Dear Colleagues,
As 2009 draws to a close I wanted to reflect back on some of the themes we explored at the start of the year to gauge progress made this year.
In doing so it seems important to mention the challenging times that 2009 has meant to lot of people all over the globe, which if anything has demonstrated how very interdependant we all now are.
Earlier in the year I shared a view as to what the openEHR clinical community had expressed a want/need in pursuing in 2009 and beyond.
http://www.openehr.org/mailarchives/openehr-clinical/msg01306.html
Over the course of this year, slowly but steadily progress has been made in a number of these areas that we can be pretty happy with I think.
So allow me to briefly recap on some of the agreed priorities and related progress in 2009....
1-improve communication & educational materials about openEHR
As ever the areas of communication and educational material has work to do, the openEHR mailing lists and wiki being the main stay of communication and material with Google Wave under exploration of late.
You may have already seen the very open and honest communication from David Ingram (Chair of the openEHR Foundation) posted to openehr.org over the weekend.
http://www.openehr.org/295-OE.html?branch=1&language=1
Given the lack of any dedicated Foundation resource for these activities, which helps explain the challenge at this time, it may be most fair to say that there has been some progress with more work to do, a theme which I'll return to as I close.
2-clearer mechanisms for clinicians to get involved & network around openEHRs work
The release of the openEHR Clinical Knowledge Manager (CKM) in April 2009 I believe was a major milestone for openEHR.
http://www.openehr.org/knowledge
Now that the CKM is publicly available, I find it a very helpful place to explain to others who are trying to better understand the mission of openEHR and "what are archetypes?".
In many ways the idea of coordinating a global audience to agree on clinical concepts and definitions may have seemed a near impossible task at the start of the year..
I think the steady progress that has been made by all those involved in CKM (now over 400 users in 50 countries) already demonstrate the huge potential that a community effort can accomplish in this field.
Many thanks to all those involved, particularly the small number of editors who have helped to coral and coordinate this challenging effort (anyone interested in considering a role as an editor please let me know)
The online poll/vote in July 2009 on the "Top 10 archetypes for use in an Emergency" was another useful demonstration of the value of harnessing our collective intelligence to make decisions.
http://www.openehr.org/wiki/display/healthmod/Poll+Results+-+Top+10+archetypes+for+use+in+an+Emergency
The top 10 archetypes selected contain some of the most key of clinical concepts, so tackling them was always going to take time.
Thankfully important progress has been made in these areas with work to be done on concepts like Medication and Allergy. I hope to get an update from the Archetype Editorial Group on where we are in the New Year, so we can complete this effort in 2010.
3-tools for the clinicians to develop openEHR solutions (archetypes, templates, UI etc)
The public release of the open source OpenEHR Reference Framework and Application in June 2009 was another key milestone for openEHR.
http://opereffa.chime.ucl.ac.uk/
Again, in the context of limited resource and a very small team, UCL CHIME have managed to make available online a tool that I can show clinical colleagues a very simple, clinically relevant, documentation tool that exposes openEHR archetypes, SNOMED CT, User Interface issues for debate and discussion. This has been a great help to me in promoting the important work of openEHR.
Its been good to see the interest that this openEHR effort has generated within the NHS and wider afield as there is a steady international increase in appetite for these type of tools. (will be interested in any feedback from those busy folk who have downloaded for their own local efforts).
The open source nature of this framework is clearly important to the effort, though further work needs to be done to find the right funding mechanism for this and other open source tools the community requires.
4-clearer mechanisms around archetype, template governance etc
My sense is that the CKM development and poll vote for Top 10 vote etc have offered a preliminary start to the challenge of international governance of archetypes, etc.
In this weeks update from the openEHR Chairman, David Ingram makes clear that the board is actively seeking and open to all suggestions on this.. with opportunities being explored to improve on this via IHTSDO etc.
In that context, the joint statement in September 2009 between the openEHR Foundation and IHTSDO foundation was another important development during the year.
http://www.ihtsdo.org/news/article/view/ihtsdo-and-openehr-begin-collaborative-work-programme/
The recent discussion/plans for an openEHR community meeting during 2010 (be that at Medinfo or elsewhere next year) may be an important time to help progress the discussion and debate that is needed to get this right. I'd be particularly grateful for any ideas/views on how we can improve on the governance issue..
For example, as 2010 commences I plan to refresh a discussion, involving the clinical community looking again at clinical requirements to help steer the openEHR technical community (in areas such as how archetypes/templates/UI should interrelate etc) where open discussion and debate might be helpful.
5-additional work to ensure close fit between openEHR solutions and Decision
Support/Business Rules engines.
To date from my viewpoint, this remains an ambition, which I hope we will see realised to some extent as openEHR implementations grow and mature. Rong Chens excellent PhD recently published offers a view of the future in this field.
http://www.openehr.org/shared-resources/publications/archetypes.html
To close, I wanted to mention that after 5 years at NHS Connecting for Health, promoting clinical leadership, process improvement and health IT standards (ie openEHR) I have made a move on in recent weeks. I hope my move will allow me time for a couple of things.
Firstly I am now helping my hospital base with more Informatics leadership that is required to tackle some key service improvement pressures that need to be addressed. Within that environment, I am already preparing a case for a local project - to foster collaboration between interested parties, aimed at development on an open record architecture platform. While this is a longterm goal in an environment with short/medium and long term priorities, I hope it will be an important development in linking frontline pressures with international best practice.
In addition, I hope that the move will allow me time to work with UCL CHIME to more directly help the mission of the openEHR Foundation, in particular sharing the learning and progress we are making.
You might be interested in this short and snappy screencast on the "Healthcare Change Challenge & the role of openEHR" that I have put together in recent days.
http://www.screencast-o-matic.com/watch/cQlFXHhtt
Hope you might find it of interest and please feedback your views so that I can work on progressing and improving on this communication and educational resource in the New Year.
So in the context of the challenging year that 2009 was, I hope you'll agree that important progress has been made, which bodes very well for the future of openEHR..
As ever, keen for views/discussion/debate on these points.... in the New Year perhaps...
With best wishes for your Christmas and looking forward to 2010,
Kind regards,
Tony
Dr. Tony Shannon
Consultant in Emergency Medicine, Leeds Teaching Hospitals
Clinical Lead for Informatics, Leeds Teaching Hospitals
Honorary Research Fellow, University College London
Chair, Clinical Review Board, openEHR Foundation
+44.789.988 5068 tony.shannon@nhs.net