Outcomes & conclusions of the openEHR course in spanish (& ideas for the future)

Implementers (archive)
1

Hi everyone,

Recently we have ended the first edition of the course with a huge success. And now we are thinking about the next steps to take.

Here is a post on my blog about the conclusions and future actions: http://informatica-medica.blogspot.com/2012/01/conclusiones-del-curso-de-openehr-en.html
(yo can see it in english by clicking ENGLISH on the top right corner of the blog).

I want to share with the community a couple of ideas mentioned there. It would be very nice to know what you think.

openEHR certification:

The first idea is on standarizing openEHR training, and to think about an openEHR certification. I think this could be very good for the community and for the openEHR organization too.

It could be possible to create a mail list for openEHR trainers (openehr-trainers@openehr.org)? So we could discuss about the topics and ways of evaluation, and come out with an standard minimal program to all openEHR courses.

If we reach a standard minimal program for openEHR courses, could we get formal support from openEHR.org to issue internationally valid openEHR certificates? (obviously this is a question for the future, but IMO we need to start thinking about it now).

10 projects to adopt openEHR:

We thought about 10 projects (or so) in two areas: software and clinical modeling.

Because openEHR propose a tool-chain based process of creating EHRs, we need to have each one of the links of that chain in order to adopt and implement openEHR easily.

Now there is a little tooling available, and some of it is not open source. In projects at a national level we need to use open source software, because each country will need to make it’s own customizations to each tool.

In the other hand, we need to model other things that are clinical knowledge too, like processes and rules to enable CDS, in order to support full EHR implementation (e.g. I think we could recommend ways to express rules based on archetype ids and paths, and create software tools to support that specification, but we need to work the openEHR services specs first…).

There is a diagram on my blog post that shows the tools we propose to 1. develope if there is no tool that support its functionality or it’s closed-source, 2. improve the current open source tools.

On the clinical modeling side, we have engaged doctors and nurses on the creation and translation of archetypes. Now there are two of our students that already commited archetypes to the CKM: Dr. Domingo Liotta and Dr. Leonardo Der Jachadurian.

I hope we could propose to create prototypes of those projects in out local universities and coordinate the projects so we do not overlap each other, with the objective of completing the tool chain with open source developments.

What do you think?

2

Hi Pablo,

The first idea is on standarizing openEHR training, and to think about
an openEHR certification. I think this could be very good for the
community and for the openEHR organization too.
If we reach a standard minimal program for openEHR courses ...

From experiences with an another standard (HL7) based training courses
I'd say it may be hard to reach consensus as to what the minimum should
be - there is a fair amount of difference between various countries, as
well as how one structures a (set of) training courses [e.g. 1 long one,
an introductory and an advanced], and the target audience [e.g.
clinical, hardcore programmers without any clinical knowledge].

In general the most useful thing for all concerned is probably for the
standards organization to make a statement like "we know that trainer X
provides good quality training courses" [this aids the trainer in
selling the training course, it aids the prospective attendee as a
statement of quality, and it aids the standardization body because it
has a known list of educators it can refer to]. Determining who provides
a good quality training course may not always be that easy to quantify,
but in these relatively small standardization communities (whether
openEHR, HL7, DICOM, IHE, etcetera) the nomination for approval can be
backed up / seconded (or the reverse: "thumbed down") by other known
active volunteers.

TTYL,

-Rene

3

Hi Pablo, and all

I perfectly agree your idea. I have thought as you mentioned.
I am planning my tool-chains on my Ruby implementation, too.
Certification criteria are very difficult to evaluate. Training course
would be a homework to localize.

