The next generation EHR

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1 The next generation EHR European EHR standard OpenEHR Ocean Informatics Gerard Freriks v

2 Electronic Patient Record What do we expect? We need and expect EHR-systems that: 2

3 Electronic Patient Record What do we expect? We need and expect EHR-systems that: communicate with other systems without hassle or reprogramming 2

4 Electronic Patient Record What do we expect? We need and expect EHR-systems that: communicate with other systems without hassle or reprogramming support work process of any (small) group of cooperating healthcare providers 2

5 Electronic Patient Record What do we expect? We need and expect EHR-systems that: communicate with other systems without hassle or reprogramming support work process of any (small) group of cooperating healthcare providers facilitate innovation 2

6 Electronic Patient Record What do we expect? We need and expect EHR-systems that: communicate with other systems without hassle or reprogramming support work process of any (small) group of cooperating healthcare providers facilitate innovation can easily be used for clinical research and public health 2

7 New Paradigm: The actors Health Government Organisations Work processes People Information Communication Technology ICT 3

8 New Paradigm: What is needed? Health is heterogeneous Health ICT is heterogeneous ICT 4

9 New Paradigm: What is needed? Health is in constant flux Health ICT is in constant flux ICT 5

10 New Paradigm: What is needed? Health is in constant flux Health it will never end ICT is in constant flux ICT 5

11 New Paradigm: What is needed? Health Government Organisations Work processes People Information Communication Technology ICT 6

12 New Paradigm: What is needed? Health Government Organisations Work processes People Stability in the middle Information Communication Technology ICT 6

13 New Paradigm: What is needed? Health Laws, regulation Standards Agreements ICT 7

14 New Paradigm: What is needed? Many autonomous organisations Many autonomous Work processes Many autonomous people Health Laws, regulation Standards Agreements ICT 7

15 New Paradigm: What is needed? Many autonomous organisations Many autonomous Work processes Many autonomous people Many autonomous ICT systems Health Laws, regulation Standards Agreements Many autonomous operating systems Many computer languages Many data bases ICT 7

16 New Paradigm: What is needed? Health Government Organisations Work processes People Stability in the middle Information Communication Technology ICT 8

17 New Paradigm: What is needed? Health Government Organisations Work processes People Stability in the middle Standards Language Information Communication Technology ICT 8

18 New Paradigm: What is needed? Health Government Organisations Work processes People Stability in the middle Information Information Communication Technology 9 CT

19 New Paradigm: What is needed? Health Government Organisations Work processes People Information Stability Standard in the expression middle Information Communication Technology I. 9 CT

20 New Paradigm: What is needed? Health INFORMATION I.TC 10

21 New Paradigm: What is needed? Health I-volution INFORMATION I.TC 10

22 New Paradigm: What is needed? Solutions Health INFORMATION I.TC 11

23 New Paradigm: What is needed? Solutions Health Messages Paradigm Archetype Paradigm INFORMATION I.TC 11

24 New Paradigm: What is needed? Message paradigm Health Government Organisations Work processes People 12 Information Communication Technology ICT 19

25 New Paradigm: What is needed? Message paradigm I- Standardise a work process Health Government Organisations Work processes People 12 Information Communication Technology ICT 19

26 New Paradigm: What is needed? Message paradigm I- Standardise a work process 2 -Use a RIM (Reference Information Model) Health Government Organisations Work processes People RIM 12 Information Communication Technology ICT 19

27 New Paradigm: What is needed? Message paradigm I- Standardise a work process 2 -Use a RIM (Reference Information Model) 3- Produce the message Health Government Organisations Work processes People RIM 12 Information Communication Technology ICT 19

28 New Paradigm: What is needed? Message paradigm I- Standardise a work process 2 -Use a RIM (Reference Information Model) 3- Produce the message 4- Implement uniformly messages in systems by changing software Health Government Organisations Work processes People RIM 12 Information Communication Technology ICT 19

29 New Paradigm: What is needed? Message paradigm I- Standardise a work process Health 2 -Use a RIM (Reference Information Model) 3- Produce the message Government Organisations Work processes People 4- Implement uniformly messages in systems by changing software RIM 5- Install the new software in all end-user systems 12 Information Communication Technology ICT 19

30 New Paradigm: What is needed? Message paradigm I- Standardise a work process 2 -Use a RIM (Reference Information Model) 3- Produce the message 4- Implement uniformly messages in systems by changing software Health Government Organisations Work processes People RIM 5- Install the new software in all end-user systems 6- Each new version or new set of Information Communication Technology ICT messages needs the same cycle 12 19

