openEHR COVID-19 Project

That’s a great summary of the amazing progress made but much more importantly validation that this work was worthwhile. As you know, whilst the idea of an inpatient admission triage seemed sensible, we were all a little anxious that it might not turn out to have real value but simply add to the documentation burden of already hard pressed staff. I’m delighted therefore that your hunch was correct and this will have a very positive effect on others who not unreasonably did wonder about the value.

I will work further on a new version of the screening template to reflect changes in UK advice, some good ideas from the Australian screening form and possibly some more snomed coding.

It woukd be great to hear an update from anyone else developing apps based on the template even if they have made local adjustments.

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9 posts were split to a new topic: AQL issues and the Health risk archetype

There probably is something here worth doing but it is going to be tricky to identify a core set of measures that can be agreed and do not collide too much with an existing EPR.

One approach might be to modularise things such that small parts (embedded templates) can be reused by multiple implementers but with something more like an exemplar template which is itself less likely to be actually deployed other than in clean-room scenarios.

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Hi all,

You may have noticed that in the last couple of hours @siljelb and I, as co-leads for the clinical modelling program and responsible for the governance of the CKM, have created a COVID-19 project (https://ckm.openehr.org/ckm/projects/1013.30.81) to complement the existing COVID-19 incubator (https://ckm.openehr.org/ckm/incubators/1013.30.80).

Please note: the existing incubator was previously named ‘COVID-19 project’ which may have been somewhat ambiguous and confusing.

This is to facilitate appropriate governance for the archetypes and templates as we respond to the COVID-19 crisis, as well as to provide some useful insight into data models contained within each.

For those of you not aware, the incubators operate as development and collaboration ‘sandpits’. Owners and members operate autonomously and can upload, modify and delete to suit their purposes.

On the other hand projects are tightly governed, meaning that only archetypes and templates that are have the potential (as determined by Editors and the Clinical Knowledge Administrators) to go through a peer review process and be published are uploaded to a project. Of course, in the review process there may always be situations where major changes are required or the draft archetypes may be deemed totally unsuitable and be rejected, but the intent in archetype design within projects is to create a model/pattern that will be broadly reusable beyond a single use case or data set.

In this specific case, we are acutely aware of the agile processes that were involved in the initiation of the COVID-19 work. Some initial work has been deliberately pragmatically ‘quick and dirty’ in order to get initial drafts kicked off - this was absolutely necessary at the time and invaluable as the foundation for further work to build upon. However, as time has progressed and a broader variety of use cases become evident, we have also been able to identify some reusable patterns that were not obvious in the first or second requirement documents/packages.

In the spirit of CKM transparency, location of an archetype or template within an incubator or project will provide some insight to system developers and implementers about the design intent by the model author. Of course, as incubator models become more refined and mature, then they can always be ‘promoted’ by Editors transferring them into a governed project. Similarly a whole incubator may be ‘promoted’ to a governed project.

However, critically, implementers also need to understand that being an ‘early implementer’ of data set from an incubator may be a two-edged sword with the risk of inherent technical debt. Just as any artefact within CKM with a draft status may evolve and be refined through the review process, incubator assets may also be totally incompatible with the CKM priority of creating a coherent international ecosystem of archetypes and may never have a forward path into the governed projects.

I hope this provides some clarity about the reasoning for both the COVID-19 project and incubator. It is our hope that we can continue to refine most of the work contained in the incubator and promote it to the project over time, but there are no guarantees, especially at this early stage.

@siljelb and I will do all we can to support this international effort from a governance point of view, and to complement the innovation and global leadership being demonstrated by our CKM community.

Thanks+++ to all who are actively involved, and we wish you and your families good health and safety during these difficult days. You are making an important difference :pray:

Kind regards

Heather

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2 posts were merged into an existing topic: Archetype specialisation and tooling issues

12 posts were split to a new topic: Dutch COVID-19 template for elderly care

If anyone wonders what openEHR template development looks like you might want to dip into this video of me and @heidi.koikkalainen hothousing a new template based on a prototype developed by NDS Scotland.

This is to help people express their wishes about what they wish to happen should they get very sick. Was work in process but sadly being ‘hurried up’ .

The template is now at https://ckm.apperta.org/ckm/templates/1051.57.233 with the .opt at https://ckm.apperta.org/ckm/templates/1051.57.233/opt

From 45 mins, we show how the template can be used to build a simple form, save some data then query it back using the Better Ehr Explorer.

From Balsamiq prototype to simple app based on fully structured, queryable data, based almost completely on shared international archetypes in 1hr 15 minutes.

