# e-health services landscape - initial proposal, open forum
**Category:** [Technical (archive)](https://discourse.openehr.org/c/technical-archive/156)
**Created:** 2018-10-23 14:58 UTC
**Views:** 1
**Replies:** 9
**URL:** https://discourse.openehr.org/t/e-health-services-landscape-initial-proposal-open-forum/14393
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## Post #1 by @system
Every so often I get bored of what I am doing and start trying to draw one of those 'services roadmap' kind of diagrams. These often pretty pictures appear in slide presentations, in standards, whitepapers etc, but are not often used as a tool to help map out the road ahead. We do however need some sort of vision of the future for staking out new services. I like my latest version enough that I thought it would be worth putting up publicly to get reactions and input.
Please comment and/or add content to [the wiki page](https://openehr.atlassian.net/wiki/spaces/spec/pages/357957633/Services+Landscape+for+e-Health).
- thomas
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## Post #2 by @system
I miss lifestyle and sport\-services which are not explicitly problem related\. Maybe others have other suggestions, but I like to focus on these\. I think that is the near future, and not already planning them in will be a missed chance\. The meaning of the term Healthcare will change to its true meaning\. Care related to Health, not only illness\. Lifestyle data will be important, already now insurance companies are registering if customers smoke or do sport, and which sport\. Some people write down everything they eat\.
People use their smartphone to communicate and exchange information\. Interestingly, an increasing number of people collect health data on their smartphone such as information about their mood, activity level, nutrition or vital signs including blood pressure or blood glucose levels\. Medical research could greatly benefit from these ‘real life’ data\. I think OpenEhr must be prepared for this to come, give it room, embrace it\.
The same counts for archetypes, there are no archetypes on CKM which are fit to register these kind of things\.
I had this discussion already a few times on OpenEhr mailinglists, I only got laughters as reply, that is why I hesitate to discuss it here, but with this, I give it one more chance, just for fun, not expecting any serious result\.
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## Post #3 by @system
I do not see my message appear on the archive\. Maybe it has to do with formatting, I saw to late that there was quite some formatting in my previous message\. I try replying without formatting\.
Sorry if it will appear twice on the list\.
I miss lifestyle and sport\-services which are not explicitly problem related\. Maybe others have other suggestions, but I like to focus on these\. I think that is the near future, and not already planning them in will be a missed chance\. The meaning of the term Healthcare will change to its true meaning\. Care related to Health, not only illness\. Lifestyle data will be important, already now insurance companies are registering if customers smoke or do sport, and which sport\. Some people write down everything they eat\.
People use their smartphone to communicate and exchange information\. Interestingly, an increasing number of people collect health data on their smartphone such as information about their mood, activity level, nutrition or vital signs including blood pressure or blood glucose levels\. Medical research could greatly benefit from these ‘real life’ data\. I think OpenEhr must be prepared for this to come, give it room, embrace it\.
The same counts for archetypes, there are no archetypes on CKM which are fit to register these kind of things\.
I had this discussion already a few times on OpenEhr mailinglists, I only got laughters as reply, that is why I hesitate to discuss it here, but with this, I give it one more chance, just for fun, not expecting any serious result\.
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## Post #4 by @system
Hi Bert,
The only way archetypes get included in CKM is that someone builds them and offers them for sharing. And scope for all archetypes includes your use case of consumer entered data, where it is appropriate. So if something you need is not there please work actively with us to improve the situation.
I suggest that you propose candidate archetypes to CKM where they don’t exist or make change requests to existing ones where they need improvement.
Consider:
- Lifestyle factors - [https://ckm.openehr.org/ckm/#showArchetype_1013.1.1648](https://ckm.openehr.org/ckm/#showArchetype_1013.1.1648)
- Story/History - [https://ckm.openehr.org/ckm/#showArchetype_1013.1.68](https://ckm.openehr.org/ckm/#showArchetype_1013.1.68). Named ‘story’ precisely to be inclusive of consumer entered data.
