What is an Open Platform?

Definition of a Platform

In software design, a platform is an architecture where the applications are separated from the data upon which they operate. The data is stored in a shared repository on the platform which also provides shared services useful to many applications. Applications communicate with the platform via an Application Program Interface (API), simplifying the task of building applications.

Platforms underpin many modern digital services in sectors including banking, travel and retail, and enable innovators to create new services and applications that would be impractical were the platform not available.

What makes a platform "open"?

An open platform is a platform based on open standards such that any willing party can build applications or platform services that work together. The best example of an open platform is the Internet itself.

In health and care, a definition of an open platform has been provided by the Apperta Foundation (a not-for-profit created by NHS England with the remit to support the adoption of open standards across health and care) in “Defining an Open Platform”. The primary author of this document is inidus’ CEO.

Some existing vendors are repositioning their products as a platform, and some are erroneously describing their platform as “Open”. A proprietary platform that includes a limited number of open APIs IS NOT an open platform as it does not satisfy the definition from the Apperta Foundation

Keeping patient data safe

The use of “open” in “Open Platforms” refers to the use of open standards and is not used in the same way as “Open” in “Open Data” that implies the data itself is freely accessible to everyone.

Open platforms make data available in an open format to AUTHORISED users only. inidus allows the patient to decide who is authorised to see their data and what they are allowed to use it for.

The inidus open platform

The key components of the inidus open platform are shown in the figure. We deliver this from the cloud. The platform is fully compliant with the "Defining and Open Platform".

Further information about the inidus platform will be found here

Screen Shot 2019-04-16 at 11.35.58

What open standards are used?

The core standards for an open platform are:

  • openEHR - for the storage of structured and coded clinical records;
  • IHE-XDS - For the storage of documents and images linked to openEHR records;
  • HL7 FHIR - for interfacing with existing systems; and
  • SNOMED-CT - the international terminology standard mandated in the NHS

Is this “open source”?

No! Open platforms are about open standards and are agnostic with regard to the licensing model of components. It is irrelevant whether they are open source or proprietary as long as they are compliant to the relevant open standards.

What is openEHR?

openEHR is an open standard supporting the definition, persistence and querying of structured clinical data. A Clinical Data Repository (CDR) compliant with the openEHR standard is a core component of our platform.

We provide a summary of openEHR here

What is IHE-XDS?

IHE-XDS is an open standard for sharing documents. It is widely used as the standard for Vendor Neutral Archives (VNAs), for sharing documents and clinical images. IHE-XDS can be used to store any unstructured or semi-structured data, and is well supported with software available from many vendors. IHE-XDS has been widely adopted in a large number of implementations across the globe.

IHE-XDS and openEHR compliment each other. openEHR is well-suited to handle fine-grained, structured and coded data whilst IHE-XDS is better able to handle clinical images and documents. Two of the largest implementations of an open platform (Moscow and Slovenia) use openEHR and IHE-XDS working together to create a comprehensive Electronic Health Record.

Open platform ecosystems

An open platform ecosystem is a competing and collaborating group of entities providing applications and platform services for health and care organisations and patients, that are compliant with open platform standards.

The open platform approach expects that there will be multiple platform implementations from a variety of vendors. Patients will decide which of these they choose to store their record in. Within the context of the UK, it is highly likely to be the platform provided by their local NHS organisation.

All platform instances:

  • Operate to identical standards;
  • Are federable;
  • Allow applications to seamlessly access data for different patients from multiple repositories; and
  • Allow patient records to be transferred between repositories.

Feral or shadow IT systems

A feral or shadow IT system is a system created “under the radar” of the IT management within health and care organisations. They are created typically by individuals working in health and care organisations or individual contractors and micro-enterprises building small systems to meet needs not met by corporate systems. While some will be professional developers, many are “hobbyist” developers building systems alongside their day job.

The nature of the feral systems market is such that it is difficult to get information about its size. An audit of a number of  large London NHS Trust identified over 1,000 feral systems in use[1]. We understand that this kind of number is typical, with the numbers of feral systems in smaller community and mental Health Trusts being much smaller (we estimate typically 100). This would suggest in excess of 160,000 feral systems across the NHS, with about 25,000 being created each year.

Our PaaS is well placed to support the large number of feral or shadow IT Systems many of which may presently have little or no governance.