It’s encouraging to see Matthew Gould, the CEO of the newly formed NHSX is spending time at
the clinical frontline before he formally starts in his post in July. After reading Matthew Gould’s most recent blog, it’s clear his time so far with care professionals is helping inform his views; recognising that health IT is frustratingly clunky, siloed and way behind other sectors.
We recognise that there is some important new thinking and messages with his most recent welcome declaration;
“we’re going to focus on standards and platforms, keeping the centre as ‘thin’ as possible”.
This shift is an acknowledgement that the health IT market is underperforming, one size doesn’t fit all and we need a new approach to health IT.
This latest initiative by NHSX, has a good deal in common with the work of the Ripple Foundation. In advocating user centred design, the use of open standards and open source for healthcare, and now this focus on the platform approach in healthcare, these principles resonate with us very much. This more open approach is a good fit with the clinical community too, where sharing knowledge and research for the betterment of health outcomes is understood as a public good.
While we welcome this shift towards a healthcare platform by NHSX, our experience has taught us this is non-trivial challenge, so would urge NHSX to learn from others in this field tackling this same challenge, both in the UK and abroad such as the Global Goods initiative from Digital Square.
The state has an important role to play in supporting companies tackle this fragmented market that is dominated by a few big tech players. If done right, a platform based approach can help to stimulate new entrants to the market and drive innovation.
One particular challenge NHSX will face will be finding the balance between coordination and control of platform development while letting innovators innovate at the frontline, to get the right information, at the right time, to help care professionals deliver the best possible care.
What does the NHS mean by a platform in healthcare anyway?
We believe NHSX, should be working towards the definition of an open platform, as defined by Apperta Foundationand therefore start the move away from closed platform/monoliths, which both Yorkshire & Humber LHCR and NHS Scotland are already working towards.
“Open platforms liberate both data and applications making them portable and interoperable across different platform implementations…. The open platforms approach is vendor and technology neutral, eliminates lock-in, facilitates innovation and competition, and forces vendors to compete on quality, value, and service”.
Indeed the Apperta paper on Defining an Open Platforms, defines 8 core platform principles:
Open Standards Based
Shared Common Information Models
Supporting Application Portability
Vendor and Technology Neutral
Supporting Open Data
Providing Open APIs
Operability (as in DevOps)
So as well as continuing to meet care professionals at the frontline, we, Ripple Foundation and Apperta Foundation, would welcome a conversation with Matthew Gould and NHSX colleagues to discuss our learnings and expertise in this field as well as to discuss strategic investment into open platform innovation via the 1% Fundto enable a small safe start, the iterative curation of common platform components and collaboration between the frontline and NHSX.
Ripple Foundation is proud to be leveraging the multi-purpose QEWD.js as a world leading integration framework to meet the increasing demands of Healthcare IT.
QEWD.js is an incredible versatile middleware that Ripple Foundation, a not for profit organisation, is endorsing as part of its showcase stack in the pursuit an open health and care platform to improve clinical systems. It offers an integration framework that can link the UI components you need with the APIs you want and the database you use. QEWD.js is a framework that is perfect for web integration challenge because it is fast, capable, flexible and scalable.
Ripple Foundation have five reasons why they believe that QEWD.js is a great choice for the 21st Century demands that clinicians and technicians face:
Web Integration Framework – ready, willing and able
Quick and Easy Development – gets you up and running quickly
Quality for Enterprise – built to be superfast, solid, secure and scalable
Open Source – openly shared to be publicly and freely accessible
Rob Tweed, the technical leader behind QEWD.js and co-owner of M/Gateway Developments Ltd said, “I’m acutely aware of the issues that health and care is facing not only in Britain but also around the world. I am encouraged that Ripple Foundation see the value of our quality web enterprise development platform – QEWD.js – to help tackle some of the issues facing HealthIT. It’s open source, super-fast, scalable and adaptable – what’s not to like?”
Dr Tony Shannon, Director of Ripple Foundation said, “QEWD.js is a key component of the Ripple Foundation’s showcase stack and should be taken very seriously. It’s been cleverly crafted by Rob Tweed and it’s an incredibly versatile integration framework that is swift, agile and flexible. If you combine QEWD.js with the rest of Ripple Foundation’s showcase stack – PulseTile and EtherCIS – they offer the basis of an open platform that can be used across the world – large or small scale. Being modular, the flexibility is yours – please use it, get involved, build upon it and share the learning”.
