openEHR Archetype Use and Reuse Within Multilingual Clinical Data Sets: Case Study

BackgroundDespite electronic health records being in existence for over 50 years, our ability to exchange health data remains frustratingly limited. Commonly used clinical content standards, and the information models that underpin them, are primarily related to health data exchange, and so are usua...

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Main Author: Leslie, Heather
Format: Article
Language:English
Published: JMIR Publications 2020-11-01
Series:Journal of Medical Internet Research
Online Access:https://www.jmir.org/2020/11/e23361
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author Leslie, Heather
author_facet Leslie, Heather
author_sort Leslie, Heather
collection DOAJ
description BackgroundDespite electronic health records being in existence for over 50 years, our ability to exchange health data remains frustratingly limited. Commonly used clinical content standards, and the information models that underpin them, are primarily related to health data exchange, and so are usually document- or message-focused. In contrast, over the past 12 years, the Clinical Models program at openEHR International has gradually established a governed, coordinated, and coherent ecosystem of clinical information models, known as openEHR archetypes. Each archetype is designed as a maximal data set for a universal use-case, intended for reuse across various health data sets, known as openEHR templates. To date, only anecdotal evidence has been available to indicate if the hypothesis of archetype reuse across templates is feasible and scalable. As a response to the COVID-19 pandemic, between February and July 2020, 7 openEHR templates were independently created to represent COVID-19–related data sets for symptom screening, confirmed infection reporting, clinical decision support, and research. Each of the templates prioritized reuse of existing use-case agnostic archetypes found in openEHR International's online Clinical Knowledge Manager tool as much as possible. This study is the first opportunity to investigate archetype reuse within a range of diverse, multilingual openEHR templates. ObjectiveThis study aims to investigate the use and reuse of openEHR archetypes across the 7 openEHR templates as an initial investigation about the reuse of information models across data sets used for a variety of clinical purposes. MethodsAnalysis of both the number of occurrences of archetypes and patterns of occurrence within 7 discrete templates was carried out at the archetype or clinical concept level. ResultsAcross all 7 templates collectively, 203 instances of 58 unique archetypes were used. The most frequently used archetype occurred 24 times across 4 of the 7 templates. Total data points per template ranged from 40 to 179. Archetype instances per template ranged from 10 to 62. Unique archetype occurrences ranged from 10 to 28. Existing archetype reuse of use-case agnostic archetypes ranged from 40% to 90%. Total reuse of use-case agnostic archetypes ranged from 40% to 100%. ConclusionsInvestigation of the amount of archetype reuse across the 7 openEHR templates in this initial study has demonstrated significant reuse of archetypes, even across unanticipated, novel modeling challenges and multilingual deployments. While the trigger for the development of each of these templates was the COVID-19 pandemic, the templates represented a variety of types of data sets: symptom screening, infection report, clinical decision support for diagnosis and treatment, and secondary use or research. The findings support the openEHR hypothesis that it is possible to create a shared, public library of standards-based, vendor-neutral clinical information models that can be reused across a diverse range of health data sets.
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spelling doaj.art-12db21708f644747905d32f4bf930dec2022-12-21T19:46:59ZengJMIR PublicationsJournal of Medical Internet Research1438-88712020-11-012211e2336110.2196/23361openEHR Archetype Use and Reuse Within Multilingual Clinical Data Sets: Case StudyLeslie, HeatherBackgroundDespite electronic health records being in existence for over 50 years, our ability to exchange health data remains frustratingly limited. Commonly used clinical content standards, and the information models that underpin them, are primarily related to health data exchange, and so are usually document- or message-focused. In contrast, over the past 12 years, the Clinical Models program at openEHR International has gradually established a governed, coordinated, and coherent ecosystem of clinical information models, known as openEHR archetypes. Each archetype is designed as a maximal data set for a universal use-case, intended for reuse across various health data sets, known as openEHR templates. To date, only anecdotal evidence has been available to indicate if the hypothesis of archetype reuse across templates is feasible and scalable. As a response to the COVID-19 pandemic, between February and July 2020, 7 openEHR templates were independently created to represent COVID-19–related data sets for symptom screening, confirmed infection reporting, clinical decision support, and research. Each of the templates prioritized reuse of existing use-case agnostic archetypes found in openEHR International's online Clinical Knowledge Manager tool as much as possible. This study is the first opportunity to investigate archetype reuse within a range of diverse, multilingual openEHR templates. ObjectiveThis study aims to investigate the use and reuse of openEHR archetypes across the 7 openEHR templates as an initial investigation about the reuse of information models across data sets used for a variety of clinical purposes. MethodsAnalysis of both the number of occurrences of archetypes and patterns of occurrence within 7 discrete templates was carried out at the archetype or clinical concept level. ResultsAcross all 7 templates collectively, 203 instances of 58 unique archetypes were used. The most frequently used archetype occurred 24 times across 4 of the 7 templates. Total data points per template ranged from 40 to 179. Archetype instances per template ranged from 10 to 62. Unique archetype occurrences ranged from 10 to 28. Existing archetype reuse of use-case agnostic archetypes ranged from 40% to 90%. Total reuse of use-case agnostic archetypes ranged from 40% to 100%. ConclusionsInvestigation of the amount of archetype reuse across the 7 openEHR templates in this initial study has demonstrated significant reuse of archetypes, even across unanticipated, novel modeling challenges and multilingual deployments. While the trigger for the development of each of these templates was the COVID-19 pandemic, the templates represented a variety of types of data sets: symptom screening, infection report, clinical decision support for diagnosis and treatment, and secondary use or research. The findings support the openEHR hypothesis that it is possible to create a shared, public library of standards-based, vendor-neutral clinical information models that can be reused across a diverse range of health data sets.https://www.jmir.org/2020/11/e23361
spellingShingle Leslie, Heather
openEHR Archetype Use and Reuse Within Multilingual Clinical Data Sets: Case Study
Journal of Medical Internet Research
title openEHR Archetype Use and Reuse Within Multilingual Clinical Data Sets: Case Study
title_full openEHR Archetype Use and Reuse Within Multilingual Clinical Data Sets: Case Study
title_fullStr openEHR Archetype Use and Reuse Within Multilingual Clinical Data Sets: Case Study
title_full_unstemmed openEHR Archetype Use and Reuse Within Multilingual Clinical Data Sets: Case Study
title_short openEHR Archetype Use and Reuse Within Multilingual Clinical Data Sets: Case Study
title_sort openehr archetype use and reuse within multilingual clinical data sets case study
url https://www.jmir.org/2020/11/e23361
work_keys_str_mv AT leslieheather openehrarchetypeuseandreusewithinmultilingualclinicaldatasetscasestudy