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Modeling EHR with the openEHR approach: an exploratory study in China
Lingtong Min1, Qi Tian1, Xudong Lu2
1College of Biomedical Engineering & Instrument Science, Zhejiang University, Zheda Road, Hangzhou, 310027, China.
BMC Medical Informatics and Decision Making
|August 31, 2018
Summary
This study demonstrates the feasibility of using the openEHR approach for electronic health record (EHR) archetyping in China. While most EHR requirements were met, challenges in localization and tool support remain for broader openEHR adoption.
Area of Science:
- Health Informatics
- Digital Health
- Healthcare Interoperability
Background:
- The openEHR approach, utilizing two-level modeling, enhances electronic health record (EHR) interoperability.
- Developing comprehensive EHR archetypes is crucial for large-scale, interoperable EHR systems.
- The feasibility of archetyping a complete hospital EHR dataset using openEHR in China, a nascent market for openEHR, remains largely undocumented.
Purpose of the Study:
- To investigate the feasibility and challenges of archetyping a complete EHR dataset in China using the openEHR approach.
- To present a case study of EHR modeling in China.
Main Methods:
- An iterative archetype modeling method was employed, involving requirement collection, data normalization, concept organization, archetype searching, editing, and review.
- Existing Chinese EHR standards and systems were used as resources for requirement identification.
- A clinical data repository (CDR) was implemented using developed archetypes to verify modeling feasibility.
Main Results:
- Sixty-four archetypes were developed, with 91% (59) found in the Clinical Knowledge Manager (CKM).
- 35 archetypes were directly reusable, while 23 required modifications (revisions, new versions, extensions, specializations).
- Six new archetypes were developed, and legacy hospital EHR data was successfully integrated into the CDR.
Conclusions:
- Existing CKM archetypes adequately represent most Chinese EHR requirements, with exceptions for local hospital management customizations.
- The case study confirmed the feasibility of the openEHR approach for EHR modeling in China.
- Challenges including localization, tool support, and agile publishing processes persist for wider openEHR implementation.
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