Shinji Kobayashi

4

Hi, Pablo and all,

I was talking last week with Thomas about an openEHR standard course who could be taught in the various countries that are adopting or considering to adopt openEHR approach. Brazil, as you know, chose both the EHR information ( RM) and content model ( archetypes, templates and term sets)l but there's a lack of training and guidance material to all levels of people, from newbies, clinicians and those interested in or implementing it.
I was asked by the Brazilian HIT society to create and presenting a short introductory webinar on openEHr and clinical models and discussed that's why I came up with the idea of having standard materials on it, who could be used all around the world.
A formal certification process to trainers or advisors could be a way to fill this gap. In Brazil, our HIT society is developing a certification process for HIT professionals, ProTICs, based on the model that COACH, the Canadian HIT society. There are several " certifying profiles"' , but I don't know if there are one for "advisor". I received recently an email from hits

5

Sorry, am using an iPad and sent inadvertently the email before finished. I was telling that IHTSDO sent a request for candidates to become snomed ct implementation advisors. Ihtsdo will , however, fund their training, and openEHR foundation doesn't have the means to do that. How could we do it effectively without changing the business model of the foundation? Joining efforts with our HIT societies could be a way to achieve it. What do you think?

Jussara Rotzsch

6

Hi Jussara, Pablo and all,

I’m in full agreement that we need to improve education and training opportunities about openEHR and all associated technologies. Essentially our current educational activities could be classified as professional development, they are many and varied. I gather from Pablo’s comments that there is a desire to extend this to a credentialing/internationally recognised award/qualification. Jussara is suggesting the adoption of a certification process. Either way we need to document what an openEHR certified person will be able to do so that employers will have some idea of what the person will be able to achieve for the organisation once employed.

Australia has a very well developed highly regulated vocational education and training sector that is based on a very sound educational structure that we could use as a guide to design a suitable educational framework for openEHR. I’m happy to assist in this process as we are already engaged in this type of work nationally via the Australian Health Informatics Education Council http://www.ahiec.org.au/ . My colleague, Heather Grain is working with ITHSDO who have also adopted much of the Australian educational framework. They are developing the required educational outcome standards and adopting a credentialing process. Heather is also working with the HL7 education committee.

The comments that follow are from an educator’s perspective. I have chaired IMIA’s education committee, was a member of its taskforce to develop educational guidelines and I established and managed Central Queensland University’s Health Informatics centre. I’m semi-retired, manage a registered training organisation and I currently teach people how to train others.

My reading of our overall objectives tells me that we are looking to achieve International consistency in education and training outcomes. That requires quality management and governance of some type. For example openEHR teachers need to have suitable knowledge and skills to take on that task. One entity needs to indicate what suitable knowledge and skills are and govern this. This requires agreed standards/guidelines.

The process to develop a suitable education/training framework consists of the following steps:
• Define roles, functions and high level competency outcome standards
• Analyse and document these into individual units of competency
• Link units of competency to qualifications at various levels of complexity and intellectual demand to suit any national educational framework.

From the openEHR Foundation perspective I suggest that we develop the overall outcome standards against which individuals who have completed any educational course in any country can be tested to become a certified openEHR practitioner. This is the ITHSDO model. My question is what knowledge and skills does an a certified openEHR practitioner need to have? Is it the same for all? Can we identify some job titles?

From an educational and workforce planning perspective we need to do this in greater detail when following those 3 steps. Each unit of competency needs to have a title, a description/summary that broadly communicates the content and skill area addressed, define employability skills included (these are generic competencies such as communication, teamwork, problem solving etc), any pre-requisite knowledge/skills required, scope regarding its application in the workplace, the competency sector/field [this is where there are many units of competency within the same context at various degrees of complexity such as networks, software engineering), elements of competency and associated performance criteria, required skills and knowledge (what a person needs to know to perform this work), range statements to provide context , essential operating conditions etc, and an evidence guide for assessment purposes.

[All Australian nationally endorsed training packages and competency standards are freely available from the Government database at www.training.gov.au , it has a good search engine, these provide good examples of the documentation I'm referring to]

Our students come from different backgrounds, have a variety of previous knowledge and skills and tend to follow different career paths. Ideally our openEHR education framework needs to be able to accommodate these different learning pathways to ensure we can adequately prepare the workforce to maximise the value of adopting openEHR. This can be achieved by developing an openEHR training package similar to any Australian Training Package and making this freely available. This does require a solid governance process and a lot of people willing and able to contribute. If we want to go down that path then we need to develop a strategy to get there.