31 New Paradigm: What is needed? Message paradigm I- Standardise a work process Health 2 -Use a RIM (Reference Information Model) 2-5 years 3- Produce the message 1.5 years 4- Implement uniformly messages in systems by changing software.3-1 years 5- Install the new software in all end-user systems 6- Each new version or new set of Government Organisations Work processes People RIM Information Communication Technology ICT messages needs the same cycle 12 19

32 New Paradigm: What is needed? Message paradigm I- Standardise a work process Health 2 -Use a RIM (Reference Information Model) 2-5 years 3- Produce the message 1.5 years 4- Implement uniformly messages in systems by changing software.3-1 years 5- Install the new software in all end-user systems 6- Each new version or new set of Government Organisations Work processes People RIM Information Communication Technology ICT messages needs the same cycle 12 19

33 Standardised healthcare workers All are not able to adopt to local workflow, local culture, and needs

34 Standardised healthcare workers All are not able to adopt to local workflow, local culture, and needs

35 New Paradigm: What is needed? Message paradigm Health Government Organisations Work processes People Information Communication Technology ICT

36 New Paradigm: What is needed? Message paradigm Health The consequences: Government Organisations Work processes People Information Communication Technology ICT

37 New Paradigm: What is needed? Message paradigm Health The consequences: No innovation Government Organisations Work processes People Information Communication Technology ICT

38 New Paradigm: What is needed? Message paradigm Health The consequences: No innovation Government Organisations Work processes People No health economy Information Communication Technology ICT

39 New Paradigm: What is needed? Message paradigm Health The consequences: No innovation Government Organisations Work processes People No healthcare economy Information Communication Technology ICT

40 New Paradigm: What is needed? Message paradigm Health The consequences: No innovation No healthcare economy Government Organisations Work processes People NO I-volution Information Communication Technology ICT

41 New Paradigm: What is needed? Archetype paradigm Health Government Organisations Work processes People Technology Communication I.TC

42 New Paradigm: What is needed? Archetype paradigm Health Government Organisations Work processes People INFORMATION Technology Communication I.TC

43 New Paradigm: What is needed? Archetype paradigm Health Work process I.TC

44 New Paradigm: What is needed? Archetype paradigm 1- All I.TC-systems implement only once one Reference Model Health Work process RM I.TC

45 New Paradigm: What is needed? Archetype paradigm 1- All I.TC-systems implement only once one Reference Model Health Work process 2- Using tools based on the Archetype Model co-operating healthcare providers produce a collection of health concepts (archetypes) AM RM A AAA I.TC

46 New Paradigm: What is needed? Archetype paradigm 1- All I.TC-systems implement only once one Reference Model Health Work process 2- Using tools based on the Archetype Model co-operating healthcare providers produce a collection of health concepts (archetypes) A AT A AM RM A AAA 3- For a specific work process they define Templates using Archetypes and tools I.TC

47 New Paradigm: What is needed? Archetype paradigm Health Work process A AT A AM RM A AAA I.TC

48 New Paradigm: What is needed? Archetype paradigm 1.Templates are implemented immediately and without any cost Health Work process A AT A AM RM A AAA I.TC

49 New Paradigm: What is needed? Archetype paradigm 1.Templates are implemented immediately and without any cost 2.Each work process can change and lead to new Templates A AT A Health Work process AM A AAA RM I.TC

50 New Paradigm: What is needed? Archetype paradigm 1.Templates are implemented immediately and without any cost 2.Each work process can change and lead to new Templates 3.Local adaptations are always possible A AT A Health Work process AM A AAA RM I.TC

51 New Paradigm: What is needed? Archetype paradigm 1.Templates are implemented immediately and without any cost 2.Each work process can change and lead to new Templates 3.Local adaptations are always possible A AT A Health Work process AM A AAA 4.Expressing health knowledge is no longer dependent on the co-operation of the ICT industry RM I.TC

52 New Paradigm: What is needed? Archetype paradigm 1.Templates are implemented immediately and without any cost 2.Each work process can change and lead to new Templates 3.Local adaptations are always possible A AT A Health Work process AM A AAA 4.Expressing health knowledge is no longer dependent on the co-operation of the ICT industry RM 5.Communication with legacy systems is always possible I.TC

53 New Paradigm: What is needed? Archetype paradigm Health Work process A AT A AM RM A AAA I.TC

54 New Paradigm: What is needed? Archetype paradigm Consequences: Health Work process A AT A AM RM A AAA I.TC

55 New Paradigm: What is needed? Archetype paradigm Consequences: Health Work process Innovation A AT A AM A AAA RM I.TC

56 New Paradigm: What is needed? Archetype paradigm Consequences: Health Work process Innovation A AT A AM A AAA Health economy RM I.TC

