Tim,
By way of introduction my company Extensia arose as a spin-off out of
a Health informatics program at the DSTC CRC where work has been
undertaken with Ocean Informatics and others under DoHA and GPCG
sponsorship to scope, specify and enhance artifacts that became a
HealthConnect trial and through technology collaborations fed
concepts and techniques into the OpenEHR model during the startup
phases of OpenEHR. DSTC and Ocean collaborated to architect models
and solutions in recent years prior to each exploring separate
commercial paths.
During the last 2 years Extensia has developed a robust OpenEHR
records server based on the OpenEHR model and archetype aware tools
with a view to 'practical' use of the OpenEHR models. This has been
branded RecordPoint and is being used in Public Health enterprise and
GP Division for records repository and shared EHR. Built into this
is a security, privacy and consent model that was specified by a
community of GP's and health industry contributors to provide a
usable and useful interface to storing, presenting and retrieving
data. The server supports a web services interface, web browser
access and is able to import new archetypes online and interact with
them instantaneously. A built in wizard allows the archetypes to be
selected to create new compositions for clinical document
interaction. This has been available for some 18 months, has been
tested thoroughly, has performance benchmarks and is packaged as a
RecordPoint Server.
The OpenEHR approach does not derive its full benefit unless it is
used in an interoperable model and accordingly we have built tools to
support an ecosystem of components that allow an archetype driven
approach to health information sharing. Accordingly a number of
tools have been created to be used to interact with archetypes, embed
archetype aware code into other applications or develop new
applications using the tools. These include
- high level archetype objects for application programmers ( because
Archetypes can be very complex)
- Utilities for record display and editing
- archetype designers tools to create new archetypes for distribution
- record browser utility
- dll to run with Microsoft Access ( for those who must ) and .Net
applications
- .Net libraries
- web services interfaces.
- Prototype Ruby interface ( subject to a better serialization library )
These tools allow the Archetype artifact to be defined and used
throughout an Archetype Aware ecosystem with front end tools to
create client based archetype applications, tools to define new
archetypes and to store them in a highly scalable records server. In
essence to simplify and streamline a complex information model for
use at a clinical and applications programming level.
To some degree we have been in internal mode due to corporate
restructuring and a focus on current projects, so there has not been
much fanfare to date. Our efforts have been to embody much of this
into clinically friendly systems for shared record repositories and
portals. In the new year more market information will be forthcoming.
In short, technology based on the OpenEHR model is working, is
available, is in commercial use.
Mark Gibson
Extensia Solutions Pty Ltd
[EMAIL PROTECTED]
On 14/12/2006, at 7:49 AM, Tim Churches wrote:
David Guest wrote:
The data is identified as such and grouped in a hierarchy. But its
description and constraints are entirely open and undefined. I guess
its a useful lowest common denominator
Does anyone think openEHR will ever produce the goods?
There has been correspondence on the openhealth mailing list regarding
this issue recently. David More quipped about "geological timescales",
perhaps with some justification. To summarise and paraphrase
(accuratey
I hope) the thread: the openEHR people assure us that several private
firms are using openEHR-based systems in deployed proprietary vertical
health apps, and that lots of profs and students in various
universities
are studying and tinkering with it. The openEHR specifications have
been
accepted as a proposed standard (but not ratified or approved as a
standard as yet). Furthermore, Ocean Informatics and the openEHR
Foundation are themselves working on a suite of tools which actually
implement the ideas behind openEHR, but these tools are in different
stages of completeness: tools to define and edit openEHR archetype
definitions are complete and available as open source. Tools to
actually
store and retrieve data using openEHR archetypes are at alpha or beta
stages in the openEHR secret laboratory, but have not been fully
tested
and are not ready for production use. Thomas Beale has offered
access to
an openEHR engine hosted in the Ocean Informatics labs, to be accessed
via a proprietary Web service interface requiring the use of a
Microsoft
C# .NET DLL on the client side, for capability-testing purposes by
interested parties (contact Thomas Beale at Ocean Informatics if
you are
interested). All these openEHR tools still under development may or
may
not be open sourced in the future - the Ocean Informatics and openEHR
people need to investigate business models. Other parts of the openEHR
puzzle, such as a shared library of openEHR archetype definitions,
and a
full query language, are still on the drawing board or in only early
stages of implementation. Oh, there is also an open source version
of an
openEHR storage/retrieval kernel being written in Sweden, but it is
not
yet complete either.
I asked the same questions of the Ocean Informatics and openEHR people
in 2003, and after much email correspondence and head scratching, I
was
assured that usable, production-quality openEHR implementations
would be
available quite soon. The same assurances were given just a few weeks
ago. I conclude that they are indeed a bit further along now with
actual
implementation than they were three years ago, but still have quite a
way to go, but it is very hard to extrapolate the progress line to
divine when it might cross the V1.0 boundary, although the fact that
they were working on GEHR (the predecessor to openEHR) about 15 years
ago, and the openEHR has been going for nearly a decade might provide
some clues. Perhaps the remaining distance is being halved with every
passing year? Or perhaps I am just a cynical bastard?
Tim C
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