DIPS Arena New Archetype-based EHR Sigurd From, DIPS ASA
The largest EHR vendor in Norway Product areas Clinical Process Support - EHR Administative Process Support Medical Services & Integration Main offive in Bodø (130 employees) > 25 years with knowledge in health informatics - ICT background - Healthcare background Tromsø (26 employees) DIPS ASA 200 employees Trondheim (8 employees) Cover hospitals in 3 of 4 Norwegian Healthcare Regions, Public and private Oslo (32 emplyees) Revenue 2012: 229 MNOK
History of DIPS The first version of DIPS was created at the Hospital in Bodø in 1987 The EHR solution was further developed for internal use at the hospital. Then delivered to other hospitals in Norway. In 1997 DIPS ASA was founded as a company In 1999 DIPS was delivered as the first EHR in Norway on the Windows platform Since 2000 DIPS ASA has grown from the smallest to the largest EHR vendor in Norway
DIPS Classic ca. 500 features/functions 7,5 millions line of code Windows based First versjon in 1999 62 000 users Critical to many hospital operations
Todays Market Situation Region Mid-Norway Oslo University Hospital
Next important delivery: Oslo University Hospital
DIPS Arena - Our new EHR
DIPS Arena - Objectives 1 2 3 A dynamically structured patient record based on archetypes and templates A consistent process-support in line with clinical and administrative needs A frictionless, fast and fluid user experience across devices
We must do it smart DIPS Arena will not be a copy of DIPS Classic We try to think smart and find better ways to handle the needs and requirements Making it a better solution for clinicians Better overview Process support Decision support through guidelines The capacity to develop (and maintain) software is limited At the same time the requirements and complexity is growing We must find more sustainable ways of developing DIPS One initiative is to do Model Driven Engineering
DIPS Arena - Model driven development Users Variables, archetypes and terminology Templates Process templates and clinical pathways Authorization templates and mandates Instanciate and use Domain experts modellerer Date content User Interface Work processes Security Model driven Creator A stable /well defined core Services and interfaces Referencemodels Standards Database schemas OpenEHR Two-level Modelling Core development Team
openehr
openehr models Archetype Query Language Terminology Subset Syntax RM SM EHR Security EHR Extract Demographic virtual EHR { } { domain patterns{ core{ terminology service Composition demographic service Integration Common Data Structures Data Types EHR service Support (identifiers, terminology access) archetype service Template OM openehr Archetype Profile Archetype OM AM Source: Rong Chen, Guest lecture at UiT, IFI, June 2008. Two level modelling and futureproof information system
System architecture
Service-Orientation (SOA) An architecture pattern based on loosely coupled, reusable and autonomous units-of-functionality ( services ) integrated using well defined and standardized interfaces ( API ), independent of any particular product or technology
DIPS Arena - Architecture Arena Desktop Client Client Components Arena Mobile Client Application Services DIPS Integration Services Context Manager Third Party Systems Clinical Systems Laboratory Systems Radiology Systems DIPS Cross Enterprise Integration Services Communicator Interactor Health Record Panorama Message Broker PACS Medication Service Broker Enterprise Services National Services Oracle RDBMS Storage Services Apache Solr Reporting Services Oracle BI/RDBMS Support Systems Medical Devices
Architecture of DIPS Health Record Apps Arena Apps Arena Apps Arena Apps Arena Apps Arena Apps EPJ/PAS AQL A B Application Service Interfaces Document Services vehr Services Ehr Query Form Health Record Search Compos ition Template DIPSDB ARCHETYPEDB Oracle DB Solr
Implementation in DIPS Arena
DIPS Arena: New desktop
Activating one patient
Overview of active contact for one patient
Archetype: Blood pressure An archetype is a model of a specific (clinical) concepts, covering all imaginable uses of that archetype An archetype consists of data elements and/or other archetypes
Archetype, Template and User Interface Arketype Template - OPT User Interface
Visualisation of data from an archetype query
Clinical Workflow The OpenEHR Domain Model is focused around a generic clinical workflow Published knowledge Personal experience Evaluations Observations Patient Archetypes Investigator Instructions Actions Templates Documents Patient Record Investigator agents
Example of Instructions and Actions
Archetype infrastructure
Archetype distribution CKM
Admin for archetypes in DIPS Arena
Admin of templates
Architecture of DIPS Health Record Apps Arena Apps Arena Apps Arena Apps Arena Apps Arena Apps EPJ/PAS AQL A B Application Service Interfaces Document Services vehr Services Ehr Query Form Health Record Search Compos ition Template DIPSDB ARCHETYPEDB Oracle DB Solr
Further development AQL support General form renderer Archetype, template and form tools GDL support
Integration between systems Msg Register AT AT Public actor CKM AT AT AT AT Hospital 1 Msg Msg Hospital 2