Everything you’re missing out on in the newly released CKM_1.19.0 

Ocean Health Systems will this month release a new version of their Clinical Knowledge Manager (CKM). CKM_1.19.0 focuses on a wide variety of improvements, addressing a total of 155 issues with added features set to provide greater flexibility to remote archetype revisioning, improve crawlability and revision histories and modify the review round process, all whilst making the platform more accessible by improving compliance with WCAG Level AA – and a whole lot more. Since 2008, clinicians have been using Clinical Knowledge Manager (CKM), a comprehensive repository and collaboration environment to manage, describe, and understand clinical data models.  

How does CKM work?  

Clinical Knowledge Manager is a powerful collaboration tool to manage, describe, and understand clinical data models. This powerful collaboration tool helps users identify and define models of clinical content. It also helps organisations manage, describe, and understand clinical data models and how they can be used across applications. Replacing time-consuming manual methods with streamlined online collaboration facilities. 

What’s new in CKM_1.19.0? 

• Improved UX and more efficient governance 
• Enhanced crawlability and direct linking functionality.  
• Optimisation for social media sharing 
• More intuitive revisioning history 
• Review round notification improvements 
• Increased compliance with WCAG Level AA standards 
• A new Overview Page 
• Mindmaps on all projects 
• Catalan localisation of CKM 
• Better performance under load 

“From improved federation, an enhanced sharing experience, finetuned governance and revisioning mechanisms to vastly increased accessibility and a new overview of projects and incubators, we have refined various facets of the Clinical Knowledge Manager, guaranteeing a smooth user experience for editors, reviewers, and all CKM users,” said Dr Sebastian Garde, CKM Product Lead for Ocean Health Systems.

For federated CKM Instances, this release improves the user experience and efficient governance of remote archetypes. Editors can now apply a refined filtering mechanism on archetypes, utilizing both the archetype ID and displayed concept name. Filtering based on specific projects and based on creation or modification dates is also now supported. 

CKM now presents the Semantic Versions of both remote and local archetypes and in cases where an imported version lacks a semantic version, this is visually indicated.  Notably, users now have the flexibility to compare a newer revision of a remote archetype with the one currently used in the local CKM to quickly assess whether an update is needed. Direct access to the local archetype is now possible.  

All this is to support editors in the decision when to update a remote archetype and governance around this. 

The Ocean Health Systems team have also rolled out an automatic population feature for the “Reference to original resource” text area when internalizing an archetype. 

In line with an ongoing commitment to improving platform accessibility and visibility, users can look forward to significant updates to CKM’s crawlability features and direct link enhancements. Projects and subdomains have been modified to be more crawl-friendly, ensuring enhanced search engine interactions. The Repository Report Overview Page has been refined to offer an improved crawlable experience. Moreover, CKM’s JSON-LD Structured Data Generator that is relevant for search engine indexing has received some key fixes and enhancements. 

REST-like direct links are now provided (in the browser toolbar) for discussions, archetype proposals, individual Change Requests, subdomains and various resource statistics.  

The CKM startup pages have been optimized for social media sharing. This includes integrated Open Graph and Twitter social media tags, ensuring a streamlined presentation of content when shared.  

Additionally, to amplify the visibility and sharing experience, Open Graph Meta Tags and Twitter cards have also been enabled for archetypes, templates, projects, and subdomains. Whether you’re sharing a CKM direct link on platforms like Discourse, LinkedIn, Mastodon, Slack, Facebook, Twitter/X, or others, you can now expect a preview of your shared content. 

In this release, look forward to enhancements to the Revision History of resources such as archetypes and templates to improve clarity and provide more intuitive revision tracking.  

Editors and other users checking out a resource to a branch will now see a “Reason for Checkout” feature, with the ability to display a shortened version of the free-text reason directly in the branch title. Also, the latest published revision will be highlighted with a green tag in the revision history. Any revision of a committed branch that wasn’t committed to the immediately subsequent trunk revision will now be distinctly indicated. 

Change requests mentioned in the log message (e.g. CR-123) can now be opened directly from revision history. 

Using the Review Round process? Editors will now receive an immediate notification if an active review round already exists. This warning will also be reiterated just before the final creation of the review round.  

