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© Thomas Beale 2010 Thomas Beale openEHR Services architecture
© Thomas Beale 2011 The Services Part
© Thomas Beale 2011 Enterprise Comprehensive Basic Old view… EHR Multimedia genetics workflow identity Clinical ref data Clinical models terms Security / access control realtime gateway telemedicine HILS other provider UPDATE QUERY demographics guidelines protocols Interactions DS Local modelling notifications DSSPAS billing portal Allied health patient PAYER Msg gateway Imaging lab ECG etc Path lab LAB Secondary users Online drug, Interactions DB Online archetypes Online terminology Online Demographic registries Patient Record
© Thomas Beale 2011 General approach Build from bottom up – ‘Native’ services Needed services, consistent with information and model artefacts And from top-down – ‘Standard’ services Connect IHE, HSSP etc to native services
© Thomas Beale 2011 Services IHEIHE se tsts terminology f rere data java C# etc Querying HSSPHSSP NativeNative
© Thomas Beale 2011 On Services... Some architectural inspiration from Microsoft Connected Health Framework (CHF) Native layer Take as much of IHE, HSSP etc interfaces & adapt for native compatibility, making archetype-aware Standards layer Service – service connection
© Thomas Beale 2011 ProcessModels Service Models Information Models Microsoft CHF
© Thomas Beale 2011 EHR Service demographics Security & privacy Workflow & Pathway Services
© Thomas Beale 2011 The openEHR services architecture
© Thomas Beale 2011 Native services All services archetype/template aware Numerous APIs generated from templates Query service based on AQL / a-path No SQL queries against physical database!!!
© Thomas Beale 2011 Key data services - EHR ARCHETYPE-AWARE Virtual EHR – fine-grained creation, modification, retrieval, querying EHR back-end – coarse-grained DVCS-like interface – ‘change-set’ based EHR audit log
© Thomas Beale 2011 Key data services - patient Demographics – ARCHETYPE-AWARE Authentication info Patient relationships HCP relationships – teams etc EHR subject X-ref service openEHR EHRs are identified by EHR id only Deals with merged & split EHRs, i.e. 2 subject ids 1 EHR, 2 EHR ids 1 subject Enables dynamic distribution of EHRs Becoming the EHR meta-data service
© Thomas Beale 2011 Key knowledge services Archetypes & templates Terminology ref-sets Terminology service access Inferencing Terminology administration Medications, devices Allergies & interactions database
© Thomas Beale 2011 Key process services Event-based notifications Care pathway Based on archetyped openEHR structures Booking / appointments Requires access to patient requests & doctor’s diary & other resource availability data Doctor’s diary Forces syncing of appointments to filler Patient diary Allows multi-function visits
© Thomas Beale 2011 Key elements that MUST WORK Standardised querying of data, based on knowledge artefacts, not physical DB standardised knowledge artefact identification, including versions standardised ability to designate finest grain items in the data Enabling URI to any data item
© Thomas Beale 2011 Services lessons Need native and standard layers, i.e. Inside-out, outside-in Knowledge-based architecture brings new needs: New knowledge services – archetypes, ref-sets Other services must be knowledge-aware Business services need to be small, with changeable interfaces
© Thomas Beale 2011 Knowledge awareness means... Service layer understands: knowledge artefact identification system Fine-grained data item identification Which means we need standardised knowledge models Aka Detailed Clinical Models
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