57 New Paradigm: What is needed? Archetype paradigm Consequences: Health Work process Innovation A AT A AM A AAA Health economy RM Evolution I.TC

58 New Paradigm: What is needed? Archetype paradigm Consequences: Innovation Health economy Evolution A AT A Health Work process AM RM A AAA I.TC

59 New Paradigm: What is needed? Archetype paradigm Consequences: Innovation Health Work process AM I-volution A AT A RM Health economy A AAA is possible I.TC Evolution

60 New Paradigm: What is needed? EHR-Systems Message Paradigm Health

61 New Paradigm: What is needed? EHR-Systems Message Paradigm Health

62 New Paradigm: What is needed? EHR-Systems Archetype Paradigm Presentation Layer Business Logic Layer Domain Content Model RM Information Layer Template Persistance Layer

63 New Paradigm: What is needed? EHR-Systems Archetype Paradigm Presentation Layer Healthcare Business Logic Layer Domain Content Model RM Information Layer Template Persistance Layer

64 New Paradigm: What is needed? EHR-Systems Archetype Paradigm Presentation Layer Healthcare Business Logic Layer Domain Content Model RM Information Layer Template Persistance Layer

65 New Paradigm: What is needed? EHR-Systems Archetype Paradigm Presentation Layer Business Logic Layer Domain Content Model RM Information Layer Template Persistance Layer Presentation Layer Business Logic Layer Domain Content Model RM Information Layer Template Persistance Layer 24

66 New Paradigm: What is needed? EHR-Systems Archetype Paradigm Presentation Layer Business Logic Layer Domain Content Model RM Information Layer Template Persistance Layer Presentation Layer Healthcare Business Logic Layer Domain Content Model RM Information Layer Template Persistance Layer 24

67 New Paradigm: What is needed? EHR-Systems Archetype Paradigm Presentation Layer Healthcare Business Logic Layer Domain Content Model RM Information Layer Template Persistance Layer Presentation Layer Healthcare Business Logic Layer Domain Content Model RM Information Layer Template Persistance Layer 24

68 Role of European Standards 25

69 26

70 EN13606 Standard openehr Implementable specification OceanEHR product suite Software products Part 1 EHR communication Reference Model EHR-system specification EHR-system (EhrBANK) Part 2 Archetype Model Archetype Definition language Archetype Model Archetype Definition language Archetype Editor Template Model Template Editor Archetype Editor ADL Workbank Template Editor ADL Bank Part 3 Domain term list Domain term list Other Clinical Models Domain term list Other Clinicial Models Part 4 Patient mandate Implementable specification of Patient mandate Software respecting Patient mandate EhrGate Part 5 Implementation guide Specification for interfacing with legacy systems via messaging 26 Interfacing service for interfacing with legacy systems via messaging EhrAdapter

71 EN13606 Standard openehr Implementable specification OceanEHR product suite Software products Part 1 EHR communication Reference Model EHR-system specification EHR-system (EhrBANK) Part 2 Archetype Model Archetype Definition language Archetype Model Archetype Definition language Archetype Editor Template Model Template Editor Archetype Editor ADL Workbank Template Editor ADL Bank Part 3 Domain term list Domain term list Other Clinical Models Domain term list Other Clinicial Models Part 4 Patient mandate Implementable specification of Patient mandate Software respecting Patient mandate EhrGate Part 5 Implementation guide Specification for interfacing with legacy systems via messaging 26 Interfacing service for interfacing with legacy systems via messaging EhrAdapter

72 EN13606 Standard openehr Implementable specification OceanEHR product suite Software products Part 1 EHR communication Reference Model EHR-system specification EHR-system (EhrBANK) Part 2 Archetype Model Archetype Definition language Archetype Model Archetype Definition language Archetype Editor Template Model Template Editor Archetype Editor ADL Workbank Template Editor ADL Bank Part 3 Domain term list Domain term list Other Clinical Models Domain term list Other Clinicial Models Part 4 Patient mandate Implementable specification of Patient mandate Software respecting Patient mandate EhrGate Part 5 Implementation guide Specification for interfacing with legacy systems via messaging 26 Interfacing service for interfacing with legacy systems via messaging EhrAdapter

