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Norwegian national governance of archetypes

Norwegian national governance of archetypes. Silje L. Bakke Archetype coordinator National ICT Norway. Norway. You are here !. 1750 km. 1750 km. Norwegian public hospital system. Four Regional Health Authorities (RHAs) 24 Hospital Trusts, each with one or more hospitals

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Norwegian national governance of archetypes

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  1. Norwegian national governance of archetypes Silje L. Bakke Archetype coordinator National ICT Norway

  2. Norway Youarehere! 1750 km 1750 km

  3. Norwegian public hospital system • Four Regional Health Authorities (RHAs) • 24 Hospital Trusts, each with one or more hospitals • 100 % EHR adoption • Two main EHR vendors • Siemens (Central Norway) • DIPS (everywhere else) • One strategic coordinating health trust for IT (National ICT) • Directorate of Health dept of E-health

  4. openEHR in Norway • No clinical use - yet • DIPS is implementing openEHR, implementation is being tested in hospitals • University Hospital of Northern Norway (Tromsø) has been testing for Gastrolab(?????) • Oslo University Hospital will deploy DIPS Arena for Trauma and A&E in Oct 2014

  5. openEHR in Norway, continued • National ICT has developed and deployed a national archetype governance scheme • Three people employed • Leader and two coordinators • Total of two full time positions • Goals • High quality archetypes • Semantic interoperability through use of identical archetypes

  6. openEHR in Norway, continued • Clinical Knowledge Manaker (CKM) • Norwegian CKM online onFebruary7 2014

  7. Governanceorganisation

  8. The governancemodel

  9. The governance model – development • Distributed archetype development • Local initiatives define requirements • “Do-ocracy” – doers make the decisions • Regional resource groups • Assist local initiatives • National design group • Specialist group w/ technical focus • Archetypes can be uploaded to CKM as “draft” • Facilitates collaborative development

  10. The governance model – review • National editorial group • Initiates reviews • Specifies requirements for reviews • Regional resource groups • Recruit healthcare professionals for reviews • CKM is key • Severalreviewrounds • Consensus →approvalphase starts

  11. The governance model – approval • National editorial group • Assess quality of review • Approves archetypes for publication • Approved archetypes are marked as “published” in the Clinical Knowledge Manager

  12. Preliminary results • GovernancemodelapprovedOctober 2013 • EditorialgroupformedJanuary 2014 • CKM in productionFebruary 2014 • First threearchetypes under review • Participatingclinicians from all over the country • Good input from clinicians • CKM workswell for it’s purpose • Someimprovementofgovernancemodel is needed (si noe mer om registerspesifikke arketyper!)

  13. Clinicianresponse, first time users «Should intrauterine weight be part ofthisarchetype? This is an important parameter for obstetricians.» «Shouldthisfieldperhaps have an assumedvalue?» Cliniciansgetthis.

  14. Further plans • Get a catalogueofbasicarchetypesapproved • BP, T, P, RR, weight, height, MEWS, ++ • Priority support for initiatives w/ imminent deployment • Oslo University Hospital • Improvingthegovernancemodel • Recruit more clinicians for reviews • Achievewider support from healthcareprofession and specialistorganisations

  15. Will it work? • Will we be able to catch and keeptheinterestofclinicians? • …willtheyagreewitheachother? • Will thevendor support be goodenough? • Whywill it workthis time? • Eacharchetype is self-contained and portable, as opposed to earlierapproaches • Tools, distributed, available online, social media aspect, senseofcommunity • Maximum dataset, reducesneed for absolute consensus

  16. Vise CKM live • Graf over brukere i CKM • Prioriterer arketyper som kan gjenbrukes • Hva mener vi med gjenbruk? • Aggregering til styringsdata på organisasjonsnivå og på helsepersonellnivå • Registerrapportering • Trender på enkeltpasienter (blodtrykkskurve vsblodtrykksmedisinering; derfor Blodtrykk) • samt historikk (tdligere operasjoner av samme type) • Sammenstillinger (samle forskjellig informasjon i ett bilde) • Søk (spesifikk informasjon, «hva slags protese var det igjen?») • Prosesstøtte (slippe å eksplisitt skrive hva man ønsker å gjøre) • Beslutningsstøtte (derfor MEWS) • Oppfordrer til bruk av internasjonalt definerte arketyper, og deling av de vi lager i Norge

  17. Questions? Photo: Harald Hognerud

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