Presentation to Oxford AHSN CIO Forum May 2015.

1. Dr Ian McNicoll
Co-Chair openEHR Foundation
HANDIHealth
Hon. Research Associate UCL
Oxford AHSN CIO Forum
Time for an open
Standards Platform?

2. 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

3. Megasuite architecture

4. ‘Best of breed’ architecture

5. ‘Closed platform’ architecture

6. ‘open platform’ architecture

7. SMARTPlatforms
Pluggable Webapp
API
HL7 FHIR
Clinical Content
Exchange NHS API
‘inVivo’
Datastore API
Detailed
Clinical Content
Development
Clinical leadership PRSB
Terminology
Centre
HSCIC
Non
openEHR
systems
Archetype+ SNOMED Clinical
Content definitions

8. HSPC: SMART on FHIR on Clinical
Models

9. 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

10. www.openehr.org

11. openEHR - key goal
Provide 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

12. openEHR - Specifications
Normal 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

13. 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

14. 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

15. National ‘standards’ development

16. Web-based ‘democratised’
collaborative review

17. HSCIC

18. openEHR in practice: Clinical Data
Repositories

19. App development

20. 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

21. SMARTPlatforms
Pluggable Webapp
API
HL7 FHIR
Clinical Content
Exchange NHS API
‘inVivo’
Datastore API
Detailed
Clinical Content
Development
Clinical leadership PRSB
Terminology
Centre
HSCIC
Non
openEHR
systems
Archetype+ SNOMED Clinical
Content definitions

22. From Russia with Love?
http://www.woodcote-consulting.com/moscow-
ehealth-a-model-for-the-uk/

23. openEHR summary
• Designed for storing and querying
rich clinical dataset
• New content is defined directly
by clinicians and can be immediately
uploaded into the clinical data repository
• Vendor-neutral data models
Technology-neutral data models
• Vendor-neutral data querying
Technology-neutral data querying