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qewd-hit-platform: QEWD Modular Platform for Health IT Demonstrator

Rob Tweed [email protected]
15 July 2020, M/Gateway Developments Ltd http://www.mgateway.com

Twitter: @rtweed

Background

The QEWD HIT Platform is a set of modular QEWD Containers that interoperate as a demonstrator for Healthcare IT integration, and which provide the basic building blocks for an operational system.

The Platform's Containers will run on any Linux server or virtual machine, and also on a Raspberry Pi (Models 3 or 4).

The HIT Platform is based around some important standard building blocks:

  • OpenID Connect (OIDC) for user authentication (cf NHS Login)
  • OpenEHR for clinical information
  • FHIR for demographic and other non-clinical information

As such, these very much conform to the vision set out by NHSX.

The platform consists of a set of QEWD Containers, each of which plays a specific role:

  • an OIDC Provider which can emulate NHS Login, and which also provides user authentication for the demonstration and configuration/maintenance applications that are included with the Platform
  • an Orchestrator service that provides the externally-facing interface to the suite of applications and MicroServices
  • a set of MicroServices:
    • an OIDC Client which is responsible for interfacing with the OIDC Provider
    • a simple FHIR-based Master Patient Index (MPI) which maintains and serves up patient demographic information
    • an OpenEHR Interface service which greatly simplifies how to maintain and fetch data from OpenEHR
    • an Audit service which keeps a log of all incoming requests received by the Orchestrator.

In the QEWD HIT Platform Github Repository, you'll see the files for each of these Containers in their own specific folders as follows:

  • main: the Orchestrator Container
  • oidc-provider: the OIDC Provider Container
  • oidc-client: the OIDC Client MicroService Container
  • fhir-mpi: the FHIR-based MPI MicroService Container
  • openehr-ms: the OpenEHR Interface MicroService Container
  • audit-ms: the Audit MicroService Container

The key idea of the QEWD HIT Platform is to remove much of the normal learning curve associated with OpenEHR, allowing you to build applications around OpenEHR quickly and simply, but in a way that can be scaled to enterprise production levels.

See the presentation slides for further background and rationale behind the QEWD HIT Platform.

Quick Start

If you'd like to try out the QEWD HIt Platform, and also experience its use with the PulseTile User Interface, along with a working, Dockerised openEHR System (EtherCIS), follow these quick and simple steps:

  1. You'll need a Linux server or Virtual Machine, or a Raspberry Pi (Model 3 or 4).

  2. Install Docker (if you don't already have it installed)

  3. Make sure you are using a non-root user with sudu privileges, and ensure the user can invoke docker commands without needing to use sudo (for the latter, see the instructions in the link for step 2 above)

  4. Now, simply run the following commands:

     cd ~
     git clone https://github.com/robtweed/qewd-hit-platform
     cd ~/qewd-hit-platform
     source quick-install.sh
    

Carefully read the on-screen instructions and answer all the questions. In most cases, you should be able to accept the default that is offered for each question.

  1. When the installer is finished, make sure that ports 8000, 8080 and 8081 are externally-accessible. For example, on Digital Ocean Droplets, you'll need to do the following:

     ufw allow 8000
     ufw allow 8080
     ufw allow 8081
    

Note: you shouldn't need to do anything on a Raspberry Pi to enable these ports.

  1. Fire up all the Docker Containers using:

     source startup.sh
    

The first time you run this, it has to download the various Docker Containers. Next time(s) you run the startup command, they will start pretty quickly.

  1. You should now have a fully operational system running on your server, and all the applications provided with the QEWD HIT Platform should be available for use.

For example, to try out the PulseTile UX/UI, in a browser go to:

    http://xx.xx.xx.xx:8080/pulsetile

    where xx.xx.xx.xx is the IP address or domain name of your Linux server

You can watch this video which shows the quick install process in action.

  1. To stop all the Docker Containers:

     cd ~/qewd-hit-platform
     source shutdown.sh
    

For further details about the QEWD HIT Platform, its moving parts and applications, read the rest of the documentation shown and linked below.

OpenEHR

The QEWD HIT Platform and OpenEHR

The primary aim of the QEWD HIT Platform is to provide a simple, easy-to-understand and easy-to-use interface to OpenEHR systems, and therefore reduce the otherwise significant learning curve for which OpenEHR systems are renowned.

The QEWD HIT Platform can integrate with any OpenEHR system.

If you already have access to an OpenEHR system, then you can install and configure the QEWD HIT Platform to interface with it.

Running your own OpenEHR System

If you want to set up your own OpenEHR server to use with the QEWD HIT Platform, the simplest approach is to use one of the available Dockerised versions of EtherCIS. These usually actually consist of two Docker Containers, one of which provides the REST front-end, whilst the other provides the Postgres Database that EtherCIS uses for data storage.

These EtherCIS Docker Containers are used for the Quick Install process described in the previous section. They implement the latest EtherCIS version 1.3.

If you're installing manually, then it's best to install the EtherCIS Containers in the sequence below. Detailed installation/configuration instructions are provided in each of the Github repositories:

The QEWD HIT Platform Interface to OpenEHR

The QEWD HIT Platform focuses on the creation, reading and updating of instances of a patient's Clinical Headings (eg Allergies, Procedures, Medications, etc), represented in an OpenEHR system by Templates.

It turns out that these interfacing operations (create, read, update) primarily involve the transformation of one JSON format into another (eg FHIR JSON format to/from the JSON format used by OpenEHR).

A key feature of the QEWD HIT Platform is that these transformations are performed in a declarative way, rather than programmatically, using a transformation template which is, itself, a JSON document.

A key goal of the QEWD HIT Platform is to create, as a result of this declarative JSON transformation approach, a straightforward, scalable solution that does not require specific programming skills, to create a set of definitive transformation template documents that can be jointly developed, agreed and shared across the NHS (and beyond), therefore avoiding the otherwise all too common reinvention of the same wheels.

This aspect of the QEWD HIT Platform is therefore important to understand, and is documented in detail here

Built-in Applications

The QEWD HIT Platform includes 4 browser-based applications: three for maintenance, configuration and monitoring of the Platform, and one that demonstrates a simple user interface around the core MPI and OpenEHR APIs:

  • demo application: a simple browser-based application that demonstrates the core HIT Platform's MPI and OpenEHR APIs

  • openehr-maint: A browser-based (React) application that allows you to populate and maintain clinical heading data in your OpenEHR system

  • oidc-provider-admin: A browser-based (React) application that allows you to maintain the configuration and user database of your OIDC Provider

  • qewd-monitor-ms: A browser-based (React) application that allows you to monitor and control the QEWD environment of each of your QEWD HIT Platform MicroServices.

Note: all four applications use the OIDC Provider for user authentication.

QEWD HIT Platform Documentation

Installing, configuring, running and using the QEWD HIT Platform is described in the following documentation:

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