Category Archives: openehr

openEHR turns 20 today

openEHR was officially created on 13 March 2003, 20 years ago today. Prof David Ingram thought of the name, and he and a small band of optimists – Dr Sam Heard, Dr Dipak Kalra, David Lloyd and myself – launched … Continue reading

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Why using expressions in workflow is wrong

One of the basic elements of design common to all workflow languages, including YAWL and BPMN, is the inclusion of logical expressions on decision nodes. This seems harmless, and we followed it in openEHR’s Task Planning specifications. However, it is … Continue reading

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A Lingua Franca for e-health takes shape with GraphiteHealth

Colleagues in e-health often say to me: why don’t you make openEHR easier to map to <insert popular interop standard> (used to be HL7v3, then HL7 CDA, now, HL7 FHIR… DSTU2/3/4/5?). To which I usually reply: if you are implying … Continue reading

Posted in FHIR, Health Informatics, openehr, standards | Tagged , , , | 4 Comments

What is interoperability?

There are some rather obscure definitions of health IT’s favourite term interoperability floating around, for example:

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Directions in clinical guideline programming – CHA2DS2-VASc

The above shows a typical web form calculator for the CHA2DS2-VASc score, used for estimating the risk of stroke in patients with non-rheumatic atrial fibrillation (AF), primarily for the purpose of deciding the use of anti-coagulant therapy [Wikipedia]. How would such … Continue reading

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Aide Memoire for Computable Domain Models

Sometimes a graphic is worth more than words. This is an attempt to capture all the salient features of multi-level modelling, the openEHR way. See the openEHR primer for the story. Although this is ‘our way’ of doing it, I … Continue reading

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Clinical Decision Logic Fun

How close can we get to making a clinical decision logic language look like the published guidelines which it is used to encode? Below is an openEHR Decision Logic Module (DLM) example, in the current form of the openEHR Decision … Continue reading

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Towards a standard analysis of computable guidelines, clinical workflow, decision support and … the curly braces problem

Why don’t we have widespread clinical decision support (CDS), computable guidelines, clinical workflow (plans), and why don’t the pieces we do have talk to the health record? The first time I heard such challenges framed was around 2000, and even … Continue reading

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FHIR Fixes – the Observation.value problem

As described in some detail in this earlier post on the FHIR formalism, a number of FHIR Resources contain ‘choice’ attributes of the form attribute[x], such as the one shown above in Observation. These are mapped in the FHIR UML … Continue reading

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Why using HIT standards fails to achieve interoperability

I started working in the Health IT area in 1994, on a major European Commission funded project. I attended years of standards meetings at HL7, CEN and occasionally OMG and ISO from 1999 to about 2012. And I’ve observed the … Continue reading

Posted in Computing, openehr, Philosophy, standards | Tagged , , , , , | 1 Comment