73 EN13606 Standard openehr Implementable specification OceanEHR product suite Software products Part 1 EHR communication Reference Model EHR-system specification EHR-system (EhrBANK) Part 2 Archetype Model Archetype Definition language Archetype Model Archetype Definition language Archetype Editor Template Model Template Editor Archetype Editor ADL Workbank Template Editor ADL Bank Part 3 Domain term list Domain term list Other Clinical Models Domain term list Other Clinicial Models Part 4 Patient mandate Implementable specification of Patient mandate Software respecting Patient mandate EhrGate Part 5 Implementation guide Specification for interfacing with legacy systems via messaging 26 Interfacing service for interfacing with legacy systems via messaging EhrAdapter

74 EN13606 Standard openehr Implementable specification OceanEHR product suite Software products Part 1 EHR communication Reference Model EHR-system specification EHR-system (EhrBANK) Part 2 Archetype Model Archetype Definition language Archetype Model Archetype Definition language Archetype Editor Template Model Template Editor Archetype Editor ADL Workbank Template Editor ADL Bank Part 3 Domain term list Domain term list Other Clinical Models Domain term list Other Clinicial Models Part 4 Patient mandate Implementable specification of Patient mandate Software respecting Patient mandate EhrGate Part 5 Implementation guide Specification for interfacing with legacy systems via messaging 26 Interfacing service for interfacing with legacy systems via messaging EhrAdapter

75 27

76 Inventory Repository Terminology integration Generic viewer Data entry EN13606 Standard - OpenEHR Implementable specification Clinical Archetype repository - - OceanEHR Product Suite Software products Tools for clinical archetype/ clinical template handling Ocean Knowledge Manager Terminology server - - EHRview Ocean Forms 27

77 Inventory Repository Terminology integration Generic viewer Data entry EN13606 Standard - OpenEHR Implementable specification Clinical Archetype repository - - OceanEHR Product Suite Software products Tools for clinical archetype/ clinical template handling Ocean Knowledge Manager Terminology server - - EHRview Ocean Forms 27

78 Inventory Repository Terminology integration Generic viewer Data entry EN13606 Standard - OpenEHR Implementable specification Clinical Archetype repository - - OceanEHR Product Suite Software products Tools for clinical archetype/ clinical template handling Ocean Knowledge Manager Terminology server - - EHRview Ocean Forms 27

79 Inventory Repository Terminology integration Generic viewer Data entry EN13606 Standard - OpenEHR Implementable specification Clinical Archetype repository - - OceanEHR Product Suite Software products Tools for clinical archetype/ clinical template handling Ocean Knowledge Manager Terminology server - - EHRview Ocean Forms 27

80 European EHR standard CEN/tc251 En13606

81 European EHR standard CEN/tc251 En13606 EHR Extract Part or all of the electronic health record for one person, being communicated

82 European EHR standard CEN/tc251 En13606 EHR Extract Folders Part or all of the electronic health record for one person, being communicated High-level organisation of the EHR e.g. per episode, per clinical speciality

83 European EHR standard CEN/tc251 En13606 EHR Extract Folders Compositions Part or all of the electronic health record for one person, being communicated High-level organisation of the EHR e.g. per episode, per clinical speciality Set of entries comprising a clinical care session or document e.g. test result, letter

84 European EHR standard CEN/tc251 En13606 EHR Extract Folders Compositions Sections Part or all of the electronic health record for one person, being communicated High-level organisation of the EHR e.g. per episode, per clinical speciality Set of entries comprising a clinical care session or document e.g. test result, letter Headings reflecting the flow of information gathering, or organising data for readability

85 European EHR standard CEN/tc251 En13606 EHR Extract Folders Compositions Sections Entries Part or all of the electronic health record for one person, being communicated High-level organisation of the EHR e.g. per episode, per clinical speciality Set of entries comprising a clinical care session or document e.g. test result, letter Headings reflecting the flow of information gathering, or organising data for readability Clinical statements about Observations, Evaluations, and Instructions

86 European EHR standard CEN/tc251 En13606 EHR Extract Folders Compositions Sections Entries Clusters Part or all of the electronic health record for one person, being communicated High-level organisation of the EHR e.g. per episode, per clinical speciality Set of entries comprising a clinical care session or document e.g. test result, letter Headings reflecting the flow of information gathering, or organising data for readability Clinical statements about Observations, Evaluations, and Instructions Multipart entries, tables,time series, e.g. test batteries, blood pressure, blood count