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Ripple Foundation leverages leading edge QEWD.js
The world of healthcare can now begin to leverage the power and potential of the EtherCIS Clinical Data Repository. EtherCIS development has been supported by the non profit Ripple Foundation and this leading technology now provides the key foundation of its “showcase stack” and work towards an open platform in healthcare. EtherCISdevelopment is led by Christian Chevalley of ADOC Software Development and the EtherCIS technology is now the leading open source implementation of the openEHR standard in action (including AQL support). The openEHR standard has been adopted and implemented across healthcare systems throughout the world, representing the future of health IT.
Christian Chevalley of ADOC Software Development said, “EtherCIS being open sourced is not accidental, it is organically inherited from its fundamental components and philosophy. It is based on the open standard openEHR that specifies an open, vendor neutral, patient centred clinical data handling and knowledge engineering. Its implementation has been feasible due to the remarkable progress of the open source database PostgreSQL supporting the combination of relational and document typed data efficiently. Most of EtherCIS components have been derived from open source building bricks: service architecture, object oriented database querying, data serialisation, Web communication etc. As such, it is the result of the contributions of hundreds of analysts and developers.
Christian continued to say, “Open Source entitles anybody to have access to the source code, uses and copies the software and contributes to it; it is technically extremely convenient, however to promote successfully EtherCIS into the highly competitive Healthcare IT arena, it had to be free as in Libre. As a free and open software platform, it gives the freedom to anyone to create copy and run a clinical applications that is respectful of the fundamental right to store, query and interchange medical information without being tied to a specific vendor, proprietary encoding or physical location.
“Ripple Foundation has been instrumental to make this achievable; it has not only provided the necessary means to achieve EtherCIS development, but has also stimulated the collaboration, contributions and reviews by clinicians and IT peers, internationally. The result is a solid and relevant IT platform that is now naturally and logically fully integrated into the Ripple Foundation, supporting the adoption of an open health and care platform. The mission and values that Ripple Foundation is abiding by firmly sits with my own views, so I’m thrilled that EtherCIS is now officially part of the Ripple Foundation family.”
Dr Tony Shannon, Director of Ripple Foundation said, “We are honoured to be supporting EtherCIS as a key element of the Ripple Foundation’s open platform showcase stack. We know to improve health IT we need data, information and knowledge to support the complex and highly pressurised health and care system. EtherCIS ensures that information and data can be accessed, stored and exchanged securely because it a world leading open source example of the vendor-neutral & technology-neutral openEHR standard in action, developed and tested in the context of a highly usable clinical application. EtherCIS is a Clinical Data Repository fit for 21st Century Health and Care.”
Ripple Foundation is a community interest company that is supporting the adoption of an open health and care platform. It is a clinically led team that working with communities to support using an integrated digital care platform for today and the future. Open source, open standards and underpinned by an open architecture that can be used worldwide.
Ripple Foundation is supporting and promoting the #1percent open digital platform challenge fund that is hoped will stimulate and support both the creation and adoption of an open digital ecosystem for the nation.
EtherCIS Clinical Data Respository. More info available at ethercis/
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Ripple Foundation launches EtherCIS to the world of healthcare
Ripple Foundation is launching a series of three videos that introduces viewers to openEHR. openEHR is an open, clinically lead approach to creating a standards based healthcare platform for the 21st Century. This includes standardised clinical content and information models for the health and care market. Allowing vendors and developers of front-end and back-end solutions to leverage a common set of standards to help design, store and querying rich clinical information sources. openEHR is leading the international field in this effort, with benefits for stakeholders and key decision makers which allows them to :
let their clinical experts be directly involved in solution development, via archetype authoring
built a patient centred record while avoiding technology and/or vendor lock-in
retain ownership of the data for primary and secondary use
Put another way… it is an open data standard, both vendor and technology neutral, that’s been designed to support the needs of 21st Century Healthcare.
Each video is approximately two minutes long and can be shared with anyone who wishes to understand more about openEHR.