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openEHR and Clinical Knowledge Manager

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A reader recently commented about something called openEHR. Maybe I was a little swayed by anything that says open since open source has used the term open so much. The idea of an open EHR sounded really interesting to me. I’m still not sure I completely understand the plan of openEHR, but I was put in contact with a fine lady named Heather Leslie who is working with openEHR on a product called Clinical Knowledge Manager (CKM).

I must admit that when I read the various information on clinical knowledge manager’s attempt to create clinical archetypes I was pretty lost. Maybe I’m just dumb or maybe across the pond (the project started in the UK) they are just using different terminology. Possibly it’s a little of both.

When I got this email about clinical knowledge manager the concept of creating clinical archetypes was new to me. I could be wrong, but reading it now they should have just said their creating standards for clinical data. That’s a concept I can understand and appreciate.

From what I can tell, it seems like CKM is essentially a wiki-like platform for displaying and improving these clinical standards (or archetypes if you prefer). I really think that the power of the crowd is the only way clinical standards are going to be defined, so the idea of a wiki-like website where people can collaborate around clinical standards sounds exciting. My only fear with it all is that if I’m having trouble cutting through much of the technical jargon, I wonder how many doctors will want to participate in this discussion. This seems like a really noble goal, but I can help but question if CKM and openEHR are not keeping EHR interoperability simple.

Time will tell how many EHR choose to adopt the clinical archetypes that openEHR creates. That will be the true measure of how valuable CKM will be to healthcare. I will be interested to see how this rolls out and if they can garner enough EHR interest and participation to make it a viable standard.

The following is an email about participating in clinical knowledge manager and more information on how it works: Read more..

April 24, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

CCHIT and Open Source HIMSS Meeting – Audio and Powerpoint Slides

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I’ve been meaning to post about the CCHIT and open source meeting at HIMSS for a while now and just haven’t ever gotten around to it. I did post my twitter thoughts on the CCHIT/Foss meeting, but I think there’s plenty more that could be said about that meeting.

For those of you that missed it, you can find the audio of the meeting on the CCHIT website and I’ll embed the powerpoint presentation from the meeting below:


My biggest complaint from the meeting was a slide that Mark Leavitt used to describe why he feels that CCHIT isn’t excluding the little guy. Basically it talks about the size and market share of the EHR vendors that have applied for CCHIT certification (you can see it as slide 12 above).

I can’t quite place why this measure feels wrong, but it does. Maybe it goes back to something one of my professors taught me when doing research analysis. He basically said, that when first looking at the numbers does it feel right. Considering what I know about the EHR and EMR market and CCHIT certification in particular, I know that something doesn’t feel right. Let me explain a few reasons and hopefully someone else smarter than me can comment on what else is wrong with this measurement.

First, the graph showing practice sizes served is misleading. I don’t know specifically how they found out which size practices a certified EHR vendor served, but I’m guessing it was self reported by the EHR vendor itself. If this is the case, most EHR vendors will say they can work in any practice size. So, that basically makes the data pretty useless. Possibly you could look at the size of the practices using the EHR system, but even then you get into trouble because how do you define “using” the system. A few EHR vendors can claim tons of purchases of their EHR software, but then you find out that very few if any of those purchases are actually implemented.

The second part of the slide shows a nice pie chart of the size of EHR vendors that are certified. The challenge I have with this chart is that it may just illustrate how small the EHR industry really is right now. The revenues of EHR companies are spread out over 300-400 EHR companies. Considering 5-15% (depending on where you look) adoption, that means that the majority of EHR companies are all small businesses with very low revenue.

I bet if we did a percentage of EHR vendors that did CCHIT certification for each of their annual revenue classifications you’d see something like this:
> $100 million – 100% CCHIT certified
$21 – 100 million – 90% CCHIT certified
$11 – 20 million – 50% CCHIT certified
$1 – 10 million – 15% CCHIT certified
< $1 million – 3% CCHIT certified

I’m just pulling these numbers out of the air, but I think you can see the principle of how CCHIT certification is being adopted by large EHR vendors and not as many small EHR vendors. CCHIT’s measure is just wrong. It should be percent in that EHR size category that are getting certified. It’s not the percentage of all CCHIT vendors that are doing it.

Reminds me of the common phrase that statistics can tell you anything you want to know. Something for all you EMR and EHR fans to chew on over the weekend.

I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.