where to start?

Hello!
Im a psychologist from Brazil and ahead of a project to develop a
management system for psychology services. www.gestorpsi.com.br

The project is being sponsored by FAPESP, a public research agency in
São Paulo, Brazil

The system will manage the administrative tasks as well as the clinical
and research tasks involving psychology services.
The system will be free software and it will be possible to incorporate
other clinical practices on it

We are about to begin the construction of the administrative system and
we found the new openehr last week.

I'd like to know where to start to use the openehr model in our system.

There is a lot of documents on openehr website and I'm a bit lost
As far as I understood, openehr is more about the clinical data than the
administrative data (appointments, payments, schedules)
We will start with the development of the administrative part of the
system and I'd like to know if there is something that we have to deal
now regarding openehr

Here I found what I believe is the starting point
http://www.openehr.org/specifications/project.html
http://www.openehr.org/svn/specification/TAGS/Release-1.0.1/publishing/roadmap.html

If possible I'd like to receive directions on how we can use openehr in
our development
we will develop using java and the system will be web based

My team manager is worried if openehr will make things easier or harder
for the development team

Regards

Oliver Zancul Prado

Oliver Zancul Prado wrote:

Hello!
Im a psychologist from Brazil and ahead of a project to develop a
management system for psychology services. www.gestorpsi.com.br
...

There is a lot of documents on openehr website and I'm a bit lost
As far as I understood, openehr is more about the clinical data than the
administrative data (appointments, payments, schedules)
  

Currently there are more archetypes for clinical than administrative
content. However there is nothing to stop the creation of more
administrative archetypes. Administrative archetypes in openEHR are
based on the ADMIN_ENTRY type - see
http://www.openehr.org/uml/release-1.0.1/Browsable/_9_0_76d0249_1109249648736_872559_12384Report.html

We will start with the development of the administrative part of the
system and I'd like to know if there is something that we have to deal
now regarding openehr

Here I found what I believe is the starting point
http://www.openehr.org/specifications/project.html
http://www.openehr.org/svn/specification/TAGS/Release-1.0.1/publishing/roadmap.html
  

See the Getting Started link -
http://www.openehr.org/shared-resources/getting_started.html

If possible I'd like to receive directions on how we can use openehr in
our development
we will develop using java and the system will be web based
  

the current open source project is in Java. See
http://www.openehr.org/projects/java.html

- thomas beale

Dear Oliver

Everyone wants to build things from scratch - it is human nature. I would suggest these days that it is a bit like deciding to build a car from scratch rather than getting one that is built by someone else. The fact is that it is incredibly expensive these days to build software from scratch. Administrative systems are difficult if they include everything required, health records are very complicated.

We would suggest that you look to a Service Oriented Architecture and concentrate on the front end requirements. Beatriz is an expert on health care standards and the company she works for have already learned a lot about openEHR. It would undoubtedly be worth collaborating on this.

So to answer the key question - will it be easier or harder to use openEHR? Harder to build software, easier to meet the needs of your clients and patients for the years to come. The question is - do you build health record software or use software that has been built? You can go to the who is using openEHR space and look for suitable partners. Building complex monolithic systems from scratch these days is for big companies with massive resources.

So have a chat with Beatriz and see what you come up with.

Cheers, Sam

Oliver Zancul Prado wrote:

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OceanCsmall.png

Hello Sam.
We are trying to reach Beatriz and other people in Brazil involved with openEHR and we want to attend at the Workshop on Open Source Health Informatics Projects at Rio in 2008.
I spent the last days reading openEHR documents and at monday we will have a meeting when I want to share with the team what Ive learned about openEHR

I know its expensive and hard to develop software, thats why I’ve always searched for some way to not reinvent the wheel with my project.

GestorPsi only exists because in Brazil there is no good software made for psychologists. Not for EHR and not for services management.

And all the health software’s company that I could find works with proprietary software.

Since the beginning the hole idea is to use free software at all levels.

Now that I understood a bit about archetypes I know that this will enable to have one system for psychology and also for other health practices.

But your question remains: Build or use?

The better would be both.
We will build because its the nature of the project and of the founds.

But would be better if we could do this with partners.
And we are open and seeking partnerships and collaborations.

Lets wait for Beatriz and other contacts in Brazil

I will do everything possible to develop using openEHR model and to use free code or software/system available under opensource licences.

If at the end we fail to have some usable stuff, at least we may still have a lot of archetypes about psychology and social sciences stuff.

Regards

Oliver

Sam Heard wrote:

Hello Thomas
We installed the java project but It give an error and does not start. We will try to find and fix the problem.
I think with something “real” to see will be easier to understand

I am reading the architecture overview and I could figure out some more about openEHR.
Also Ive downloaded a archetype editor (the java one) and could see what archetypes are about

I have some questions and the answers could help me see if I understood the model.
I dont know if they are too newbie to ask or not, lets see

Inventories, questionnaires and scales like Beck Depression Inventory and many others:
Usually you have many questions and the answers are coded (calculated) and then you have a scale result.
Can we have the scale itself as archetype or only the “scale result” as archetype (an observation entry)?
I found that its possible to have body mass calculation as archetype, but how about more complex types of calculations?

