Open Source Solutions for a Master Person Index

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Open Source Solutions for a Master Person Index

Will RossAMIA -- November 10, 2007

Chicago, Illinois

Example of unintended

consequences of technology

deployment.University of

California at DavisApril 2005 [c]

MENDOCINO informatics / November 2007

Mendocino & Lake Counties, California

• Over 100 miles north of San Francisco

• 4,700 square miles > (DE + RI)

• Population 144,000 (30 / sq. mi.)

• Largest city 16,000 people

• No Interstate Highway

• Long distances between small towns (4 hours to drive across)

• 5 hospitals, 200 total beds, 150 Physicians

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Location of Mendocino, California


About Mendocino Informatics

• Technology project management

• Specific focus on Health Information Exchange solutions

• Grant funded community software development and deployment

• Working primarily with Open Source software

• New Projects Wanted!

3MENDOCINO informatics / November 2007

Projects Completed

• Mendocino SHARE -- a prototype demonstration of health records exchange between safety net clinics

• OpenHRE -- an open source software tool kit with MPI and HRE services, built for Mendocino SHARE

• Record Locator Service -- a demonstration of the Connecting for Health Common Framework using OpenHRE

• NHIN Architecture Prototype -- a demonstration of the Connecting for Health Common Framework using OpenHRE

• ClearHealth -- feature development of open source EHR and Practice management functionality

• OS-CDE -- bench test of an open source fork from a proprietary Master Person Index software package


Current Projects

• Redwood Health Information Collaborative -- a community-based health information technology steering committee led by the Mendocino County Department of Public Health (policy focus)

• Redwood MedNet -- a new community-based non-profit organization formed to build and manage a health information exchange for local health care stakeholders (deployment focus)

• OpenEMPI.org -- form an open community to acellerate development and critical evaluation of open source solutions for community or enterprise master person index (MPI) (development focus)


Overview of the OpenEMPI ProjectOpenEMPI seeks to provide an open community to develop and to critically evaluate open source solutions for use as an Enterprise Master Person Index (EMPI)

• Articulate an accessible framework for development of open source MPI in any computing environment (J2EE, PHP, .NET, etc.)

• Contribute meta-analysis useful for open source MPI implementations on any computing platform

• Seek recommendations for a standards based approach towards development of an EMPI

• Aim for a structured evaluation process


OpenEMPI on the Web

• Launched by Stuart Turner in January 2007

• Additional editing by Will Ross

• Collaborators welcome

• Blog

• http://www.openempi.org

• Wiki

• http://wiki.openempi.org


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OpenEMPI Blog


http://www.openempi.org

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OpenEMPI wiki


http://wiki.openempi.org

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OpenEMPI wiki



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OpenEMPI wiki



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OpenEMPI wiki



Some Open Source MPI Projects

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project code sponsor

OpenEMed Java Public Project (USA)

OpenHRE Java Browsersoft / Connecting for Health

CDX Gateway .NET CSC / Connecting for Health

OHF Java IBM / Eclipse / IHE

Febrl Python Public Project (Australia)

“OS-CDE” Java California HealthCare Foundation


Open Source MPI Projects

• TeleMed built by Los Alamos National Labs in 1990s

• Based on Object Management Group distributed object specifications

• Renamed OpenEMed in 2000

• J2EE environment

• Available on Sourceforge

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http://openemed.org



• OpenHRE built by Browsersoft, Inc. in 2004 for the Mendocino SHARE project• v 0.1 released August 2004 showing a basic health

information exchange services

• v 0.5 released February 2006 for Connecting for Health demonstration of a Record Locator Service

• v 1.0 released January 2007 for NHIN Prototype Architecture• J2EE environment

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http://www.openhre.org



• CDX Gateway built by CSC for the Massachusetts SHARE project as part of the NHIN Architecture Prototype

• Version 1.0 released January 2007 for the NHIN Prototype Architecture

• Runs in a .NET 2.0 Framework

• Download as is, no support available from CSC

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https://ehr.consult.csc.com/cfh/code/download.aspx



• Eclipse Open Healthcare Framework (OHF) plugins developed by IBM for the NHIN Architecture Prototype

• Based on the Integrating the Healthcare Enterprise (IHE) developed by HIMSS for the annual Connectathon

• In IHE, PIX/PDQ profiles enable patient queries, uploads and merges

• IBM plugins for Eclipse OHF implement PIX/PDQ client actor profiles

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http://wiki.eclipse.org/index.php/OHF_IHE_Client_plugins

PIX/PDQ



• Febrl (Freely extensible biomedical record linkage) is developed by a collaboration between the Data Mining Group at the Australian National University (ANU) and the New South Wales Department of Health

• Implementation of the Fellegi and Sunter probabilistic matching method

• v 0.3 released April 2007, v 0.4 (GUI) to be released soon

• Written in Python

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http://datamining.anu.edu.au/projects/linkage.html


Open Source Care Data Exchange

• Care Data Exchange = proprietary software package custom developed by CareScience for the California HealthCare Foundation (CHCF) community HIE project in Santa Barbara

• Santa Barbara project launched in 1999

• Nonprofit RHIO created, user agreements signed

• Software built, data feeds configured, service established

• Inadequate community adoption for sustainability

• Santa Barbara project cancelled in November 2006

• OpenRHIN (“Open Regional Health Information Network”) proposed by California HealthCare Foundation in November 2006 with an open source model



• OpenRHIN produced no takers

• In December 2006 OpenEMPI submitted a proposal to CHCF to allow an investigation of the CDE software

• CHCF counter-offered a request for a demo of the CDE as an Open Source Record Locator Service

• In February 2006 OpenEMPI launched the OS-CDE = “Open Source Care Data Exchange” project



Open Source Care Data Exchange Investigation, February 2007Dave Minch, Will Ross, Stuart Turner, Jim Hazen, Odysseas Pentakalos, Shaun Grannis, Jeff Wallace, Scott Duvall. Photo by Richard Haley.


Open Source Care Data ExchangeTasks to build a workbench demo of the OS-CDE

• Identify and discard/disable/bypass any Proprietary IP

• BEA WebLogic portal

• UPenn Neural Net

• DataJunction (XML transformation tool)

• Oracle DBMS

• Adapt to various unnecessarily complex CDE legacy issues

• Complex and suboptimal clinical repository schema

• Cumbersome data loader to flow content into schema


Open Source Care Data ExchangeSolutions deployed by the OS-CDE

• Substituted FOSS IP

• JBoss

• Xalan & Xerces (XML processing)

• PostgreSQL

• Built drop in matching algorithm

SSN + FN + LN

SSN + YB + MB + DB

SSN + FN + YB + ZIP

FN + LN + YB + MB + DB



• Bench test successful

• Substantial engineering steps remain

• Refactor code for modularity

• Develop a complete software requirements specification

• Build formal use cases

• Review & anotate the logical and data models

• Productize the code for community release

• CHCF is in the process of conveying the code to the open source community


More Open Source MPI SolutionsMore software to be investigated

• “eCharts” is the current project name for another open source MPI in development, planned for release in 2008

• OpenMRS perhaps working on MPI functionality?

• Sun/SeeBeyond may be released under an Open Source license (announced at CHCF “OpenRHIN” Forum in San Francisco, November 2006)

• Please send details on any new open source MPI projects to the OpenEMPI project



Will [email protected]


Open Source Solutions for a Master Person Index

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