Chinese COVID-19 Diagnosis and Treatment Decision Support: openEHR Templates and Rules

Dear Colleagues,

On behalf of all the members of Xudong’s @lvxd team, I’m pleased to share our GDL rules and related archetypes regarding the Chinese COVID-19 Guideline. The files are now available on GitHub (https://github.com/ZJU-BME-VICO/openEHR-COVID-19). Everyone is encouraged to test, use, fork, and feedback on the rules and archetypes freely.

In China, COVID-19 broke out in December 2019 and has been under control for a couple of weeks. Of all the 81093 patients, 72703 are already fully recovered and reunion with their families. This achievement is significant, and the experiences leading to it are worth sharing with the world. Some researchers are already working on translating the Chinese guidelines to English and Persian (probably other languages as well) to facilitate the sharing among care-givers. We, as informaticists, believe taking advantage of the open standard (i.e., openEHR) and a formal guideline language (GDL2 in this case) would not only accelerate the sharing process globally but also reduce the ambiguity in the narrative texts.

Since our primary goal is supporting the diagnosis and treatment, the archetypes and GDL rules are adopted from the diagnosis and treatment part of the Chinese guideline. The data elements and rules in the rest parts of the guideline are out of our scope. The GDL rules are authored and validated by the GDL2 Editor. Detailed instructions are available in GitHub.

To demonstrate how the rules can be used in clinical decision support applications, we are developing a demo. Since we didn’t manage to find a dedicated open-source GDL2 execution engine, we choose a quick and dirty solution - translating GDL2 to Drools and using the Drools rule engine. The related Java data model and the Drools rules are also available in our GitHub project. To talk about the positive side, we hope this additional work will attract those non-hard-core openEHR users to use our GDL rules.

At this moment, we are working on adapting the archetypes and rules to the latest edition of the Chinese guideline (i.e., 7th edition). In the meantime, we are also improving the demo application by adding a data entry user interface automatically generated from the openEHR template.

Heather @heather.leslie has been helping us with modeling for a couple of weeks. While we sincerely thank her for her time and efforts, we are now calling broader help (esp. from clinicians, experienced modelers, and GDL experts) to review, test, and comment on our archetypes and rules.

May our joint efforts accelerate the winning of the global battle against the virus.

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This work is progressing - you can see some of the evolving archetypes being added to the COVID-19 project. We have meetings this week and hope that we can share more with you soon.

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You can now view the latest draft of this template on CKM - https://ckm.openehr.org/ckm/templates/1013.26.291.

Congrats to @lvxd and his team for this work. As per the metadata in the template, the purpose: "The template is developed to promote interoperability among systems for the diagnosis and treatment of COVID-19. The data points included in the template were abstracted from the 7th version of Diagnosis and Treatment Guideline of COVID-19 released by the National Health Commission of the People’s Republic of China (Printed and distributed on March 3, 2020), the translated English version can be found in https://www.chinalawtranslate.com/en/coronavirus-treatment-plan-7/."

Great to see this collaboration being shared.

I expect that we will see more updates as the CDS side of the implementation evolves using GDL.

Regards

Heather

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Thanks Heather very for helping us to fix many bugs in our rough draft version template and finally achieve the more perfect version now. We are sill working on it and confirming detailed information with doctors . If anyone feel interested in this work, please give your comments, any ideas are welcome and appreciated.

Regards
Xudong

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Thank you for sharing this template. I’m really interested in how it’s used in practice. It appears to be oriented at hospital care, right? And it appears to be intended to be updated frequently when new data comes in right? But there are also elements that reflect a daily progress note, but not enough to assume it’s the only progress note for covid patients. Or is this template mainly used for research purposes and is record keeping for daily medical care being done in a different record? I’m very curious to learn more.