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. 

It took years of research and development, but the hard work of founders Drs Peter Schloeffel and David Rowed, Thomas Beale and Sam Heard resulted in the openEHR two-level modeling approach, which materialised into the openEHR technical specifications and clinical information models. The founders went to great lengths to ensure that confused and confusing arguments over esoteric models of poorly defined terminology and processes were halted and the industry stopped falling into reinvention which was inhibiting progress. 

The idea of a universal electronic health record was further developed in line with the following principles: 

1. The data structure suited health records
2. That structured data could be stored, viewed and shared even if the structure was not known to the system
3. That language was not critical, and data structures created in one language could have other languages added
4. That all data could be displayed safely – though creation of classes that allowed information to be organised (e.g. observations with protocol – data about measuring the value which did not impact on the interpretation, and state – where the interpretation could be affected (needed to be displayed)
5. The data structures were “upgradable” (backwardly compatible) and could have multiple terminologies attached (for meaning) or as part of the structure itself (small vocabularies)

This organisation of data allowed people to cooperate and agree on data structures in a way that was not possible before. Crowd sourcing of structures (using CKM) was a logical follow-on – something that is unique to openEHR.

“I believe that openEHR has a big future for information that is critical to systems and needs to be shared widely. It will always be the ideal approach for research in health – which is the aim of many physicians in their daily work and allows specific data collections without involving major system providers,” said Dr Tom Beale.

“For large shared repositories it is ideal, and if we can simplify the multiple “views” of archetypes and store these in CKM in a way that easily allows for large shared repositories it is ideal, and if we can simplify the multiple “views” of archetypes and store these in CKM in a way that easily allows anyone to create and share data sets (as well as setting national standards), it will change the world.”

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, Jamaica, Canada, Catsalut, Catalonia, the team celebrate a continued committed to continuing to deliver scalable solutions to suit any size organisation, care setting, and budget. 

Ocean Health Systems provides a suite of clinical applications for infection control, staff health, shared care records, and care planning to governments, hospitals, and primary care organisations, which were developed using the openEHR repository and clinical information models, Multiprac.

As advocates the use of health information standards with a long involvement with health IT standards committees, the Ocean Health Systems team continues to contribute to the national and international standards, delivering comprehensive health software solutions for the broader community of healthcare providers. As the organisation enters a new phase in both product and service delivery, more than ever customers come first. 

“For the team, this means making a difference in clinical environments is our focus – technology is just the enabler. We believe a good health solution is one that delivers quality services to all people, when and where they need them,” said Lukas Eksteen, General Manager.

“Each product in our suite is delivered with the end-users in sight. We pride ourselves on including clinicians as active participants in the development and delivery of our products. Our staff, who come from both IT and clinical backgrounds, help us understand our customer’s needs.” 

As a health solution provider specialist, Ocean works with national eHealth programs, government health departments, public and private hospitals, primary care providers and software vendors both within Australia and internationally. 

Mark Messiha, Test Analyst for Ocean, said he thoroughly enjoys being able to part in making sure applications work both functionally and making a difference to patient health outcomes. He particularly enjoys being able to guide application functionality to ensure functions are configurable meaning it is easy to turn them on and off.

Ocean, with its development of standardised solutions to share meaningful personal health data, has achieved many milestones over the years not only in its product development but also in its diversification of customers into international markets including Britain, Europe and North America. Some key highlights include: 

• Initiation and fostering of the authoring of the internationally agreed openEHR clinical models
• Providing the preferred openEHR clinical model repository and governance tool used in 109 countries and separate instances for multiple national eHealth organisations;
• Rolling out our Enterprise-scale infection surveillance implementation for 120 hospitals
• Internationally deployed developers in Australia, UK, Germany
• Delivering System Integration consulting to an Australian health department to specify the mappings of HL7 laboratory result messages into an openEHR clinical data repository.
• The first OHS platform customer, Marand, going live with Ocean platform as the basis for a Pediatric Hospital HIS in Slovenia.
• Delivering OpenEHR and CKM system training in Norway, the UK, and beyond. 
• The first collaboration between Ocean and CQUniversity led to the ArchetypeFinder tool in 2006, a predecessor to CKM, based on an OWL Ontology and capable of creating some nice reports.
• Partnering with Marand and Infinity for the pilot of the Moscow city integrated medical information system.
• NeHTA (National e-Health Transition Authority) investing in Clinical data groups based on openEHR. Investigation of transformation from openEHR to CDA, which lead to a CKM as well and funded work that helped CKM move forward, especially the CKM projects, later the Australian Digital Health Agency CKM. 
• Further internationalisation with international Projects & CKMs in various countries: Brazil (CENTERMS CKM), Slovenia (Ministry of Health in Slovenia), Slovakia, UK (HSCIC: Health and Social Care Information Centre), UK Apperta, Canada, Sweden, Australia, Singapore, Norway, Russia, Germany (HiGHmed)
• Contribution to Snomed coding system in Australia
• Collaboration and integration with GP patient data systems such as Medical Director, Best Practice, and ZedMed across Australia 
• Having two LinkedEHR Apps in PEN CS application named Topbar. This helped import patient data from the Clinical Management Systems into LinkedEHR.  
• Implementing eReferrals for LinkedEHR 

CKM lead Sebastian Garde noted that 2023 and beyond promises growth and diversification. Growing CKM, a Catalonian CKM, developing and delivering CKM Rocks and ADL2. 

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.