Two Level Modelling With Archetypes
The key innovation in the openEHR framework is to leave all specification of clinical information out of the information model but, most importantly, to provide a powerful means of expressing what clinicians and patients report that they need to record so that the information can be understood and processed wherever there is a need. Clinical information models are specified in a formal way ensuring the specifications, known as 'archetypes', are computable. The set of openEHR archetypes need to be quality managed to conform to a number of axioms such as being mutually exclusive. The archetypes can be managed independently from software implementations and infrastructure, in the hands of clinician groups to ensure they meet the real needs on the ground. Archetypes are designed to allow the specification of clinical knowledge to evolve and develop over time. Challenges in implementation of information designs expressed in openEHR centre on the extent to which actual system constraints are in harmony with the information design.
In the field of Electronic health records there are a number of existing information models with overlaps in their scope which are difficult to manage, such as between HL7 V3 and SNOMED CT. The openEHR approach faces harmonisation challenges unless used in isolation.
While individual health records may be vastly different in content, the core information in openEHR data instances always complies to archetypes. The way this works is by creating archetypes which express clinical information in a way that is highly reusable, even universal in some cases. To get to the point where information is suitably presented for clinical care it always involves a number of archetypes. These combinations of archetypes are called 'templates'; aggregations of archetypes which may also be refined for use in a particular situation. Templates may be used to specify forms, documents or even messages.
The openEHR approach uses the CEN- and ISO-standardised "archetype definition language" (expressed in ADL syntax or its XML equivalent) to build archetypes; these are reusable, formal models of domain concepts. Archetypes are used in openEHR to model clinical concepts such as "blood pressure" or "medical prescription".
Read more about this topic: Open EHR
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