- Goal - [https://ckm.openehr.org/ckm/#showArchetype_1013.1.124](https://ckm.openehr.org/ckm/#showArchetype_1013.1.124)
- Physical activity summary - [https://ckm.openehr.org/ckm/#showArchetype_1013.1.2877](https://ckm.openehr.org/ckm/#showArchetype_1013.1.2877)
- Tobacco smoking summary - [https://ckm.openehr.org/ckm/#showArchetype_1013.1.2466](https://ckm.openehr.org/ckm/#showArchetype_1013.1.2466)
- Smokeless tobacco summary - [https://ckm.openehr.org/ckm/#showArchetype_1013.1.2817](https://ckm.openehr.org/ckm/#showArchetype_1013.1.2817)
- Tobacco use - [https://ckm.openehr.org/ckm/#showArchetype_1013.1.1629](https://ckm.openehr.org/ckm/#showArchetype_1013.1.1629) – needs to be internalised from the old NEHTA CKM and updated with more recent patterns
- Alcohol consumption summary - [https://ckm.openehr.org/ckm/#showArchetype_1013.1.1521](https://ckm.openehr.org/ckm/#showArchetype_1013.1.1521)
- Alcohol intake [https://ckm.openehr.org/ckm/#showArchetype_1013.1.216](https://ckm.openehr.org/ckm/#showArchetype_1013.1.216) – also needs to be updated with more recent patterns
- Substance use – [https://ckm.openehr.org/ckm/#showArchetype_1013.1.146](https://ckm.openehr.org/ckm/#showArchetype_1013.1.146) - needs an update based on further requirements and finalisation of other OBS patters for tobacco and alcohol
- Food item - [https://ckm.openehr.org/ckm/#showArchetype_1013.1.1922](https://ckm.openehr.org/ckm/#showArchetype_1013.1.1922)
- Dietary nutrients - [https://ckm.openehr.org/ckm/#showArchetype_1013.1.2745](https://ckm.openehr.org/ckm/#showArchetype_1013.1.2745).
- Micronutrients - [https://ckm.openehr.org/ckm/#showArchetype_1013.1.2744](https://ckm.openehr.org/ckm/#showArchetype_1013.1.2744)
- Fetal movement - [https://ckm.openehr.org/ckm/#showArchetype_1013.1.216](https://ckm.openehr.org/ckm/#showArchetype_1013.1.216)
And all the others that are applicable across all domains…
- Story
- Body weight
- Height
- Waist circumference
- BMI
- Vital signs – Blood pressure, pulse, temperature
- Family History
- Problems
- Adverse reactions
- Menstrual cycle
They may not be ready for use out of the box for your purpose or published or covering all potential concepts, but there are a considerable number that are applicable for use by consumers and are not a bad starting point.
Kind regards
Heather
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## Post #5 by @system
Thanks for your advice, Heather. To be honest about this. The problem is that I did not study medical informatics, and I am not sure that archetypes I write will be regarded as good enough to stand in the showcase. I was hoping to get some interested to help with that, and then someone who is regarded as knowledgeable to get them in the place and keep them there. Because if that fails the work has been done in vain. And I have a busy life.
But that plan failed. So now plan B. I have found decent datamodels to register different kind of sportactivities, and the archetypes you list will certainly help. So maybe I give it a try and people will after reading this, judge my work mildly.
So thanks again, after my holiday (tomorrow I go), I will give it a try. I have already written quite a few archetypes, of reasonable quality, but of course not as matured as the good wines from CKM.
best regards
Bert
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## Post #6 by @system
I like the idea of some of the archetypes being compared to good wines 😊
Another alternative is to submit the requirements you have identified, maybe best by email to me, and we can see how we might best be able to support you. It might not be a rapid turn around, though. I think getting these archetypes into good shape would be useful to many app developers.
Would that be helpful to you?
Cheers
Heather
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## Post #7 by @system
That is very helpful. I think too that it will be beneficial for OpenEhr.
I will send you requirements within two weeks, and then we see where we go from there,
Thanks very much for helping
Bert
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## Post #8 by @system
As mentioned elsewhere, while I completely agree on the lifestyle / sports / wellness needs in the wider e-health context, at the moment I am not sure if special SOA services are needed or not, since these kinds of data can be committed to the EHR using the generic EHR service, just as for any other kind of data - it's just different archetypes. It may be that special services for e.g. performance tracking or whatever are needed, but for now I'm assuming all that stuff is done by applications, not services.
- thomas
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## Post #9 by @system
The reason I come to this is that services have a semantic meaning, also the patient summary has.
And trend is that data in an healthcare application tend to be first patient centric and than around that patient is a cloud of problems. I think there is more, for example lifestyle.
But I already repeated this many times, and I guess application developers will need to learn this the hard way. It is not just OpenEhr, it is just that I feel involved with OpenEhr.
Thank you for coming back to this, I will await further discussions.
Best regards
Bert
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## Post #10 by @system
A revised version of the services landscape is now [available here](https://openehr.atlassian.net/wiki/spaces/spec/pages/357957633/Services+Landscape+for+e-Health).
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**Canonical:** https://discourse.openehr.org/t/e-health-services-landscape-initial-proposal-open-forum/14393
**Original content:** https://discourse.openehr.org/t/e-health-services-landscape-initial-proposal-open-forum/14393