Evelyn

Prof Evelyn J.S Hovenga, Director, CEO & Trainer
Inquiries: T: 1300 285 512
M: +61 (0)408 30 9839 F: (07) 3112-5915
E: e.hovenga@ehe.edu.au Skype: evelynhovenga

eHealth Education Pty Ltd ABN 89 133 868 050
Trading as RSC Training and eHe Training RTO 32279
Web: www.ehe.edu.au and www.ehetraining.com.au

7

Hi Rene,

Hi Pablo,

The first idea is on standarizing openEHR training, and to think about
an openEHR certification. I think this could be very good for the
community and for the openEHR organization too.
If we reach a standard minimal program for openEHR courses …

From experiences with an another standard (HL7) based training courses
I’d say it may be hard to reach consensus as to what the minimum should
be - there is a fair amount of difference between various countries, as
well as how one structures a (set of) training courses [e.g. 1 long one,
an introductory and an advanced], and the target audience [e.g.
clinical, hardcore programmers without any clinical knowledge].

I know it will be difficult to reach consensus, but it’s not impossible. Firstly, I think we (trainers) need to sit down and talk about what we think and what we want to do in/with our courses, until now I have not seen any discusions about how to standarize openEHR training and I’ve been in the openEHR community since 2006, and maybe this initiative could have a good outcome and be beneficial to the community.

Now we see many demands of the e-health community, from openEHR software tools, to openEHR training (there is place for everyone!), and I think we need to make a smart move as a community, because these are spreading & adoption opportunities for openEHR as a standard.

In my case, I think a openEHR course should include the core element: the dual model (IM+AM), at an “above basic” level, something to help students understand the concepts and let them continue investigating after the course ending. To do so, we need to include basic tooling use (I’ve included the use of the AR, ADLWB and our EHRGen). Maybe that is enough for a clinical modeler profile, but for a developer is not, they need to understand what to implement in software and in wich way. For that I’ve created a class on “how to implement openEHR in an information system”, and I included two approaches: the binding approach (used by Opereffa project) and the autogeneration approach (used by the EHRGen framework). An introductory level course could leave out the tooling chapter.

In general the most useful thing for all concerned is probably for the
standards organization to make a statement like “we know that trainer X
provides good quality training courses” [this aids the trainer in
selling the training course, it aids the prospective attendee as a
statement of quality, and it aids the standardization body because it
has a known list of educators it can refer to]. Determining who provides
a good quality training course may not always be that easy to quantify,
but in these relatively small standardization communities (whether
openEHR, HL7, DICOM, IHE, etcetera) the nomination for approval can be
backed up / seconded (or the reverse: “thumbed down”) by other known
active volunteers.

For this community this is very difficult to evaluate, e.g. right now I think I’m the only guy doing an spanish openEHR course, and maybe I’m terrible as a trainer, but there’s nobody else to compare with. Obviously, I could show the student’s evaluation of my performance on the course, but I’m more concerned about giving a better course (and maybe an openEHR certification) to my students than comparing me with other trainers, since I want to collaborate with them to agree on some topics and ways of evaluation. I know that maybe this is not the way of SDOs, but I believe this should be the openEHR way.

I really want to get consensus and work on this subject in 2012 with anyone who want’s to collabotare to improve openEHR training.

Does anyone think that a openehr-trainers mail list would be helpful to focus the discussion on those subjects?

Kind regards,
Pablo.

8

Hi Shinji,

I think (hope) that trainers could discuss and agree on the core topics of an standard openEHR course, and then create an upper level layer to localize this core topics to the student’s profile and the depth level (basic, intermediate, advanced) required by each course. Maybe I’m oversimplifying something really hard to do, but why not give this a chance?

IMO having a specific place to discuss training related topics is the very first step to reach consensus.

I’d like to discuss tool chains too! Maybe we can agree on general concepts and implement them on different technologies, that would be the best proof that the openEHR approach works and that doesn’t matter what technology do you like.
I’ve a very basic requirement list on each tool mentioned on my blog post diagram (http://1.bp.blogspot.com/-Yd3JhnuVjgk/TwMepovkBeI/AAAAAAAAE-4/7UCf-ry2JqY/s1600/openEHR+Toolchain+ppazos+sm.png). I’ve not included datawarehousing tools, but they should be part of the ecosystem too.