As part of the Ocean Health Systems commitment to make CKM more accessible, in this release, CKM’s compliance with WCAG Level AA standards has been significantly enhanced. This includes refining image alt attributes for relevance, ensuring colour contrasts across all themes meet the required benchmarks, and restructuring our page layouts to prioritize accessibility. Steering clear of table structures for layout and using the ARIA presentation role to mark the structure as presentational only. iframe title tags have been modified, rectified form label inconsistencies, and interface elements like buttons and links have been refined to be WCAG-AA compliant. This also extends to CKM’s OPT to HTML transformation. These changes can be an important help for users with disabilities. 

In this update, a new Overview Page presents a comprehensive view of All Projects and Incubators, grouped by Subdomains and easily accessible via the Project Menu. A dedicated overview page showcasing all projects has also been made available for each individual subdomain.  

Each project in CKM now shows a mind map with all archetypes of the project, offering a more intuitive understanding of project structures bringing projects to life.  

To ensure clarity in resource governance, the Project Resources View and Project Dashboard now visually delineate between archetypes referenced from a remote CKM and those referenced from another local project or incubator. 

With this release of CKM, it’s now possible to acknowledge multiple contributors to a translation alongside the primary translator. This adjustment necessitated an addition to the openEHR specifications, which CKM now fully supports, including when translating archetypes directly within CKM. 

Additionally, CKM’s Audit log has seen multiple improvements for a more streamlined user experience. 

In line with keeping our systems current, Archie has been upgraded to verison 3.0., in line with the conversion of archetypes from ADL 1.4 to ADL 2. The LOINC version used in CKM has also been updated to version 2.74. 

Under the hood, a considerable amount of foundational work has been conducted, including a clean-up of stylesheets and enhanced theme creation, CKM’s Picture Server has been completely rewritten, ensuring better performance under load. The team has future-proofed several backend queries and has worked extensively on many code improvements, cleanup, and refactoring. 

Finally, Ocean Health Systems is pleased to announce the addition of a new Catalan localisation of CKM, as well as finetuning of localisations for example related to Catalan and Norwegian date formats to enhance user experience across diverse locales. 

Director of Ocean Health Systems, a founder of OpenEHR and CKM, Dr Sam Heard, noted in 1998 when the system was first being developed, that “standards at the heart of health systems is the only assured way to interoperability”. 

CKM is the meeting point of clinicians who want to collaborate on models, and developers who want to use models. CKM manages and helps govern the lifecycle of clinical models enabling:  

• Informal Discussions, Change Requests & Archetype Proposals   
• Formal Reviews (content, terminology bindings, translations)   
• Projects & Incubators   
• Use 5 mins or 1 hour of specialised clinician’s time; instead of days in physical meetings. 

CKM, and its lightweight version CKM Rocks, enable the development of clinical models that can fulfil local, regional, and national requirements. These computer processable models allow knowledge reuse as a solid foundation for a “Digital Health Ecosystem”. They allow customisations for local use cases, and they can be accumulated in repositories to be used as the basis of future clinical models to help the benefits of CKM reach all healthcare groups within Australia and internationally. 

About Ocean Health Systems 

25 years ago, Ocean Health Systems emerged to defragment a disjointed Australian healthcare sector. On a mission to enable integrated care through the controlled sharing of standardized, meaningful, personal health information, the team successfully fostered and commercialised the first openEHR clinical data repository and online clinical information model governance tool, Clinical Knowledge Manager (CKM). Whilst high costs, integrated care barriers and an underpinning need for standardised health records continue to plague the Australian health sector, openEHR continues to shine as the world’s only extensible, standardised health record system – and it’s home-seeded.  

25 years on, with major clients globally, and success stories in well-known facilities run by facilities in Queensland (Australia), Australian Commission on Safety and Quality in Health Care (Australia), Nasjonal IKT HF (Norway), HiGHmed Medical Informatics (Germany), Apperta – UK, Slovenia, Finland, Canada, Catsalut – Catalonia, the team celebrate a continued committed to continuing to deliver scalable solutions to suit any size organisation, care setting, and budget.  

The Ocean Health Team deploys solutions with little to no disruption to operations, incorporating legacy infrastructure to create total interconnectivity, including the ability to talk to external applications such as Cerner. Just ask our clients across international and national departments of health, health networks, large hospitals, aged care providers and smaller practices alike.