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Evaluating Model-Driven Development for large-scale EHRs through the openEHR approach.

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Summary
This summary is machine-generated.

Implementing openEHR for electronic health records in Norwegian hospitals revealed socio-technical challenges. Assumptions of clear separation and user control in Model-Driven Development (MDD) were not met, highlighting the complexity of domain modeling.

Keywords:
ArchetypesElectronic health recordsModel-Driven DevelopmentUsersopenEHR

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Area of Science:

  • Health Informatics
  • Information Systems Engineering
  • Sociology of Technology

Background:

  • The openEHR standard offers a Model-Driven Development (MDD) approach for electronic healthcare records.
  • Its implementation in Norwegian hospitals was examined to understand practical challenges.

Purpose of the Study:

  • Identify socio-technical challenges of openEHR implementation in Norwegian hospitals.
  • Empirically investigate assumptions regarding separation of concerns, user control, and organizational modeling.

Main Methods:

  • Longitudinal case study utilizing an interpretive approach.
  • Data collected through 440 hours of participant observation, 22 semi-structured interviews, and extensive document analysis over 4 years.

Main Results:

  • Separation of clinical and technical concerns was aspirational; both required combined clinical and technical expertise.
  • User control and commitment were limited in large-scale projects due to the complexity of domain modeling.
  • Modeling emerged as a complex standardization process influencing both the model and healthcare practices.

Conclusions:

  • Developing archetype-based systems necessitates a broad, diverse group of contributors with unclear roles.
  • The process of MDD impacts medical practice by requiring standardization of practices for uniform medical concepts.