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Dipak Kalra (born 18 July 1959, London, UK) is President of the European Institute for Health Records and of the European Institute for Innovation through Health Data. He undertakes international research and standards development, and advises on adoption strategies, relating to Electronic Health Records.
Dipak Kalra studied medicine at Guy's Hospital in London, and specialized in General Practice. He is a Fellow of the Royal College of General Practitioners. He worked as a London GP for a decade before specializing in Health Informatics. He obtained a PhD in Health Informatics in 2003 and is a Fellow of the British Computer Society.
Kalra plays a leading international role in research and development of Electronic Health Record architectures and systems, including the requirements and models needed to ensure the robust long-term preservation of clinical meaning and protection of privacy. He leads the development of CEN (European Committee for Standardization) and ISO (International Organization for Standardization) standards on EHR interoperability, personal health records, EHR requirements, and has contributed to several EHR security and confidentiality standards.
He has led multiple European projects in these areas, including Horizon 2020 and the IMI programme alongside pharma companies, hospitals and ICT companies. He recently co-led a €16m project on the re-use of EHR information for clinical research, EHR4CR, alongside ten global pharma. He is a partner in another IMI project, EMIF, on the development of a European clinical research platform federating multiple population health and cohort studies. Dipak also led an EU Network of Excellence on semantic interoperability, and is a partner in other EU projects on the sustainability of interoperability assets, the transatlantic sharing of patient summaries and quality labelling.
Dipak is President of the European Institute for Innovation through Health Data (www.i-HD.eu), which seeks to drive best practices in the trustworthy use of high quality and interoperable health data by all stakeholders, for optimising health and knowledge discovery. He is also President of the European Institute for Health Records (EuroRec), which is the coordinator or a partner in many EC projects on electronic health record quality and systems accreditation, interoperability and the uses of health data for research. EuroRec leads a network of national ProRec Centres which promote good quality EHR system adoption across Europe.
Dipak Kalra is Professor of Health Informatics at University College London [1] and Visiting Professor of Health Informatics at Ghent University.
Dipak is a member of multiple standards bodies including BSI Group, CEN, ISO and HL7-UK (International HL7 Implementations).
Dipak was a founding Director of the openEHR Foundation, a not-for-profit company which exists to promote and publish, via the Web, the formal specification of requirements for electronic health record information, supporting development of open specifications for health information systems.
Dipak's innovations in EHR architectures have been spun out into a company: Helicon Health, providing cardiovascular chronic disease management services across London.
This project, sponsored through the Innovative Medicines Initiative, comprises almost 50 academic partners and a dozen Pharma partners, developing a generic platform to provide harmonised views across multiple population health (cohort) data sets across Europe and geographically proximal EHR systems. The two initial clinical research areas are dementia and metabolic disorders. Dipak leads workpackages on semantic interoperability and ethics, and is a member of the business modeling task force.
This public-private research project, involving 35 partners from academia and 10 Pharma companies. EHR4CR is developing a platform to support remote querying of hospital electronic health records in order to enable more efficient feasibility assessment, recruitment and conduct of clinical trials. Dipak leads the Managing Entity and co-leads two work packages on requirements and on sustainable business models. The project is now spinning out a commercial platform for European scale-up to be run by Custodix, and a not-for-profit institute that Dipak will lead: the European Institute for Innovation through Health Data.
VALUeHEALTH is establishing how eHealth interoperability can create, deliver, and capture value for all stakeholders. It will develop an evidence-based business plan for self-funding priority pan-European eHealth Services beyond 2020. It will examine the maturity of existing standards and infrastructures, propose organisational changes and incentives, and perform state-of-the-art Cost Benefit Assessments, and from this produce a definitive Business Plan and Strategy for taking forward public-private investment in digital eHealth services. Dipak is the co-ordinator of VALUeHEALTH.
eStandards brings together the leading Standard Developing Organizations in Europe, supported by the eHealth Network and EuroRec. It will develop an evidence-based roadmap for eHealth standards alignment that is endorsed by SDOs, the eHealth Network, and key stakeholders. It will contribute to the European eHealth Interoperability Framework, focusing on clinical content modelling for different paradigms and embedding a quality management system for interoperability testing and certification of eHealth systems. Dipak leads tasks on multi-stakeholder engagement and the development of good practice in clinical information modelling.
