Role of OpenEHR as an open source solution for the regional modelling of patient data in obstetrics

Abstract

This work investigates, whether openEHR with its reference model, archetypes and templates is suitable for the digital representation of demographic as well as clinical data. Moreover, it elaborates openEHR as a tool for modelling Hospital Information Systems on a regional level based on a national logical infrastructure. OpenEHR is a dual model approach developed for the modelling of Hospital Information Systems enabling semantic interoperability. A holistic solution to this represents the use of dual model based Electronic Healthcare Record systems. Modelling data in the field of obstetrics is a challenge, since different regions demand locally specific information for the process of treatment. Smaller health units in developing countries like Brazil or Malaysia, which until recently handled automatable processes like the storage of sensitive patient data in paper form, start organizational reconstruction processes. This archetype proof-of-concept investigation has tried out some elements of the openEHR methodology in cooperation with a health unit in Colombo, Brazil. Two legal forms provided by the Brazilian Ministry of Health have been analyzed and classified into demographic and clinical data. LinkEHR-Ed editor was used to read, edit and create archetypes. Results show that 33 clinical and demographic concepts, which are necessary to cover data demanded by the Unified National Health System, were identified. Out of the concepts 61% were reused and 39% modified to cover domain requirements. The detailed process of reuse, modification and creation of archetypes is shown. We conclude that, although a major part of demographic and clinical patient data were already represented by existing archetypes, a significant part required major modifications. In this study openEHR proved to be a highly suitable tool in the modelling of complex health data. In combination with LinkEHR-Ed software it offers user-friendly and highly applicable tools, although the complexity built by the vast specifications requires expert networks to define generally excepted clinical models. Finally, this project has pointed out main benefits enclosing high coverage of obstetrics data on the Clinical Knowledge Manager, simple modelling, and wide network and support using openEHR. Moreover, barriers described are enclosing the allocation of clinical content to respective archetypes, as well as stagnant adaption of changes on the Clinical Knowledge Manager leading to redundant efforts in data contribution that need to be addressed in future works.

Design of automatic transabdominal ultrasound imaging system

“…Furthermore, these parameters were implemented into the microcontroller in order to enable the scan of total cervical area. These data can get integrated into health information systems and support patient care [38].…”

An openEHR Approach to Detailed Clinical Model Development: Tobacco Smoking Summary Archetype as a Case Study

“…Published DCMs are subject to continuous review and maintenance, and, if need be, further adaptation to meet evershifting health information requirements to address grand health care challenges. 2,9,11 Having well-defined, shared, and computable models of clinical concepts in the form of DCMS (such as the Tobacco Smoking Summary archetype) is key to the development of HIT systems to support health care systems and professionals to address the rising burden of disease. As all health care professionals have a story to tell, the ability to aggregate their knowledge and experience into a DCM not only ensures the success of the developed HIT system but allows us to gain a better understanding of the health care landscape that surrounds us and therefore a clearer direction as to how we should progress.…”

“…The second level comprises archetypes and templates, which use RM as building blocks to define reusable clinical content such as blood pressure measurements or laboratory results. [10][11][12] The openEHR template is a logical representation of case-specific datasets that bring together and further constrain archetypes such as a discharge summary or pathology report. 10 In MDD methodology, the term model refers to visual representations of simplified abstractions, each one specifying a different view of a complex domain, and software code can be automatically generated from these models in software development.…”

Health Information Exchange for Continuity of Maternal and Neonatal Care Supporting: A Proof-of-Concept Based on ISO Standard

“…34 Previous experience reported in Brazil had an objective to find and adapt archetypes required to represent the obstetric data required by a health service. 46 The study highlighted the complexity in modeling obstetric data, considering the variations in obstetric care for different regions of the country, and peculiar obstetrics characteristics that go beyond the usual models for electronic medical records. 46…”