87 European EHR standard CEN/tc251 En13606 EHR Extract Folders Compositions Sections Entries Clusters Elements Part or all of the electronic health record for one person, being communicated High-level organisation of the EHR e.g. per episode, per clinical speciality Set of entries comprising a clinical care session or document e.g. test result, letter Headings reflecting the flow of information gathering, or organising data for readability Clinical statements about Observations, Evaluations, and Instructions Multipart entries, tables,time series, e.g. test batteries, blood pressure, blood count Element entries: leaf nodes with values e.g. reason for encounter, body weight

88 European EHR standard CEN/tc251 En13606 EHR Extract Folders Compositions Sections Entries Clusters Elements Data values Part or all of the electronic health record for one person, being communicated High-level organisation of the EHR e.g. per episode, per clinical speciality Set of entries comprising a clinical care session or document e.g. test result, letter Headings reflecting the flow of information gathering, or organising data for readability Clinical statements about Observations, Evaluations, and Instructions Multipart entries, tables,time series, e.g. test batteries, blood pressure, blood count Element entries: leaf nodes with values e.g. reason for encounter, body weight Date types for instance values e.g. coded terms, measurements with units

89 European EHR standard CEN/tc251 En13606

90 LEGO design analogy The components of the Reference Model are like LEGO bricks Archetypes = instructions/designs constraining the use of LEGO pieces to create meaningful structures Ocean Informatics 2007

91 LEGO design analogy The components of the Reference Model are like LEGO bricks Archetypes = instructions/designs constraining the use of LEGO pieces to create meaningful structures Information model Ocean Informatics 2007

92 LEGO design analogy The components of the Reference Model are like LEGO bricks Archetypes = instructions/designs constraining the use of LEGO pieces to create meaningful structures Information model Archetype A Ocean Informatics 2007

93 LEGO design analogy The components of the Reference Model are like LEGO bricks Archetypes = instructions/designs constraining the use of LEGO pieces to create meaningful structures Information model Archetype A Archetype B Ocean Informatics 2007

94 Composing the EHR Diabetic checkup Archetypes FH Antenatal visit Weight BP HbA1c Issues Assess Ocean Informatics 2007

95 Composing the EHR Diabetic checkup Tingling feet Feeling tired Archetypes FH Weight Antenatal visit BP HbA1c Issues Assess Ocean Informatics 2007

96 Composing the EHR Diabetic checkup Tingling feet Feeling tired 76 kg Archetypes FH Weight BP Antenatal visit HbA1c Issues Assess Ocean Informatics 2007

97 Composing the EHR Diabetic checkup Tingling feet Feeling tired 76 kg 124/92 Archetypes FH Weight BP HbA1c Antenatal visit Issues Assess Ocean Informatics 2007

98 Composing the EHR Diabetic checkup Tingling feet Feeling tired 76 kg 124/92 7.5% Archetypes FH Weight BP HbA1c Issues Antenatal visit Assess Ocean Informatics 2007

99 Composing the EHR Diabetic checkup Tingling feet Feeling tired 76 kg 124/92 7.5% Excellent control Archetypes FH Weight BP HbA1c Issues Assess Antenatal visit Ocean Informatics 2007

100 Composing the EHR Diabetic checkup Tingling feet Feeling tired 76 kg 124/92 7.5% Excellent control Archetypes FH Weight BP HbA1c Issues Assess Antenatal visit Back pain 66 kg 102/64 mmhg 142/min NAD, see 4/52 Ocean Informatics 2007

101 What else do we need Health Common Services Repositories: 32 I.TC

102 What else do we need OpenEHR Health plus EuroRec and its National ProRec centers 32 Common Services Repositories: archetypes templates coding systems protocols / clinical pathways persons, organisations... Quality Assurance: requirements tests test procedures certification procedures... I.TC

103 What is openehr? Ocean Informatics 2007

104 What is openehr? An open EHR technical specification Based on research and implementation experience Software engineering methodology Single schema (lingua franca for ehealth) Separate clinical specifications Archetypes, templates, terminology Clinically driven Implementation Straight forward Deployment is independent of clinical specifications Semantic queries based on archetypes Ocean Informatics 2007

105 openehr & Ocean Multi-lingual by design Archetypes All tools Web service based Rather than messaging Path to any document, item or value Full distributed versioning A flexible way of mapping legacy data into a proper EHR (integration archetypes) A growing and active community, with multiple implementations already underway Ocean Informatics 2007

106 The openehr Foundation UK Charity based at UCL Ocean and UCL are joint share-holders Appoint Architecture review board Clinical review board Licence and manage shared IP Open source tools Non-proprietary and freely available specifications? Manage Archetypes Research collaboration and openehr laboratory? Compliance testing Ocean Informatics 2007

