App integration:
HTML5-based pluggable app
SMARTPlatforms APIScopes and permissions: OAuth
Simple sign-in: OpenID Connect
App within an App integration:
HTML5-based pluggable app
SMART example
SELECT pulse FROM EHR[ehr_id/value=$ehruid] CONTAINS COMPOSITION c
CONTAINS OBSERVATION hr[openEHR-EHR-OBSERVATION.heart_rate_pulse-zn.v1]
WHERE c/name/value='Encounter‘AND c/context/start_time/value <= $endperiod
AND c/context/start_time/value >= $startPeriod
AND pulse/data[at0001]/events[at0006|Anyevent]/ data[at0003]/items[at0004|Rate]/value/value < 60
AQL: Archetype Query Language
Model-driven
querying
SELECT pulse FROM EHR[ehr_id/value=$ehruid] CONTAINS COMPOSITION c
CONTAINS OBSERVATION hr[openEHR-EHR-OBSERVATION.heart_rate_pulse-zn.v1]
WHERE c/name/value='Encounter‘AND c/context/start_time/value <= $endperiod
AND c/context/start_time/value >= $startPeriod
AND pulse/data[at0001]/events[at0006|Anyevent]/ data[at0003]/items[at0004|Rate]/value/value < 60
AQL: Archetype Query Language
Model-driven
querying
SELECT pulse FROM EHR[ehr_id/value=$ehruid] CONTAINS COMPOSITION c
CONTAINS OBSERVATION hr[openEHR-EHR-OBSERVATION.heart_rate_pulse-zn.v1]
WHERE c/name/value='Encounter‘AND c/context/start_time/value <= $endperiod
AND c/context/start_time/value >= $startPeriod
AND pulse/data[at0001]/events[at0006|Anyevent]/ data[at0003]/items[at0004|Rate]/value/value < 60
AQL: Archetype Query Language
Model-driven
querying
Archetypes and terminology
Internal terminology
External terminologiesMedications / drug allergies: dm+d, RxNorm, proprietary
Conditions, procedures:ICD-10, SNOMED-CT
Lab tests/ analytes:LOINC, SNOMED-CT
Organisation types, Sex / gender:Local/national admin terminologies
Ripple + Termlex
CDSS: GDL/Proforma
SMARTPlatforms Pluggable Webapp
API
HL7 FHIR Clinical Content
Exchange NHS API
Clinical Data Repository
Detailed Clinical Content
Development
Clinical leadership PRSB
Terminology CentreHSCIC
Non openEHR systems
Archetype+ SNOMED Clinical Content definitions
US - Healthcare Services Platform Consortium
Useful linksopenEHR-based Form building/querying: https://www.youtube.com/watch?v=pC6mUtqqK9U
HL7 FHIR: https://www.hl7.org/fhir
SMARTPlatforms: http://smarthealthit.org/
A clinical challenge: To lead or be led by health-IT? (Linköping Nov 2015)https://www.youtube.com/playlist?list=PLHFGvRPKSumvhCrMbDrAWi2Kc0MrTHi9M
Clinical Decision Support: https://www.youtube.com/watch?v=KgBtc19LXMk