HISI Conference – 18 th November 2010 Towards use of OpenEHR Archetypes to support views of

1. HISI Conference – 18th November 2010 Towards use of OpenEHR Archetypes to support views of Cystic Fibrosis Review Records Derek Corrigan

2. Overview Problems specific to developing clinical systems OpenEHR – a potential solution? A methodology for developing OpenEHR systems Application of methodology to a clinical case Conclusions about OpenEHR experience

3. Clinical Systems -The Software Design Perspective Developing clinical systems is difficult! Clinical knowledge is broad and changes quickly Software developers are not domain specialists Clinical knowledge is embedded in software Cluttered, static and inflexible views of data

4. Clinical Systems - The Clinicians Perspective The Clinical guidelines : • Increasingly demanding multi-disciplinary care teams for best practice • This requires flexible and dynamic views of data to cater for all each team member as well as the overall team. • Incompatible with previous limitations

5. OpenEHR – A Silver Bullet? Specific implementation of 2 level information modelling employed using concepts of archetypes and templates. Courtesy of OpenEHR Foundation

6. Cystic Fibrosis – A Case Study Why Cystic Fibrosis? • Was kindly given access to CF registry documentation • Very relevant to Ireland – highest incidence in world • Best practices demands multi-disciplinary team care relating to a number of discreet clinical areas • By implication requires dynamic views of CF patient data to support different team member requirements • Could I satisfy team data view requirements using OpenEHR archetypes and templates and provide a “how-to” guide for others?

8. Step 1

9. Step 1 Cystic Fibrosis Periodic Review Covers a number of clinical areas including physical functions, nutrition, physiotherapy, medication

10. CF Registry DB Schema Step 1

11. Steps 2 and 3

12. OpenEHR Clinical Knowledge Manager (CKM) – Search for archetypes Step 4

13. Step 5 Spirometry Archetype Design Key OpenEHR Goal Should be clinically complete and reusable

14. Step 5 Spirometry Archetype Design V2

15. Archetype Editor Step 6

16. Step 7 Develop Templates (Views)

17. Step 7

18. Publish Archetypes to CKM Step 8 • Spirometry archetype submitted to OpenEHR • Aspects incorporated into new archetype they were working on • To be published on CKM and currently being used in system in paediatric hospital system in Slovenia

20. OpenEHR - Conclusions • OpenEHR worked well – descriptive enough from a data perspective – too flexible though? • Will clinicians use this? Jury still out • Design patterns for archetypes could help • OpenEHR CKM is a very powerful tool to locate and reuse existing archetypes quickly • Global OpenEHR community - archetype features developed in Ireland being used in application in Slovenia • Publication of archetypes to CKM, and governance needs to be streamlined – most still in draft form • If not done, localised archetypes will be used – defeats the aim of supporting reuse of archetypes

21. Questions ?