107 Ocean Informatics 2007

108 Initial stages openehr Archetypes - standardised clinical content Australian NEHTA clinical information project NHS England and Wales archetype based clinical specifications NHS Scotland archetype based clinical specifications Denmark reviewing Ocean tools and openehr approach Chile Agreed to support from Australian organisations to implement openehr Ocean Informatics 2007

109 Initial stages openehr Archetypes - standardised clinical content Archetypes + HL7 version 2 messages Standards Australia Emerging implementations (Aus) Ocean Informatics 2007

110 Initial stages openehr Archetypes - standardised clinical content Archetypes + HL7 version 2 messages Systems based on openehr Regional shared EHR (Ocean EhrBank) Hospital (Tepe Technology) Primary care (PEN, Infotech) Home care, Personal Health Record (Vivici) Ocean Informatics 2007

111 Initial stages openehr Archetypes - standardised clinical content Archetypes + HL7 version 2 messages Systems based on openehr Next steps Ocean Informatics 2007

112 Initial stages openehr Archetypes - standardised clinical content Archetypes + HL7 version 2 messages Systems based on openehr Next steps EHR services National/Regional services EHR banks (for personal health records) Hand-held EHR Ocean Informatics 2007

113 Initial stages openehr Archetypes - standardised clinical content Archetypes + HL7 version 2 messages Systems based on openehr Next steps EHR services The semantically computable EHR Decision and guideline support Remote care and telemedicine support Integrated personal portal Targeted ethical advertising & risk assessment Ocean Informatics 2007

114 Initial stages openehr Archetypes - standardised clinical content Archetypes + HL7 version 2 messages Systems based on openehr Next steps EHR services The semantically computable EHR EHR data standard Standardised EHR extracts Standardised queries Standardised service interface Ocean Informatics 2007

115 The role of openehr LSP NW&WM LSP NE LSP Eastern LSP London Whittington LSP Southern Royal Marsden Hospitals Mental health Lawson Practice General practice Ocean Informatics 2007

116 The role of openehr LSP NW&WM LSP NE LSP Eastern LSP Southern LSP London Shared EHR Royal Marsden Whittington Hospitals Mental health Lawson Practice General practice Ocean Informatics 2007

117 The role of openehr LSP NW&WM LSP NE LSP Eastern Spine LSP Southern LSP London Ocean Informatics 2007

118 The role of openehr LSP NW&WM LSP NE LSP Eastern Spine LSP Southern Record location Record update Cache Authorisation LSP London Ocean Informatics 2007

119 Smart company Ocean Informatics Engineering base 6 doctors with IT qualifications 15 staff Established 1996 Based in Australia and UK Largely R&D until 2007 Now contracting directly to supply product and services Consulting and tools for NHS England, Scotland OceanEHR services being installed Ocean Informatics 2007

120 Electronic Record Company BV a Dutch limited representing Ocean Informatics Distributor for Europe and the Middle East Looking for co-operation with: - National projects - European projects - local resellers - local ICT-industry providing EHR functionality Active this year in: - NL, BE, IR, SK, CK, SE -?Pl,?RO,... 47

121 Ocean Customers AMP (Insurance and Finance) Software NEHTA (National Agency) Consultancy General Practice Computing Group (National agency) Software Consultancy Veteran Health Affairs (Large provider) Consultancy TNO (National research Agency) Software Consultancy CfH (National health agency) Consultancy Training Copenhagen Hospitals (Regional health authority) Training Software Ocean Informatics 2007

122 Ocean Customers Queensland Health (Regional Agency) Consultancy Healthcare Professionals (openehr Training) Australia PEN Computing Tepe Technology (Hospital Systems) Consultancy Software (Primary care) Software Ocean Informatics 2007

123 Ocean Ocean Informatics 2007

124 Ocean We are the lead international experts on: openehr specifications and implementation Clinical content representation Archetype development Products Terminology (SNOMED-CT) EhrBank, EhrGate, EhrView, EhrQuery Archetype tools, Template Tools, GUI support Archetype enabled terminology server Archetype repository Govern openehr with UCL Ocean Informatics 2007

125 Ocean s openehr Environment Ocean Informatics 2007

126 Ocean s openehr Environment Digital repository PACS EhrBank Demographic service Ocean Informatics 2007

127 Ocean s openehr Environment Application Digital repository PACS EhrBank Demographic service Ocean Informatics 2007

128 Ocean s openehr Environment Application Digital repository PACS EhrBank Demographic service Ocean Informatics 2007

129 Ocean s openehr Environment Application Decision support EhrGate (Virtual EHR) Composer (Kernel) Query engine Work flow Digital repository PACS EhrBank Demographic service Ocean Informatics 2007

