TAC Topic Suggestion: CDS by leveraging openEHR

Attn: @akanter @burke @grace @ibacher @jdick @jteich @mksrom @mogoodrich @mseaton - and all the usual TAC-ers.

@jaan (intro here) would like to discuss his findings about how openEHR could help implement CDS with OpenMRS. Jaan has been doing some research and had a lot of exchanges with various medical informatics folks over the past few weeks. He would like to run us through his findings and hear the voice of the OpenMRS Community on the subject.

Could we do that this upcoming Monday and keep a slot for Jaan and his topic?

For those unfamiliar with openEHR, I found this very good (30 min) read here from INTEROPen:

@jaan - please amend/complement, as I may have altered your message/thoughts.


I really appreciated reading the attached white paper comparing OpenEHR and FHIR and its advocating for collaboration. I have long valued the clinical and informatics work behind archetypes and OpenEHR but have been reluctant to hitch OpenMRS’ model to it. Part of the reason was the high overhead of work required to model the data properly across our broad implementation ecosystem. Part of it was related to the lack of acceptance or valuing of the interoperability features. It is true that the world has evolved to now appreciate the needs for semantic interoperability, but I don’t know if the OpenMRS community has fully reached that level. Focusing on transmission (FHIR) rather than data modeling seems like an appropriate first step. I still am quite hesitant about tying data representation too closely to a CDR spec. I do think it is worth looking at how we information model the OpenMRS database and perhaps an intermediary stateless data layer using the OpenEHR archetypes for certain key concepts… such as pregnancy status, allergies, etc. Worth having a discussion about this!

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Thanks so much @mksd! This talk by Patrik Georgii-Hemming, the CMIO of karolinska.se is also fantastic: Highmed Symposium | Recording | Berlin | October 14, 2021 - YouTube

Looking forward to meeting you all and discussing what the easiest pilot or proof-of-concept would be – a decision tree like https://s3-eu-west-1.amazonaws.com/files.royalfree.nhs.uk/Reporting/Streams_Report.pdf perhaps? Some old colleagues of mine at DeepMind built this so I can ask them if we need help.

Do we want to schedule this conversation for next Monday, 4 April @ 3pm UTC TAC call?

@mksd, I see in Slack that Jaan would like to do this on 25 April. I’ve pencilled this in for 25-April TAC.

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Hi everyone,

I was intrigued to see the interest in openEHR from this community. I’ve often felt that there was a potentially a really good synergy between openEHR (for data) and openMRS and have spoken to your colleagues in India about the potential. I’d be more than happy to field any questions that come out of your meeting.

I have been closely involved in openEHR in a few guises over many ears and am just about to step down as Director of openEHR International.

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Is this being rescheduled? I came on the call a few minutes late.

Hi Andrew,

I think you and I have chatted about openEHR and openMRS in the past at MedInfo. If it was not inappropriate, I’d be happy to attend any rescheduled call to answer questions.

Over the last week, the timing of our Technical Action Committee (TAC) calls was in flux to accommodate the OpenMRS 3 Product & Design call. Now that we’ve confirmed the new time for TAC calls (4pm UTC), we can get this topic rescheduled.

TAC calls will now take place on Mondays at 4pm UTC.

We should probably give people at least a week or two notice for this CDS topic. There’s an AMIA Clinical Informatics Conference the week of 23 May and 30 May is a US holiday, so…

@jaan & @ianmcnicoll, would 4p UTC on Monday 16 May work for you?

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Apologies, I only just got this don’t have my notifications setup correctly. Double apologies so as I am actually off on leave that week.

@ianmcnicoll, how about the following week (23 May @ 4pm UTC)? If that works for you, then we can check with others and, assuming we have a quorum, I can make it work with my schedule.

Sorry Burke,

I’m not actually back until later that day. I’m on a hike in the Scottish wilderness or I would try to join remotely and the following week isa public holiday here.

Sorry to be so unhelpful, just bad timing.

@jaan & @ianmcnicoll,

Which Mondays in June would work for you for a 4pm UTC call?

  • 6 June
  • 13 June
  • 20 June
  • 27 June

I’m ok for all of these dates

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FYI - I was able to reach @jaan and have scheduled a discussion on CDS leverage openEHR for TAC on 27 June 2022.

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Hi @burke, @ianmcnicoll - I have a demo clinical decision support tool to share.

Should we have a call?

Demo: childfx Username & password: please email me at jaan@onefact.org. Test images: https://radiopaedia.org/articles/supracondylar-humeral-fracture-2?lang=us

Example output:

This tool was built with our collaborators, and the 501c3 I started is releasing it on Epic’s AppMarket, and I’d love to discuss how to get it into OpenMRS as well (I’m also working with the lead architect of OpenEHR to ensure it works globally).

This tool detects fractures in children’s upper extremity X-Rays, which can cause lifelong disability if not correctly addressed. However, in several countries where OpenEHR, OpenMRS, DHIS2 etc are the only option, there are few radiologists (e.g. in Malawi the rate is 1 in 8.8M). So our goal is to estimate the DALYs saved compared to commercial EHRs like Epic.

Thank you! Jaan

Hi Jaan,

This is definitely worth a conversation.


Thank you @ianmcnicoll !! What is the best format? Another TAC call?