9

Hi Pablo,

I think we could probably agree the core training requirements quite
quickly but the real problem is how any certification process could be
policed and funded. Who trains the trainers, who checks that they are
delivering the core content? In Ocean we certainly have a set of core
training materials but these are adapted and amended for every
specific customer - the requirements for a clinical audience is
somewhat different from a technical audience or mixed audience and
time avaialble differs half-day, one day, three day?? ... and again
for a vendor client vs. a national organisation. If we have 'certified
training', to what extent does that prevent us from adapting content
for specific clients and circumstances - I know this is the case for
some UK training certification processes. it is one thing to specify
the core requirements but quite another to ensure that these are being
properly adhered to.

I think the only suggestion I would have for your tool chain diagram
is that with ADL1.5 I think we will have the same tool for archetypes
and semantic templates i.e non-GUI. We will also need mapping tools
for mesage integration and requirements integration and an AQL editing
tool.

Ian

Dr Ian McNicoll
office +44 (0)1536 414 994
fax +44 (0)1536 516317
mobile +44 (0)775 209 7859
skype ianmcnicoll
ian.mcnicoll@oceaninformatics.com

Clinical Modelling Consultant, Ocean Informatics, UK
Director/Clinical Knowledge Editor openEHR Foundation www.openehr.org/knowledge
Honorary Senior Research Associate, CHIME, UCL
SCIMP Working Group, NHS Scotland
BCS Primary Health Care www.phcsg.org

10

Hi Jussara,

Maybe we should discuss about two kinds of certification: for students and for trainers.

To issue student certificates, I think we should agree on the core topics of any “certifiable” course. Maybe creating an “openEHR training board” that could evaluate each course program an say what course could or not issue openEHR valid certificates to students.

As you mention, certification for openEHR trainers would be very difficult with the current business model. IMO we need a loose model to certificate openEHR trainers, and this kind of certification should be based on merit, knowledge and experience on the standard. Those elements could be evaluated by the “openEHR training board” I mentioned before. Obviously, the people on the board should be also choosen by merit and knowledge.

About your question, I think we need to join our local HIT societies and engage people on investigating and using the standard. In fact, I was able to make the course because the people of ACHISA (http://achisa.org/) supported me, giving me all the infrastructure I needed without charging me a dime.

11

Hello all,

I can announce (we just got the confirmation for the funding last week) that the Universidad Politécnica de Valencia (UPV) in collaboration with the Universidade Federal de Minas Gerais (UFMG) will organise a 20 hours workshop about CEN/ISO 13606 next June/July at Belo Horizonte, in Brazil. There are still many details to be decided, but I think it can be of interest for many people in that region (the workshop will be in Spanish).

UPV has already given 5 courses about 13606 in Spain and 2 in Dublin and I completely agree with the general feeling. It is very complicated to find a balance between the technical and the clinical details for an heterogeneous group (which is the usual case), but at the end then is when we learn more, by sharing views from clinical and technical attendants. I also agree that some kind of adaptation is needed for each case, but I don’t think this is a big problem. Most of the course topics can usually be maintained.

Apart from these activities of UPV, I’m currently the chair of the Education Committee at the EN 13606 Association. One of the objectives of the Association is to provide training and develop a certification process for competences on the use of the norm. It is clear that these activities have a great overlap with those related to openEHR, and we should work for an alignment here (as for the specifications themselves :-). Probably, the competences for a CEN/ISO 13606 user/implementer and for an openEHR user/implementer are more than 75% the same. My intention is to present a Training and Certification Plan for CEN/ISO 13606 at the Association General Assembly next February in Seville. All of you are invited to participate in any of these activities and I will be happy to share and discuss our approach in this topic.

Regards,
David

2012/1/3 pablo pazos <pazospablo@hotmail.com>

12

Hi David,

This is a great opportunity for collaboration! I’d love to attend the meeting but I’m a little far from there. Your proposal will be published or is an internal document?

Un abrazo.