130 Ocean s openehr Environment Application Decision support EhrGate (Virtual EHR) Composer (Kernel) Query engine Work flow Digital repository PACS EhrBank Demographic service Ocean Informatics 2007

131 Ocean s openehr Environment Application EhrView Decision support EhrGate (Virtual EHR) Composer (Kernel) Query engine Work flow Digital repository PACS EhrBank Demographic service Ocean Informatics 2007

132 Ocean s openehr Environment Application EhrView Decision support EhrGate (Virtual EHR) Composer (Kernel) Query engine Work flow Digital repository PACS EhrBank Demographic service Ocean Informatics 2007

133 Ocean s openehr Environment Application EhrView EhrScribe Decision support EhrGate (Virtual EHR) Composer (Kernel) Query engine Work flow Digital repository PACS EhrBank Demographic service Ocean Informatics 2007

134 Ocean s openehr Environment Application EhrView EhrScribe Decision support EhrGate (Virtual EHR) Composer (Kernel) Query engine Work flow Digital repository PACS EhrBank Demographic service Ocean Informatics 2007

135 Ocean s openehr Environment Application EhrView EhrScribe Decision support EhrGate (Virtual EHR) Composer (Kernel) Query engine Work flow Digital repository PACS EhrBank Demographic service Terminology Service Ocean Informatics 2007

136 Ocean s openehr Environment Application Decision support EhrView Composer (Kernel) EhrScribe EhrGate (Virtual EHR) Query engine Work flow Archetypes Digital repository PACS EhrBank Demographic service Terminology Service Ocean Informatics 2007

137 Ocean s openehr Environment Application Decision support EhrView Composer (Kernel) EhrScribe EhrGate (Virtual EHR) Query engine Work flow Archetypes Digital repository PACS EhrBank Demographic service Terminology Service Ocean Informatics 2007

138 Ocean s openehr Environment Application Decision support EhrView Composer (Kernel) EhrScribe EhrGate (Virtual EHR) Query engine Work flow Archetypes Editor Digital repository PACS EhrBank Demographic service Terminology Service Ocean Informatics 2007

139 Ocean s openehr Environment Application Decision support EhrView Composer (Kernel) EhrScribe EhrGate (Virtual EHR) Query engine Work flow Archetypes Editor Digital repository PACS EhrBank Demographic service Terminology Service Ocean Informatics 2007

140 Ocean s openehr Environment Application Decision support EhrView Composer (Kernel) EhrScribe EhrGate (Virtual EHR) Query engine Work flow Archetypes Editor Workbench Digital repository PACS EhrBank Demographic service Terminology Service Ocean Informatics 2007

141 Ocean s openehr Environment Application Decision support EhrView Composer (Kernel) EhrScribe EhrGate (Virtual EHR) Query engine Work flow Archetypes Editor Workbench Digital repository PACS EhrBank Demographic service Terminology Service Ocean Informatics 2007

142 Ocean s openehr Environment Application Decision support EhrView Composer (Kernel) EhrScribe EhrGate (Virtual EHR) Query engine Work flow Archetypes Editor Workbench Digital repository PACS EhrBank Demographic service Terminology Service Archetype repository Ocean Informatics 2007

143 Ocean s openehr Environment Application Decision support EhrView Composer (Kernel) EhrScribe EhrGate (Virtual EHR) Query engine Work flow Archetypes Editor Workbench Digital repository PACS EhrBank Demographic service Terminology Service Archetype repository Ocean Informatics 2007

144 Ocean s openehr Environment Application Decision support EhrView Composer (Kernel) EhrScribe EhrGate (Virtual EHR) Query engine Work flow Archetypes Editor Workbench Digital repository PACS EhrBank Demographic service Terminology Service Archetype repository Ocean Informatics 2007

145 Ocean s openehr Environment Decision support Application EhrView Composer (Kernel) EhrScribe EhrGate (Virtual EHR) Query engine Work flow Template Tool Archetypes Editor Workbench Digital repository PACS EhrBank Demographic service Terminology Service Archetype repository Ocean Informatics 2007

146 Ocean s openehr Environment Decision support Application EhrView Composer (Kernel) EhrScribe EhrGate (Virtual EHR) Query engine Work flow Template Tool Archetypes Editor Workbench Digital repository PACS EhrBank Demographic service Terminology Service Archetype repository Ocean Informatics 2007

