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Querying EHR Data with Archetype Query Language
- 1. © 2014 Marand Querying EHR Data with Archetype Query Language Borut Fabjan Solution Architect / Head of MarandLab www.marand.com Think!EHR Platform – open health data platform Better Data Better Care
- 2. Company Facts 2 • $25M revenue • 120 employed professionals • 80 experienced software developers • Products, References and domain knowledge in healthcare and telecommunications • 25 years in IT • ISO 9001 & 27001 certified
- 3. Marand HealthCare Solutions 3 • National OnLine Health Insurance Card • Cancer Registry of Slovenia, Cancer Screening • Think!Med ClinicalTM systems − Institute of Oncology − UMC Ljubljana – Children’s Hospital Cardio Surgery, Infections Clinic, Nuclear Medicine, Radiology • Think!EHRTM Platform • Slovenia’s national eHealth Infrastructure • City of Moscow eHealth Project
- 4. Motivation 4
- 5. Motivation 5
- 6. Motivation 6
- 7. Motivation 7
- 8. Motivation 8
- 9. Motivation 9
- 10. The Quest for the Holy Grail 10 • Part of The Mythical Quest - In search of adventure, romance and enlightenment.
- 11. Motivation 11 • EHR structured data − compute health information • Clinical Decision Support • Patient Safety • Registries • Population Health • Business intelligence for payers • Medical research • Personalized-‐medicine − historically heated debate (data standards problem) • HL7 RIMv3, ISO13606, OpenEHR • Data normalization
- 12. Simple question... 12 • What is the percentage of patients with high BMI? • How many diabetes patients are controlling their sugar? • How many patients have been diagnosed with Crohn’s disease last year?
- 13. Semantic underpinning 13 • OpenEHR framework Templates • 1:N Reference Model Archetypes • 1:N Terminology interface Querying Terminologies • SnomedCT • ICDx • ICPC All possible item definitions for health Use-case specific data-set definitions Portable, model-based queries Defined connection to terminology Defines all data
- 14. Vertical semantic framework from GUI to Storage
- 15. Model-based querying • The openEHR community has defined a query language spec based on archetypes called AQL – Archetype Query Language • Compositions (records) are based on templated archetypes • Archetypes are hierarchical in structure, and every node can be addressed by its path (locatable) • Query based on clinical models, independent of persistence / storage model
- 16. AQL in a nutshell • SQL + path syntax to locate nodes or data values within archetypes SELECT data elements to be returned FROM query data source CONTAINS Containment (matches context) WHERE set filtering criteria on archetypes or any node within the archetypes ORDER BY result ordering
- 17. AQL example • Population Query for high blood pressure records • Returning a Result Set
- 18. AQL on the Battlefield • Complete EMR − Part of University Medical Center Ljubljana − 10 specialities, including ICU and surgery − New, state-‐of-‐the-‐art facility • 200+ beds, 14 ICU, 4 OR, 5 Recovery • PCs, Touchscreens, iPads • New medical devices − Integrated barcode, medical devices − All clinical content in archetypes
- 19. AQL in EMR – Lines, Tubes, Drains
- 20. AQL in EMR – Labs
- 21. AQL in EMR – Lines, Tubes, Drains
- 22. AQL in EMR – Medication Administration
- 23. AQL in EMR – Clinical Decision Support
- 25. Think!EHR Explorer AQL Query Editor
- 26. Think!EHR Explorer AQL Query Builder (QBE)
- 27. Think!EHR Explorer AdHoc Input Form Generator
- 28. Think!EHR AdHoc Form Generator
- 29. Nation wide EHR / eHealth platform • Slovenia’s national eHealth Infrastructure − Scale: 2 mio. population − IHE / OpenEHR ecosystem • Moscow City EHR Project − Scale: 12 million patients, 1B documents − Many applications, vendors, one CDR − eHealth platform for the future − Short time-to-delivery
- 30. City of Moscow eHealth platform Moscow city - 780 medical facilities, including: • 149 hospitals, 76 health centers, 428 policlinic institutions Volume: • Patients- 12 million, Beds in hospitals – 83,000 • Physicians – 45,000, all users – 130,000 • Patient visits/year - 161 million • Documents/year - 1 Billion, 25TB • Pilot live at 6 clinics as of Aug 2013!
- 31. EhrScape.com