13

Hi everyone!

I’ve updated my post adding the students evaluation of the course: MailScanner has detected a possible fraud attempt from “www.linkedin.com” claiming to be http://informatica-medica.blogspot.com/2012/01/conclusiones-del-curso-de-openehr-en.html

For being the first edition, the evaluation was quite positive. But we still have a lot of things to improve!

14

Currently it is an internal draft in my computer :slight_smile: but yes, it will be published for public comment.

David

2012/1/5 pablo pazos <pazospablo@hotmail.com>

15

Congratulations to you and your team, Pablo,

A great achievement. It is so pleasing to see you so active and involved.

I absolutely endorse your desire to get some quality certification behind any openEHR training.

In my opinion it should be done under the auspice of the Foundation, and given the changes anticipated perhaps this will be something that can be part of the new Board’s vision, but this is definitely not a trivial task.

As a community, I would love to see us start taking some of the initial baby steps to work towards this, mindful that a fully accredited program will likely take time and significant resources.

My reservations reiterate largely Ian’s comments – we have done numerous training programs over the past 5 years. Our training material has evolved significantly to reflect the changes in tooling and development of templates, querying, CKM etc to support the practical use and implementation. While this is still in a state of significant flux, and it is likely to be so for some years still, the training will be harder to standardise, but will become gradually easier. In addition, each of our training courses has been configured to reflect the needs/desires of the attendees and this creates an additional overhead that needs consideration.

Cheers

Heather

16

I sent this message yesterday but it hasn’t appeared on the list. My suggestion is essentially to focus on desired outcomes for specific roles rather than general course content in the first instance. This generic approach adopted in Australia for all vocational education and training enables customisation to suit different learner groups. The work proposed should also assist in defining and reaching agreement about the variety of depth and breadth about openEHR knowledge and skills needed by the workforce as a whole. From an educational perspective we need to be able to develop both our current and future workforce. As Heather indicates it’s not an easy task but a suitable strategy should be developed. The openEHR Foundation Board should include this in their deliberations.

Hi Jussara, Pablo and all,

I’m in full agreement that we need to improve education and training opportunities about openEHR and all associated technologies. Essentially our current educational activities could be classified as professional development, they are many and varied. I gather from Pablo’s comments that there is a desire to extend this to a credentialing/internationally recognised award/qualification. Jussara is suggesting the adoption of a certification process. Either way we need to document what an openEHR certified person will be able to do so that employers will have some idea of what the person will be able to achieve for the organisation once employed.

Australia has a very well developed highly regulated vocational education and training sector that is based on a very sound educational structure that we could use as a guide to design a suitable educational framework for openEHR. I’m happy to assist in this process as we are already engaged in this type of work nationally via the Australian Health Informatics Education Council http://www.ahiec.org.au/ . My colleague, Heather Grain is working with ITHSDO who have also adopted much of the Australian educational framework. They are developing the required educational outcome standards and adopting a credentialing process. Heather is also working with the HL7 education committee.

The comments that follow are from an educator’s perspective. I have chaired IMIA’s education committee, was a member of its taskforce to develop educational guidelines and I established and managed Central Queensland University’s Health Informatics centre. I’m semi-retired, manage a registered training organisation and I currently teach people how to train others.

My reading of our overall objectives tells me that we are looking to achieve International consistency in education and training outcomes. That requires quality management and governance of some type. For example openEHR teachers need to have suitable knowledge and skills to take on that task. One entity needs to indicate what suitable knowledge and skills are and govern this. This requires agreed standards/guidelines.

The process to develop a suitable education/training framework consists of the following steps:

• Define roles, functions and high level competency outcome standards

• Analyse and document these into individual units of competency

• Link units of competency to qualifications at various levels of complexity and intellectual demand to suit any national educational framework.

From the openEHR Foundation perspective I suggest that we develop the overall outcome standards against which individuals who have completed any educational course in any country can be tested to become a certified openEHR practitioner. This is the ITHSDO model. My question is what knowledge and skills does an a certified openEHR practitioner need to have? Is it the same for all? Can we identify some job titles?

