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Something old – something newTomas Nordheim AlmeChief Medical Officer

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A huge investment

DIPS ASA puts about 150 mill Euro in the development of DIPS Arena between 2012 and 2016

OpenEHR is a central part of the strategy

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Goal – Develop the world’s best EHR High functionality Open Flexible

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How do you move

15 Hospital Trusts + 75 000 users

to a new, standardized, service oriented, OpenEHR-based platform?

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…or put differently…

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A gigantic change of mindset

Customers love the idea of two level modelling

Harder to sell in-house OpenEHR is complex Huge first step Capacity building takes time and

constant effort

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The Norwegian advantage

3 of 4 Regional Health Trusts use DIPS Classic EHR

Planning migration to DIPS Arena Structured patient records and CDS is

the goal Where to start?

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«The interregional structured patient record project»

From April to June 2014 Clinicians and health informatics staff

from the three regions DIPS is host, but vendor neutral delivery Project deliverables to be sent to

National ICT (national CKM)– An interregional admission note– Generic and a starting point for

specialization

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The interregional admission note (draft) Step 1: Separate persistent information

from event information– 1 document => 5-7 documents

• Previous diseases (problem list)• Heredity• Social status• Use of substances (alchohol/tobacco/other)• Medication (separate module)• Critical information (separate module)• The admission note

Step 2: Structure of the different documents

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How did we work?

The starting point is the generic template for admission notes used by all hospitals today

2 page document– Background incl social – Presenting problem– Natural functions– Substance use– Clinical examination– Assessment– Plans

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How did we work?

Three workshops Material sent out in advance About 25 delegates, about 10 active

clinicians Group and plenary discussions

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National vs international

Preliminary assessment:– About 40 archetypes involved– Probably need for 5-10 new archetypes– Change request 10-15

A national admission note template based on common international archetypes is within reach

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What else?

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Three ongoing projects

Involuntary psyciatric commitment Surgery planning ER-tool

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Psyciatric commitment

New national standard a few years back Will be made statutory Current module in DIPS Classic does not fulfill the requirements Focus on process and correct paperwork/workflow A pilot for what we can achieve with archetypes Plan to pilot with University of Northern Norway in 2014

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Surgery planning

DIPS Classic contains an advanced surgery planning module

Need more process support in early planning state

A pilot for what we can achieve with archetypes Plan to pilot at University of Northern Norway in

2015

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Emergency room

Based on existing, non-archetype module Patient list/ER-wall application Built in archetype support Any archetype (last registered) can be

configured as a column in the list Enters production on October 20th at Oslo

University Hospital

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What have we learned so far?

OpenEHR is powerful and complex Issues not related to new platform

(backward compatiblity) Form quality is an issue – need to

improve form design Underestimated the need for business

logic around the structured documents– Business rules/error prevention– Applies to process oriented functionality

(instr/actions)

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What’s ahead?

Strong customer support for an open, structured, process supporting EHR

The job at hand is huge! Need a stronger and more focused

collaboration within the OpenEHR community– Industry cooperation– Academic activity– Archetypes, tooling, promotion– GDL

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Thank you for your attention!