[openEHR-announce] openEHR news from IHTSDO meeting, Denmark
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posted on behalf of professor David Ingram, Head of CHIME, UCL and chair of the openEHR Foundation. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ It has felt like a seminal week for openEHR, bringing to a good point of discussion some key issues exercising us as the group of Board and Review Board Chairs, about future strategy for the Foundation. There were three different events, all choreographed to take place within the one week and we are keen to bring them in more detail to the wider community, as quickly as we safely can. In August, through the offices of the Connecting for Health Programme in the UK, with whose teams several of our members - notably, Dipak, Sam, Tom and Heather - have been working closely for several years, now, we were asked to enter into a dialogue with IHTSDO, to explore and define a strategic relationship between the two Foundations, to take forward the work started by CfH with openEHR on interrelating archetype methodology and SNOMED terminology, to support key clinical information specifications in the UK national programme. Tony Shannon, leader of our Clinical Review Board, who leads for Clinical Content for CfH, has been influencing us strongly towards more clinically attuned data capture and incorporation of archetypes into practical tools for clinicians. On November 1st, in Copenhagen, ahead of the WoHIT conference and just after the IHTSDO general assembly, we met together to review progress made between Martin Severs and me, as respective chairs, in defining the issues that need to be explored between us, both organisations having expressed their commitment and enthusiasm for a strategic alignment and relationship under the umbrella of clinical content modelling, developed from a draft agreement prepared jointly, for Board level review. Just prior to that meeting, and, unfortunately necessitating a completely separate trip to Helsingor near Copenhagen, from London, for me, I attended and made a presentation of openEHR perspectives on the second day of an intergovernmental Workshop, sponsored by NEHTA, CfH and Canada Infoways, to consider the current status of national programmes in relation to experience of implementing and integrating health data standards. HL7, and IHTSDO, and openEHR, were invited to give their perspectives and position papers were presented, also, by several other governments (Sweden, Denmark, Singapore, Lithuania, New Zealand, European Commission were represented) and by industry representatives of major companies. IBM, Microsoft, Oracle, Cerner, BT were represented at a senior level. OHT was also represented there by its CEO. It is not for me or any of us attending (Sam, Tom and me; Dipak being committed elsewhere on half-term parenting duties) to discuss or comment in specific detail on the event or its conclusions as the event was advisory to the national programmes. The openEHR perspective prepared and delivered by me, with input and approval from Sam, Dipak, Tom and Tony, our Foundation executive team (honorary still, of course!) ahead of official papers for the meeting, is posted, now on the web site, though, as I requested to be allowed to do this. As usual with such events, the in between discussions were important, and one sensed a good deal of good-will and impetus for practical progress at an implementation level. As you may guess I described openEHR's three highest priorities as implementation, implementation, implementation, but failed, still, to answer Ogi Pishev's question as to which of the three is the most important! The meeting took place in a hotel just along the coast from Hamlet's Castle at Elsinore, allowing me the academic indulgence and frivolity of entitling my talk ' To be or not to be, that is the question - the EHR' in an effort to slightly lighten what might well have been a heavy atmosphere, I had feared. Another good resonance was with Denmark and the founding father of openEHR, historically, Niels Rossing, who awarded to us the original GEHR contract for building the first European Health Record Architecture. It is pleasing to see, nearly twenty years later, that the battle to avoid such a construct internationally, fought up-hill and down dale by so many, seems now accepted as a key component of the specifications of national programmes for the EHR. As it turned out, the atmosphere was not unduly tense, though quite intimidating as a speaker with serious matters in play and a fair amount of in-crowd banter that largely went over my head, at least, as someone quite unused to standards related meetings. I did express concerns about the CO2 quotient of international standards making activity in our field. A widely held view in discussions around the meeting seemed to be that the prevailing standards landscape was not working well enough for the purposes of national programmes. I doubt that any of this reflection constitutes a breach of Chatham House rules but if it does, maybe I got it wrong. The third event, drawing together threads of discussion about how openEHR governance has now, through its growth in influence born of practical successes, begun to outlive its early phase of agile, rapid innovation, albeit done with very careful change management and version control. All recognise, as the presentation made clear, that our governance now needs broadening, in order to make us a suitable partner to other international groups who are wanting to share mission and approach with us, as a community. We have some twenty people acting as an interim advisory board on these issues and eight of us, including Georges de Moor, representing EuroRec, who gave us half a day of his time, just before WoHIT, for which we were immensely grateful met on November 2nd. Dipak is very active on issues of archetype governance, design and certification within EU research projects and EuroRec. Skip McGaughey came to represent OHT and give us his perspective, again spending a good deal of much valued time with us, as did Ivan Pedersen head of the Danish national programme. What we have done as an openEHR group is to summarise what we learned in these three events into a three-page document, to share with all concerned. We will, as and when they are ready to promote the ideas more widely, with us, set out plans and consult on how openEHR might now move forward. Another aspect of openEHR which is outliving its time is its pocket - ie mainly in terms of bills, that of CHIME and Ocean - to support the not inconsiderable costs we have incurred in bringing openEHR to where it is today and maintaining its freedom of action. We must now confirm our future scope and vision and how we wish to achieve our goals, create a business case and related governance. We are pursuing partnerships and related funding as a key way of bringing things about, globally. All we care about is implementation, clinically, technically and organisationally and learning from implementation to find sustainable ways of helping the support for clinical work to improve, over time. It is a tricky stage of our development as there are bound to be differences of perspective and constraints on what is possible. openEHR is, always has been and will remain open in what it offers. We hope it will be able to progress, safely for all concerned, into open source tooling much more widely, through membership of OHT. We hope it will find strategic partnership with IHTSDO in the domain of clinical content in support of clinical care. We hope it will find strategic partnership with EuroRec in archetype governance, design and certification. There were lots of other discussions and I hope we can find some good ways forward on the difficult problems, that we must continue to approach with care. We must all learn honestly from experience and avoid reinventing the same or similar problems, in a new guise. There is no entitlement in our field other than that of citizens and clinicians to be better served by the outputs and outcomes of EHR efforts. If we collectively do a good job, things will get better, I feel. Overwhelmingly, the tenor of our week's meetings was of positive endorsement of openEHR and hope for building on it into the future. That is all we could have hoped for on behalf of the openEHR community that we were there to represent. David Ingram, London, 08 November, 2008 |
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