ASSESS CT will contribute to better semantic interoperability of eHealth services in Europe, in order to optimise care and to minimise harm in delivery of care. The ASSESS CT project, integrating a broad range of stakeholders, will investigate the fitness of the international clinical terminology SNOMED CT as a potential standard for EU-wide eHealth deployments. It will investigate Member State reasons for adoption/non adoption of SNOMED CT, lessons learned, success factors and the impact of SNOMED CT adoption from a socio-economic viewpoint. Dipak leads the workpackage to define policy guidance and make the final recommendations of the project.
Semantic interoperability of EHR systems is a vital prerequisite for enabling patient-centred care and advanced clinical and biomedical research. SemanticHealthNet will develop a scalable and sustainable pan-European organisational and governance process to achieve this objective across healthcare systems and institutions. The consortium comprises 17 Partners and more than 40 internationally recognised experts, including from United States and Canada, ensuring a global impact. Dipak is the project lead.
This project will design a development and adoption roadmap for sharing patient summaries between the US and the EU, with partners from both sides of the Atlantic. Trillium Bridge supports the Transatlantic eHealth/health IT Cooperation Memorandum of Understanding and Roadmap and the Digital Agenda for Europe in achieving a triple win for eHealth by establishing the foundations of an interoperability bridge to meaningfully exchange patient summaries and electronic health records among the EU and US.
EXPAND - Expanding Health Data Interoperability Services – is a Thematic Network (TN) EC project to progress towards an environment of sustainable cross border eHealth services established at EU level by the Connecting Europe Facility (CEF) and at national level through the deployment of suitable national infrastructures and services.
ISO International standards (development led by Dipak)
Health informatics is the study and implementation of computer structures and algorithms to improve communication, understanding, and management of medical information. It can be viewed as branch of engineering and applied science.
Health Level Seven or HL7 is a range of global standards for the transfer of clinical and administrative health data between applications. The HL7 standards focus on the application layer, which is "layer 7" in the Open Systems Interconnection model. The standards are produced by Health Level Seven International, an international standards organization, and are adopted by other standards issuing bodies such as American National Standards Institute and International Organization for Standardization. There are a range of primary standards that are commonly used across the industry, as well as secondary standards which are less frequently adopted.
A medical classification is used to transform descriptions of medical diagnoses or procedures into standardized statistical code in a process known as clinical coding. Diagnosis classifications list diagnosis codes, which are used to track diseases and other health conditions, inclusive of chronic diseases such as diabetes mellitus and heart disease, and infectious diseases such as norovirus, the flu, and athlete's foot. Procedure classifications list procedure code, which are used to capture interventional data. These diagnosis and procedure codes are used by health care providers, government health programs, private health insurance companies, workers' compensation carriers, software developers, and others for a variety of applications in medicine, public health and medical informatics, including:
An electronic health record (EHR) is the systematized collection of patient and population electronically stored health information in a digital format. These records can be shared across different health care settings. Records are shared through network-connected, enterprise-wide information systems or other information networks and exchanges. EHRs may include a range of data, including demographics, medical history, medication and allergies, immunization status, laboratory test results, radiology images, vital signs, personal statistics like age and weight, and billing information.
openEHR is an open standard specification in health informatics that describes the management and storage, retrieval and exchange of health data in electronic health records (EHRs). In openEHR, all health data for a person is stored in a "one lifetime", vendor-independent, person-centred EHR. The openEHR specifications include an EHR Extract specification but are otherwise not primarily concerned with the exchange of data between EHR-systems as this is the focus of other standards such as EN 13606 and HL7.
SNOMED CT or SNOMED Clinical Terms is a systematically organized computer-processable collection of medical terms providing codes, terms, synonyms and definitions used in clinical documentation and reporting. SNOMED CT is considered to be the most comprehensive, multilingual clinical healthcare terminology in the world. The primary purpose of SNOMED CT is to encode the meanings that are used in health information and to support the effective clinical recording of data with the aim of improving patient care. SNOMED CT provides the core general terminology for electronic health records. SNOMED CT comprehensive coverage includes: clinical findings, symptoms, diagnoses, procedures, body structures, organisms and other etiologies, substances, pharmaceuticals, devices and specimens.
In the field of informatics, an archetype is a formal re-usable model of a domain concept. Traditionally, the term archetype is used in psychology to mean an idealized model of a person, personality or behaviour. The usage of the term in informatics is derived from this traditional meaning, but applied to domain modelling instead.
