openEHR Clinical Strategic Directions

The Clinical Review Board has proposed 3 major areas of development:

1. An international set of archetypes which provide a standard shared model of important clinical data and a standard requirement for terminology;

2. An agreed and formal process for review, publication and ongoing maintenance of these archetypes which maximises involvement of experts from around the world by minimising the demands for their time and travel; and

3. A web-based portal to enable this process and the effective use of these archetypes in clinical applications and national eHealth programs.

Archetype Authoring and Review

The openEHR board established the Archetype Editorial Group as an expert clinical group to lead the authoring of archetypes within the openEHR community. The process for proposing, reviewing and publishing archetypes has been built into the online tool known as the Clinical Knowledge Manager. The work draws on experience developing openEHR archetypes as part of the national eHealth programs in the UK, Denmark, Sweden, Singapore and Australia. The group have proposed 10 high priority archetypes for international agreement: this work is being carried out largely within the national programs at present.

The authoring of archetypes ideally will be sanctioned by international organisations (e.g. the WHO and standards bodies). At a national level it will be important to enlist support of professional colleges as well as national government agencies.

Clinical Knowledge Manager (CKM)

The Clinical Knowledge Manager (CKM) has been established as a web portal for the reviewing, publication and governance of openEHR archetypes. Those who wish to participate at any level in this important work can register and then take part in the developments. The environment formalises the review and release process and provides an environment where interested clinicians can learn, participate and contribute to the collective effort. The CKM provides the platform for health data standardisation that can transform interoperability as the tooling to convert these models into XML schemas, CDA, CCR and other serialisations is developed. A single source of truth for health data is sorely needed in what has become a quagmire of standards.

The work rate on CKM varies depending on the international focus. With a lot of activity in one country the expertise tends to be drawn to that work. The aim is always to bring this work back to the international repository if possible. It is important to remember that historically this work has been done over and over again, each time slightly different, for many decades. What the openEHR approach is proposing is a clinician led development of quality models or archetypes that can be reused in the future. The community invites clinicians and other domain experts to participate in this work and for formal support to be provided by professional and national organisations.