Ocean Informatics and the UK NHS – Making Archetypes Really Work?

Dr Ognian Pishev of Ocean Informatics sent me this press release a few days ago.

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Ocean Informatics (Australia) Provides Clinical Content

Modelling Services to the NHS

Ocean Informatics (3 December, Sydney, Australia), a recognised leader in e-health strategy, interoperability and shared electronic health records (EHR), announces a new project with the National Health Service (NHS) in the United Kingdom.

The new project follows the successful completion of a pilot study, which tested content modelling as a technique for producing standardised structured clinical data specifications. NHS Connecting for Health (NHS CFH) has decided to continue to use the Ocean clinical modelling tools and openEHR archetypes and templates to help specify the information required to support safe and high quality health care across clinical systems in England. It is expected that over the next 6-9 months a national content models repository will evolve to provide significant support for the NHS in the specification of standardised content for clinical systems.

Using one of openEHR's key innovations known as archetypes, Ocean has developed a single source semantic modelling capability from which templates, forms, queries and other artefacts can be derived, significantly reducing work effort. openEHR archetypes and templates, being independent of the software, provide a basis for future-proof systems. Along with the reference model, they form an expressive 'DNA' of the health computing environment, without which computers cannot safely process health data. The power of the approach is recognised globally, with the CEN and ISO-standardisation of the archetype language and model.

“The real advantage of the openEHR methodology is that the clinical models are in a form that clinicians can understand and relate to, whether these are doctors, nurses or physio-therapists and social workers.” said Dr. Sam Heard, CEO of Ocean. “These detailed and fully computable specifications can be used to build applications and messages in a way that ensures the information can be understood by the receiving system”.

Significant cost savings from single source content models

The knowledge tools from Ocean enable the development of clinical content which can be used in all levels of the EHR technology, including GUI, business logic, persistence, queries, messaging and documents. This leads to a significant reduction in work effort. For the first time, queries can be used longitudinally over health data, regardless of the original source system or format. The standardised approach raises the quality of shared specifications.

The use of archetypes by the NHS has proved productive and accessible, justifying continued use in some areas of clinical specification. Work is being undertaken to position archetypes in the general EHR specification work, and alignment with other established standards in the areas of user interface, messaging (e.g. HL7 V3), clinical documents (e.g. CDA), and terminology binding (particularly SNOMED CT).

About NHS Connecting for Health

NHS Connecting for Health, which came into operation on 1 April 2005, is an agency of the UK Department of Health. NHS CFH supports the NHS to deliver better, safer care to patients, via new computer systems and services, that link GPs and community services to hospitals, and to maintain the national critical business systems previously provided by the former NHS Information Authority.

Accurate information is crucial if patients are to have choice and receive the right care at the right time. A key aim of the National Programme for IT in the NHS is to give healthcare professionals access to patient information safely, securely and easily, whenever and wherever it is needed.

The National Programme for IT is creating a multi­billion pound infrastructure, which will improve patient care by enabling clinicians and other NHS staff to increase their efficiency and effectiveness.

About Ocean Informatics

Ocean Informatics (Australia) is a leader in e-health strategy, semantic interoperability and shared EHR solutions. It has some of the most experienced clinical and technical experts in the health informatics domain, and a long history of involvement in e-health projects (in Australia and internationally), standards development (ISO, HL7, CEN, Standards Australia), and systems and tool implementation. Along with University College London, Ocean is one of the founding partners of the openEHR Foundation. openEHR is the first health computing platform to offer semantic integration of the GUI, persistence and querying, a powerful basis for higher level health computing including cross-enterprise workflow, decision support and medical research.

For background information, please visit www.oceaninformatics.com or contact Dr. Ognian Pishev, Ocean Informatics, Phone: 61295570352 Mobile 61431039291, ognian.pishev@oceaninformatics.com

Links:

NHS Clinical Models

Ocean Informatics

openEHR

NHS Connecting for Health

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While this is a press release with the usual marketing ‘hype’ contained within it, it seems to me what is being done here is potentially very important.

Essentially what is planned is that use of the Ocean approach to clinical content modeling (based on archetypes and other openEHR attributes) will allow for standardized sharable clinical content to be defined and then those information specifications be further developed and deployed – presumably on the NHS “spine” to enable basic clinical information system interoperation within the NHS.

No one should underestimate the importance, scale and complexity of this undertaking!

There is clearly an large amount of work to be done in identifying the clinical information that needs to be defined and how the archetype related work will interact with SNOMED CT and HL7 V3 which have already been adopted by the NHS.

The NHS Clinical Models site is well worth a visit to appreciate, first hand, what is being attempted here. It is a bit of a pity so many of the links currently (Dec 9, 2007) seem to be broken.

I look forward, with interest, to seeing more details of the progress of this work over the next year and to understand how this work might assist other nations who are wrestling with similar problems in their own e-Health initiatives.

David.