147 Ocean s openehr Environment Decision support Application EhrView Composer (Kernel) EhrScribe EhrGate (Virtual EHR) Query engine Work flow Template Tool Archetypes Editor Workbench Digital repository PACS EhrBank Demographic service Terminology Service Archetype repository Ocean Informatics 2007

148 Ocean s openehr Environment Decision support Application EhrView Composer (Kernel) EhrScribe EhrGate (Virtual EHR) Query engine Work flow Template Tool Archetypes Editor Workbench Digital repository PACS EhrBank Demographic service Terminology Service Archetype repository EhrBank Ocean Informatics 2007

149 Ocean s openehr Environment Decision support Application EhrView Composer (Kernel) EhrScribe EhrGate (Virtual EHR) Query engine Work flow Template Tool Archetypes Editor Workbench Digital repository PACS EhrBank Demographic service Terminology Service Archetype repository EhrHub (federator) EhrBank Ocean Informatics 2007

150 Ocean s openehr Environment Decision support Application EhrView Composer (Kernel) EhrScribe EhrGate (Virtual EHR) Query engine Work flow Template Tool Archetypes Editor Workbench Digital repository PACS EhrBank Demographic service Terminology Service Archetype repository EhrAdaptor Data transformation EhrHub (federator) EhrBank Ocean Informatics 2007

151 Ocean s openehr Environment Decision support Application EhrView Composer (Kernel) EhrScribe EhrGate (Virtual EHR) Query engine Work flow Template Tool Archetypes Editor Workbench Digital repository PACS EhrBank Demographic service Terminology Service Archetype repository EhrAdaptor Data transformation EhrHub (federator) EhrBank LifeKey Hand-held Ocean Informatics 2007

152 Ocean Partnerships Ocean Informatics 2007

153 Vivici Netherlands Clinician interaction Web prescribing Telemedicine Shared EHR Ocean Partnerships Home and longterm care Ocean Informatics 2007

154 Ocean Partnerships Vivici Netherlands Clinician interaction Web prescribing Telemedicine Shared EHR PEN Australia Aboriginal Health Services Standardised EHR Infotech Netherlands Application services Standardised EHR Home and longterm care Primary care Ocean Informatics 2007

155 Ocean Partnerships Vivici Netherlands Clinician interaction Web prescribing Telemedicine Shared EHR PEN Australia Aboriginal Health Services Standardised EHR Infotech Netherlands Application services Standardised EHR Tepe Technology Turkey Hospitals in various countries Workflow management Standardised EHR EDS United States 10 yr contract with Vet. Affairs Standardised EHR Home and longterm care Primary care Hospital care Ocean Informatics 2007

156 Ocean Partnerships Vivici Netherlands Clinician interaction Web prescribing Telemedicine Shared EHR PEN Australia Aboriginal Health Services Standardised EHR Infotech Netherlands Application services Standardised EHR Tepe Technology Turkey Hospitals in various countries Workflow management Standardised EHR EDS United States 10 yr contract with Vet. Affairs Standardised EHR? Home and longterm care Primary care Hospital care National/Regional care Ocean Informatics 2007

157 University College London, UK openehr partnership CEN Standardisation lead Central Queensland University, Australia Archetype repository design Nursing archetypes lead Linköping University, Sweden Archetype editor collaboration EhrBank support for geo-mapping University of South Australia PhD program, Masters program Mayo Clinic, USA Academic partnerships Natural language processing, Ontology Ocean Informatics 2007

158 Summary the Next Generation EHR Ocean Informatics 2007

159 Summary the Next Generation EHR European standard plays a specific role in legislation and procurement Ocean Informatics 2007

160 Summary the Next Generation EHR European standard plays a specific role in legislation and procurement A European EHR standard exists Ocean Informatics 2007

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162 Summary the Next Generation EHR European standard plays a specific role in legislation and procurement A European EHR standard exists An implementable specification has been produced by OpenEHR Ocean Informatics is the first commercial high quality and performant OEM Product Suite Ocean Informatics 2007

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164 Summary the Next Generation EHR European standard plays a specific role in legislation and procurement A European EHR standard exists An implementable specification has been produced by OpenEHR Ocean Informatics is the first commercial high quality and performant OEM Product Suite ICT-vendors can build and maintain EHR-systems at substantial reduced cost ICT-vendors can integrate existing exchange formats: Edifact, HL7v2, HL7v3 CDA,...) Ocean Informatics 2007

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166 Summary the Next Generation EHR Ocean Informatics: makes innovation in healthcare possible makes secondary re-use of EHR data and information possible (research, public health,...) makes the next generation EHR possible Ocean Informatics 2007

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