Schedules, payments and administrative tasks goes as admin archetypes, but how this relates to the GUI like the typical clinical calendar (agenda)?
I can imagine archetype as a “form” but can it goes anywhere in the system and take any form in a GUI?

Lets say you have a screening service that sent the patient to either psychotherapy or occupational therapy.
The screening service will have a archetypes template
Psychotherapy another archetype template and occupational therapy another one?
Some archetypes could be common to all three services.
Is this correct?

Information about the health service itself goes as archetype too?
eg:
screening - general screening service, works only monday, 8AM-14PM
psychotherapy - for adults with no disease conditions, behavioral oriented theory, works everyday 8AM-18-PM
child psychoterapy - for kids, psicodinamic oriented theory, works everyday 8AM-18-PM
emergency - general for everyone anytime, works 24/7

Is this related to openEHR as part of the specifications or would be outside of it?
with your clinical data you build a knowledge base to spread evidence based practices?
clinical supervision and training: to collect data about supervision and training process.

Regards

Oliver

Thomas Beale wrote:

Hi Oliver,

Hello Thomas
We installed the java project but It give an error and does not start.
We will try to find and fix the problem.

Great! That is how open source works. :slight_smile:

I think with something "real" to see will be easier to understand

Very true.

I have some questions and the answers could help me see if I
understood the model.
I dont know if they are too newbie to ask or not, lets see

Well, I'm not Tom but I hope a slightly different perspective from his
(in conjunction with his) may help you get on the road to progress with
openEHR.

Inventories, questionnaires and scales like Beck Depression Inventory
and many others:
Usually you have many questions and the answers are coded (calculated)
and then you have a scale result.
Can we have the scale itself as archetype or only the "scale result"
as archetype (an observation entry)?
I found that its possible to have body mass calculation as archetype,
but how about more complex types of calculations?

My answer may be vague but simply you "can" have any level you want.
But the basic concept is that AN archetype is ONE clinical concept. It
is an EXTREME/MAXIMAL data set for that concept. The process of
implementation is one of restriction for any application. This opens the
door for us to use an archetype in one context and yet it still be
completely valid (even contextually from the point of information
gathering) when transferred elsewhere.

You can't do this when you have different "data models" because NOT ONLY
is the context of collection lost in what "data" should be transferred,
but the entire context of the entry is disjointed.

Schedules, payments and administrative tasks goes as admin archetypes,
but how this relates to the GUI like the typical clinical calendar
(agenda)?
I can imagine archetype as a "form" but can it goes anywhere in the
system and take any form in a GUI?

An archetype is a "part of" a form/template.

Lets say you have a screening service that sent the patient to either
psychotherapy or occupational therapy.
The screening service will have a archetypes template
Psychotherapy another archetype template and occupational therapy
another one?
Some archetypes could be common to all three services.
Is this correct?

They could be (and likely are). But, when persisted in the patient
record they are recorded as a (versioned) contribution. This is kind of
the dividing line between what an archetype is and does and the reality
of creating a patient record in a system.

I don't want to "tick-off" the clinicians here. But frankly we could be
talking about auto parts or aircraft assemblies as well. Archetypes
describe the knowledge of the system. The software is based on the
reference model. With a little more domain work we could build airplane
plans with the reference model and different archetypes.

I think that as a group we just happen to believe healthcare is more
important to the world. :slight_smile:

Information about the health service itself goes as archetype too?
eg:
screening - general screening service, works only monday, 8AM-14PM
psychotherapy - for adults with no disease conditions, behavioral
oriented theory, works everyday 8AM-18-PM
child psychoterapy - for kids, psicodinamic oriented theory, works
everyday 8AM-18-PM
emergency - general for everyone anytime, works 24/7

This is a tough question for me. Frankly I haven't given much thought
about scheduling and archetypes. Off the top of my head I don't think
it makes much sense.

with your clinical data you build a knowledge base to spread evidence
based practices?
clinical supervision and training: to collect data about supervision
and training process.

DISCLAIMER: I am not a healthcare provider.

The general idea is to create reusable, international knowledge
components.

The reasoning is that so we can have software systems that can request,
share and reuse "information" from any other system. There are many
reasons for this desire and need that is alliterated in the health
informatics literature.

I hope this helps answer your questions.

Kind Regards,
Tim

Hello Thomas
We installed the java project but It give an error and does not start. We will try to find and fix the problem.

Hi Oliver,

Can you please post the details of the error to the Java list so we can have a look?

To subscribe to the Java list: http://lists.chime.ucl.ac.uk/mailman/listinfo/ref_impl_java

Cheers,
Rong