Integrating Digital Twins with openEHR based systems

Shared resources for data nosmalisation/standardisation to be used in a medical/physical digital twin project at Linköping University, IMT (Gunnar Cedersund et.al.) + Region Östergötland. See image

• About the digital twin in English https://www.youtube.com/watch?v=MvWPHM7wWV4
• Longer in Swedish; Part 1: https://www.youtube.com/watch?v=8geMW5lpSs4 Part2: https://www.youtube.com/watch?v=SxtxhjR-lAU

Tools:

• List/browse archetypes (and template examples): https://ckm.openehr.org/ckm/
• Create/edit templates (and if needed also create archetypes):https://tools.openehr.org/designer/
  • ...then export OPT (Operational template) to be used when you...
• Create GUI/forms and queries: https://tools.better.care/sandbox/studio/login
• Snomed CT browser: https://browser.ihtsdotools.org/

The "Example setup and settings" in https://github.com/modellbibliotek/klinfys-register can be used for testing in this project too.

Archetype/template links

Prioritized in the Blood glucose predicting digital twin model

• Blood glucose & HbA1c are based on the archetype combination pattern discussed at https://discourse.openehr.org/t/shared-blood-glucose-hba1c-templates/1561/2
  • Local templates of type OBSERVATION to be included in larger template of type COMPOSITION: https://github.com/modellbibliotek/digitaltwin/blob/master/local/Glucose%20test%20result%20example.t.json and https://github.com/modellbibliotek/digitaltwin/blob/master/local/HbA1c%20test%20result.t.json
• Nutrition/meals (e.g. reported from apps like MyFitnesspal etc) - start, length/end, Carbohydrates, Protein (later also Fat)
  • The Nutrition intake (OBSERVATION) archetype handles events like Meals/Snacks and can aslo be used to record a cumulative total over a time period (e.g. per day or week). Details for each event is recorded using:
    • the Dietary nutrients (CLUSTER) archetype recording total fat, protein, carbohydrates etc and can be further detailed using...
      • ...Macronutrients and...
      • ...Micronutrients archetypes
  • Alternatively, instead of [Nutrition intake] a set of Food item (OBSERVATION) entries could be used for recording nutrition. Those items could include detalis via the same above described CLUSTER archetypes (Dietary nutrients, Macronutrients, Micronutrients)
• Height
  • Height/Length
• Weight
  • Body weight
• Gender & Age are in the EHRscape test environment modelled in the EHR status object and already set for each test patient, see AQL-query and example list at https://github.com/modellbibliotek/klinfys-register that is using the same sfmi test domain
• Diagnosis (to know if the person is diagnosed with diabetes)
  • Problem/Diagnosis

Later (not currently prioritized) in the Blood glucose twin model

• Physical exercise
• ...

COMPOSITION archetypes ("wrappers" needed in order to be able to store data in openEHR)

• Self Monitoring:
  • Used in one template (Digital_Twin_Self_Monitoring) used for frequently recurring reports above, like Blood glucose, Nutrition/meals and Body weight as described above
• Encounter:
  • Used in another template (Digital_Twin_Base_Data) for reporting Basics that change less frequently. like height and diagnosis

Terminology

Some SNOMED CT codes used in the templates: https://docs.google.com/spreadsheets/d/1l7bfBePBlP1EGMIF2aSEAphvteqWXShGOCJ8Nvos0Nk/edit?usp=sharing (in a form that can be pasted as a table/list into the Archetype Designer instead of manually entered one by one)

Queries (AQL)

See separate file https://github.com/modellbibliotek/digitaltwin/blob/master/query_examples.md