The European Institute for Health Records or EuroRec Institute is a non-profit organization founded in 2002 as part of the ProRec initiative. On 13 May 2003, the institute was established as a non-profit organization under French law. Current President of EuroRec is Prof. Dipak Kalra. The institute is involved in the promotion of high quality Electronic Health Record systems in the European Union. One of the main missions of the institute is to support, as the European authorised certification body, EHRs certification development, testing and assessment by defining functional and other criteria.
The European Committee for Standardization (CEN) Standard Architecture for Healthcare Information Systems, Health Informatics Service Architecture or HISA is a standard that provides guidance on the development of modular open information technology (IT) systems in the healthcare sector. Broadly, architecture standards outline frameworks which can be used in the development of consistent, coherent applications, databases and workstations. This is done through the definition of hardware and software construction requirements and outlining of protocols for communications. The HISA standard provides a formal standard for a service-oriented architecture (SOA), specific for the requirements of health services, based on the principles of Open Distributed Processing. The HISA standard evolved from previous work on healthcare information systems architecture commenced by Reseau d’Information et de Communication Hospitalier Europeen (RICHE) in 1989, and subsequently built upon by a number of organizations across Europe.
The Health informatics - Electronic Health Record Communication was the European Standard for an information architecture to communicate Electronic Health Records (EHR) of a patient. The standard was later adopted as ISO 13606 and later replaced with ISO 13606-2 and recently ISO 13606-5:2010.
Alan L. Rector is a Professor of Medical Informatics in the Department of Computer Science at the University of Manchester in the UK.
The ISO/TC 215 is the International Organization for Standardization's (ISO) Technical Committee (TC) on health informatics. TC 215 works on the standardization of Health Information and Communications Technology (ICT), to allow for compatibility and interoperability between independent systems.
Medcin, is a system of standardized medical terminology, a proprietary medical vocabulary and was developed by Medicomp Systems, Inc. MEDCIN is a point-of-care terminology, intended for use in Electronic Health Record (EHR) systems, and it includes over 280,000 clinical data elements encompassing symptoms, history, physical examination, tests, diagnoses and therapy. This clinical vocabulary contains over 38 years of research and development as well as the capability to cross map to leading codification systems such as SNOMED CT, CPT, ICD-9-CM/ICD-10-CM, DSM, LOINC, CDT, CVX, and the Clinical Care Classification (CCC) System for nursing and allied health.
Health information technology (HIT) is health technology, particularly information technology, applied to health and health care. It supports health information management across computerized systems and the secure exchange of health information between consumers, providers, payers, and quality monitors. Based on a 2008 report on a small series of studies conducted at four sites that provide ambulatory care – three U.S. medical centers and one in the Netherlands, the use of electronic health records (EHRs) was viewed as the most promising tool for improving the overall quality, safety and efficiency of the health delivery system.
Marc Twagirumukiza is a Belgian senior physician and a senior clinical researcher in the fields of clinical pharmacology, cardiovascular and hypertension research. He is particularly oriented in data sciences and clinical drug development. He is also chair of the World Wide Web Consortium Healthcare Schema Vocabulary Community Group.
The system of concepts to support continuity of care, often referred to as ContSys, is an ISO and CEN standard . Continuity of care is an organisational principle that represents an important aspect of quality and safety in health care. Semantic interoperability is a basic requirement for continuity of care. Concepts that are needed for these purposes must represent both the content and context of the health care services.
The Clinical Care Classification (CCC) System is a standardized, coded nursing terminology that identifies the discrete elements of nursing practice. The CCC provides a unique framework and coding structure. Used for documenting the plan of care; following the nursing process in all health care settings.
The Fast Healthcare Interoperability Resources standard is a set of rules and specifications for exchanging electronic health care data. It is designed to be flexible and adaptable, so that it can be used in a wide range of settings and with different health care information systems. The goal of FHIR is to enable the seamless and secure exchange of health care information, so that patients can receive the best possible care. The standard describes data formats and elements and an application programming interface (API) for exchanging electronic health records (EHR). The standard was created by the Health Level Seven International (HL7) health-care standards organization.
Medical device connectivity is the establishment and maintenance of a connection through which data is transferred between a medical device, such as a patient monitor, and an information system. The term is used interchangeably with biomedical device connectivity or biomedical device integration. By eliminating the need for manual data entry, potential benefits include faster and more frequent data updates, diminished human error, and improved workflow efficiency.
Clinical data standards are used to store and communicate information related to healthcare so that its meaning is unambiguous. They are used in clinical practice, in activity analysis and finding, and in research and development.