From an educational and workforce planning perspective we need to do this in greater detail when following those 3 steps. Each unit of competency needs to have a title, a description/summary that broadly communicates the content and skill area addressed, define employability skills included (these are generic competencies such as communication, teamwork, problem solving etc), any pre-requisite knowledge/skills required, scope regarding its application in the workplace, the competency sector/field [this is where there are many units of competency within the same context at various degrees of complexity such as networks, software engineering), elements of competency and associated performance criteria, required skills and knowledge (what a person needs to know to perform this work), range statements to provide context , essential operating conditions etc, and an evidence guide for assessment purposes.

[All Australian nationally endorsed training packages and competency standards are freely available from the Government database at www.training.gov.au , it has a good search engine, these provide good examples of the documentation I’m referring to]

Our students come from different backgrounds, have a variety of previous knowledge and skills and tend to follow different career paths. Ideally our openEHR education framework needs to be able to accommodate these different learning pathways to ensure we can adequately prepare the workforce to maximise the value of adopting openEHR. This can be achieved by developing an openEHR training package similar to any Australian Training Package and making this freely available. This does require a solid governance process and a lot of people willing and able to contribute. If we want to go down that path then we need to develop a strategy to get there.

Evelyn

Prof Evelyn J.S Hovenga, Director, CEO & Trainer

Inquiries: T: 1300 285 512

M: +61 (0)408 30 9839 F: (07) 3112-5915

E: e.hovenga@ehe.edu.au Skype: evelynhovenga

eHealth Education Pty Ltd ABN 89 133 868 050 Trading as RSC Training and eHe Training RTO 32279

Web: www.ehe.edu.au and www.ehetraining.com.au

17

Congratulations to you and your team, Pablo,

A great achievement. It is so pleasing to see you so active and involved.

I absolutely endorse your desire to get some quality certification behind any openEHR training.

In my opinion it should be done under the auspice of the Foundation, and given the changes anticipated perhaps this will be something that can be part of the new Board’s vision, but this is definitely not a trivial task.

As a community, I would love to see us start taking some of the initial baby steps to work towards this, mindful that a fully accredited program will likely take time and significant resources.

My reservations reiterate largely Ian’s comments – we have done numerous training programs over the past 5 years. Our training material has evolved significantly to reflect the changes in tooling and development of templates, querying, CKM etc to support the practical use and implementation. While this is still in a state of significant flux, and it is likely to be so for some years still, the training will be harder to standardise, but will become gradually easier. In addition, each of our training courses has been configured to reflect the needs/desires of the attendees and this creates an additional overhead that needs consideration.

Cheers

18

Dear Colleagues,

I totally agree with Thomas’s perspective and follow the proposal that Evelyn so well described.
Factors to consider specially for the good will the openehr community had demostrated is to ensure that the material that is well designed and developed is maintained intact in regards to their intellectual property.

The feedback I got for my part of the world, The americas…the copy and paste approach does not work effectivelly and it got the potential to miss the opportunity to engage the right people for a sustanaible approach. Also, if they are a fee for these courses, I believe the openehr community as foundation should have a part of the profits that colleagues use this material.

Certification in the developing countries is not value as a quality asset , quite the opposite since they do not have much experience with this approach, they use as a commerical propaganda in order to see themselves as a global players.

It is the time to formalise the training approach from the foundation and ensure the rewards to all the hardwork is paid for. This manner the value of openehr is explicit and treat it the way it should be.

Cheers Carol

Dra. Hullin Lucay Cossio
(RN,BN,Hons,PhD,Post Doc)
IMIA LAC President
www.imia-lac.net

19

Hi everyone!

There are great ideas here, but if we leave them on the list will be forgotten, so I’ve created a page on the wiki with some ideas from your emails: http://www.openehr.org/wiki/display/edu/Formalizing+education

Feel free to edit the page to improve it.

Thanks a lot!

20

Hi Evelyn, those are great ideas. I put them here (http://www.openehr.org/wiki/display/edu/Formalizing+education) so they don’t die on the list.

All the responses have great value, and I think the wiki is the right place to record all the ideas to later think about them.