This may never get used ‘as-is’ but it shows the power of openEHR.

It was done ‘live’ with no preparation, and with a deadline of the ‘client’ teleconference 1 minute after we finished, so apologies if not exactly slick!!

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Here’s the Seattle Intensivist’s one-pager on COVID-19 - might supply a few extra data points:
https://www.onepagericu.com
And from the same site, a bunch of nice professional clinical resources.

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4 posts were split to a new topic: URI and GI symptoms recording

Details of this international project were circulated to me yesterday and may be of interest to members here. Ian has suggested I post information from the email and I have cut and pasted it here.

<<<
I am pleased to say that KI have agreed to lead the COVID-19 Helix. Martin has set up a webpage (still not public) but you can see it here https://network.crowdhelix.com/covid-19

We have also set up a COVID-19 Helix on the platform for researchers to join as there seems to be a lot of activity on the platform and also funding available. Basically we will be collating a list of all of the collaborative funding that gets announced, and providing a new helix to foster collaborations for it - we will set up covid19@crowdhelix.com email address, and anyone with expertise in relevant fields (e.g. virology, behavioural science, epidemiology) can sign up for an individual account for FREE once we’ve checked their credentials. We wish to promote this globally.

We are also speaking with Science Business to see if we can have their news items related to COVID-19 funding and other items on to the page above. They have also said they would promote the platform across their network and contacts.

In addition to the information above, you can help in the following ways:

  1. Ask researchers working on COVID-19 to join the platform and recommend it to colleagues they know globally. Access will be free if we can verify the person registering is genuine.

  2. Recommend the COVID-19 portal (web page above) to colleagues in your network - globally

  3. Ask your communications department to help us disseminate this as wide as possible.

  4. We would be very happy to receive a quote from our Ambassadors supporting this initiative and we can publish this on the page. This will give us the credibility required and get above all the noise that is happening over the internet on this topic.

  5. We would also like to add the logos from your organisation/institution to this page - please let us know if this is ok.

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Covid-19 Citizen Screening

In Norway we are working on the idea to provide citizen screening. DIPS and a few other vendors will meet tomorrow (Friday, 20. March) to discuss if we can share some information models.

The source code for the models is here: https://github.com/DIPSAS/covid-19-citizen-screening

I will update on the status tomorrow evening.

Wash your hands, take care and keep up the good work!!

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Here is a link to a shared folder I have set up with two very good short videos explaining the medical science and health service implications of the current viral epidemic. They’ve been circulated within my local Neighbours’ WhatsApp Support Group.

Also, The Times in the UK has started publishing a daily and freely available email news summary of the epidemic . You can sign up to receive this at:

thetimes.co.uk/coronavirus

Thought these resources might be useful. Best wishes to all.

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I have made an illustration to clear my thoughts on the symptom/disease state, the isolation procedure and the outcomes.

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Update from Norway
Last week was really absurd in so many ways. Norway was locked-down to face the pandemic situation. Schools are closed. People who can work at home does so. And people buy as much toilet paper as they can carry. We have no idea why they do so, but we assume it is important to have a shiny ass when facing a pandemic situation…

Our customers prepare for lots of patients in the hospitals. The health regions had working groups to decide what solution to choose. Current state is:

  • Northern and western region deploy DIPS Arena “on track of Covid-19”
  • South-east region deploy DIPS FastTrak “on track of Covid-19” (this is not native openEHR but developed based on the clinical models we made)

On Friday there was a meeting among Norwegian vendors and the Directory of e-health. The intention from the vendors was to agree on some clinical models. An outcome from this was that @siljelb takes the lead to organize and develop the shared clinical models and terminologies to be used. This is really good news. The Norwegian vendors will adapt these models. In turn this makes data inter-operable and the applications will be portable.

I find it really satisfying to experience that the principles of an open platform is what really works when it really matters.

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Is this related? https://helsenorge.no/koronavirus/koronasmitte

Yes. I think so. Without any cooperation with the industry. Came as a surprise for several vendors actually doing business in patient/citizen applications. And we did also invest some hours thinking about the information models for such a service.
This is not a time for criticism. All are very busy. I hope, when this is over, there will be a time to learn and improve.

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Hi @ian.mcnicollI have added the Symptom/Sign Screening form to EMEhealth based on https://ckm.openehr.org/ckm/templates/1013.26.288

I’ll try to cover the other more complex forms. This is what I currently have:

I still need to make some UX improvements to this form. After this I’ll work on the other assessment and report forms complying with the current templates.

6 posts were split to a new topic: Italian COVID-19 related template building

A post was split to a new topic: Pan-European Hackathon