Why openEHR?
October 8, 2006Hello, my name is Sam Heard and I am the CEO of Ocean Informatics. I want to tell you why our company believes that
openEHR holds so much promise for the future of health care in an increasingly technical world.
When I interviewed a rather recalcitrant patient recently, he leaned over, pointed at my computer screen and said, “Why are you asking me all this? It is already in there!” Not having access to information can be tedious and wasteful. You may have heard phrases like “We will just repeat this Xray, yes I know that your doctor has already done it but we do not have the results.” More importantly, it can lead to major problems. I have, for example, nearly killed a patient twice with the same drug because he was treated in hospital for the adverse effects and no information got to me (or to him it would seem). The next time he was ill, both he and I thought the safest thing to do was to use something that didn’t cause any problems last time – how far from the truth. But sharing health information between computers is difficult. This is due to both its complexity and the need for structure.
Information recorded about we human beings is far more complex than records we keep on other things such as our car services or our financial transactions. We have an understandable interest in what makes us healthy, what causes us to fall ill and what can be done to help; this knowledge is growing very rapidly in breadth and depth and is already far more than a clever doctor could learn in two or three lifetimes. Also, we doctors, and other clinicians, are somewhat eccentric and often want to record different details or arrange the record in a rather individual style. So, whatever solutions are proposed for sharing health information must be flexible with information laid out as the clinician, and perhaps even you, would like while still able to evolve and accommodate this ever growing knowledge.
And computers always need information to be structured in some manner. We could just use the structure of the file system and a word processor to share information, much as you do when you send an email. This level of information sharing has benefit, just as a fax machine does when sharing paper documents. The problem is that health records need more structure so that, for example, we can be sure who wrote what and when, who changed it and who sent it on to whom. We might need to see what the health record looked like on the 4th April last year as there is a dispute about the care a patient received. At a deeper level, we want to make sure I cannot prescribe that medication which nearly killed the patient last time – at least without a major warning, like a canon shot or siren!
You, the patient or citizen, may have your own preferences about medication that you would like the clinicians’ computer to understand, such as, “I only want to take antibiotics when there is strong evidence that it will lead to some benefit”. We also want patients to be able to enter information, such as their blood sugar or blood pressure readings in their own record. We want to achieve this as research has shown that such readings can be more important in ensuring that a patient is receiving the correct care than the readings taken by your doctor or nurse.
The
openEHR health record, developed through many years of research in Europe and Australia, offers a comprehensive solution to this problem. While it is a sophisticated technology under the hood, to clinicians and their patients it offers the secure sharing of health information in a rapidly evolving environment. It does it in a new way that means software does not have to be continually re-written to deal with changing clinical practice. Importantly, it does this in a way that means you can keep your record on a memory stick in your wallet, or at your doctors, or at the hospital or even on a national record bank if you are traveling around the country or world. For hospitals, clinics and doctors’ offices it means that the health record store can be independent of the clinical application – so when there is a need to update the clinical software the health record remains secure and interpretable. Different professionals can have software that is highly specialised for their particular line of work and still keep information in a form that everyone can read and access.
Your record, or just the bit that you want, can easily and securely be made available to the professionals taking care of you from a distance; it can be viewed over the web or edited from another site. You can move your entire health record from one place to another (without photocopying!) and it can be understood by all systems that understand
openEHR. As we said, you can view and add to your record and it will soon be possible to keep it on your home computer should you wish.
There is no other solution that promises so much. What is very important is that openEHR is not a proprietary product – it is freely available from a charity based at University College London called the
openEHR Foundation. You can read more about it from their website. Ocean Informatics has been instrumental in the development of this important advance in health care computing and has built a range of tools to help different companies implement this new specification. It is truly a health care computing platform for the future.
Want to read More?
- A technical overview of the openEHR architecture as PDF.