I’m doing some analysis around Genomics Order Entry Forms to be used to send a order to a (regional) Genomic Laboratory Hub (LIMS). It looks as though on the wire this is going to HL7 v2 ORM.
A representation of this as a form would look something like this.
In openEHR would this be a template? I’ve found details on openEHR Genomic data but not not the order itself.
The reason I ask, is I don’t think I need to give the openEHR developer a traditional interface pipe+hat (i.e. the HL7 v2 ORM) to work with, I want to make it easier for them (and the other non openEHR systems).
If this concept is supported in openEHR, I can use FHIR Q+QR ‘Template’ as the API and I then do the conversion to HL7 v2 ORM (and eventual conversion to FHIR Message/Workflow for national system)
There’s a generic ‘service request’ archetype on CKM. https://ckm.openehr.org/ckm/archetypes/1013.1.614
It might fit your needs. But I suspect we would need to create a new genomic order archetype. Depending on the overlap with sevice request it might be a totally different instruction archetype or a cluster.
Either way you would create a template on the archetypes potentially with request for service as a composition Composition Archetype: Request for service [openEHR Clinical Knowledge Manager]
Or part of an encounter composition if other clinical data gets recorded at the same time.
@ian.mcnicoll and @videhasharma are also working on genomics. So might be worth getting there view.
Ps for openehr to FHIR. Are you familiar with openFHIR?
This is the model I’ve inferred from one providers EPIC and LIMS. Have included your link to service request (thanks).
I don’t think I will be able to turn the communication method from traditional exchange of data messaging (i.e. HL7 v2 ORM_O01) to a modern workflow orientated approach (which would bring in openFHIR, EPICs FHIR API and also FHIR Workflow).
Does this model match openEHR? @richard.kavanagh
This might get a bit complicated.
The problem I’m working on is LAB-1, the interaction between Order Placer and Order Filler, described in https://www.ihe.net/uploadedFiles/Documents/PaLM/IHE_PaLM_TF_Vol1.pdf
It might be easier to use IHE PALM as focus of this discussion as it is more business communication focused.
The problem I am likely to face is the national system is saying FHIR, what already is in place is a combination of IHE PALM and HL7 v2 OML/ORM. This is saying it is not HL7 FHIR at present (and neither openEHR).
As Joost has said, basically yes. In this case I would expect an openEHR template to underpin that from (assuming the ask was to store that request in an openEHR CDR, -perhaps prior to sending the request to the lab.
This is pretty close to the approach we are taking in a Genomic testing scenario we are working on in Belfast.
In your use -case, where does the openEHR-based system fit in -? is it making the request (and storing a copy) or receiving the request and storing the copy, or both.
I’ve created a template that, I think, matches your form requirements
https://tools.openehr.org/designer/#/viewer/shared/Pz9zaGFyZWRJZD0xJDZkMTA0NGRmZWVlODQ4NWM5YWNmYjJlODQ3NDU2MGI3
I’ll see if I can get that expressed as a FHIR Logical model and upload it to Simplifier.
Thanks Ian.
I think I need to dig into this some more. I think most of the content of that form is covered in a ServiceRequest (openEHR or FHIR).
NHS England is describing an Order Form concept (non WGS and presume WGS). I think this may describe the ‘Template’ better. I’ll do some digging into that.
Not sure what happens on the Better system prior to the order. I’m trying to understand this a bit more.
The normal approach would be to save the record of the order, obviously the final report, and also potentially interim status messages coming back from the lab.
1 Like
