Mikael Nyström, Principal Informatician in Solution Management for Cambio, talks about his role within the openEHR Sweden affiliate

Driving growth and collaboration with the openEHR affiliate program

The expansion of openEHR’s affiliate network is a testament to the burgeoning support across various global communities for our standard. This groundswell, while promising, also showcases the need for continual support and peer facilitation to foster seamless operations.

Managing the setup and operations of these affiliates demands dedicated resources from openEHR and from within the affiliate organisations themselves. 

Our current affiliates, including openEHR NL – the members of which have just last week run a wonderful conference – openEHR UK, openEHR Japan, openEHR China, and others, form a robust foundation. 

The evolution of the openEHR affiliate program reflects an exciting phase, full of opportunity for collaboration and innovation. Each addition to this network strengthens the collective stride towards a more interconnected and resourceful future.

And into that picture steps Mikael Nystrom

I work for Cambio Healthcare Systems, which is a Nordic company that creates information systems for healthcare and welfare. I am principal informatician in our solution management and architecture team, and I also work with external collaborations in the informatics field and so I’ve been involved in the Swedish affiliate for quite a long time. I’m also a board member of openEHR International. 

Since 2004, I’ve worked with openEHR, which is the most common standard used for both structuring how to collect information and also how to store information for electronic record systems. 

Unlike SNOMED and ICD-10, which concentrate on defining specific items within health record systems, openEHR is geared towards guiding entries across diverse healthcare scenarios.

Tell us about the affiliate

Basically it is to be able to adapt the international openEHR standard to the specific local contexts. The focus on universally applicable elements across nations constitutes a substantial portion of OpenEHR’s scope.

But to satisfy local legislations, local behaviours and the local language, you need to adapt openEHR to the local use cases. Many of these adaptations operate at a national level, since differences in languages and healthcare system structures often exist across borders, but occasionally span a cluster of countries. Administrative aspects tend to be more local, whereas factors like disease classification and human anatomy are universally recognised.

My collaborators and I in the Swedish affiliate have a good knowledge of how the healthcare system works in Sweden and we use that shared knowledge when we agree on how it is best to implement openEHR in Sweden.

The healthcare systems in the Nordic countries have several similarities and the North Germanic languages Swedish, Norwegian and Danish are also quite similar. We therefore regularly arrange Nordic countries collaboration meetings to discuss topics of common interest.

The work is carried out during regular Teams meetings. Every second Tuesday afternoon we organise work group meetings and every second Friday afternoon we organise a management meeting.

What are you working on? 

We’re working with implementation guides tailored to the Swedish context. For example, one guide focuses on effectively implementing Swedish legislation for electronic health record systems within openEHR. Another guide covers the information needed to use the standardised graphical attention signal symbol commonly recommended by Swedish authorities. That information includes specific allergies and important diagnoses and is displayed through a graphical symbol with complementing information within electronic health records.

We are also working on translating international archetypes into Swedish to enable us to implement them in our electronic health records in Sweden.

What’s the benefit of having the affiliate program in any country, but specifically Sweden generally?

My view is that the main purposes are adapting openEHR to the local conditions of the country and to promote openEHR within the country. The latter is something that we have not worked on that much in Sweden during the last year, due to lack of time, but it is something that we previously did during conference presentations and education sessions.

Other good purposes of an affiliate might be to do common competence development about openEHR and related areas and to find collaboration partners.

How does the Swedish affiliate work? 

We hold distinct roles within the Swedish Federation for Medical Informatics, the principal organisation in Sweden dedicated to medical informatics. 

Our responsibility extends beyond the medical sphere to the wider healthcare landscape. And officially, we operate as a working group within this federation, fostering more organisation and collaboration.

I am a board member of the federation. I’m the connection between the board and the working group which is led by two rotating product owners, to ensure balanced decision-making without giving one party too much power, so to speak. The idea is to maintain two product owners at any given time, each serving for a year but alternating every six months and this overlap is designed to feature a product owner from a care provider and another from a company supplying healthcare solutions.

The day-to-day operation of the working group is overseen by these product owners, while my role – as I said – involves serving on the board and facilitating communication. 

At the moment, there are three product companies that are involved in the Swedish affiliate  – Cambio, TietoEvry and eWeave – alongside several consultancy firms interested in staying informed rather than pushing their own specific initiatives forward. There are also several healthcare providers involved in the affiliate. This collective involvement reflects a shared commitment to advancing healthcare informatics in Sweden.

Why are the Nordic countries such trailblazers when it comes to health informatics? 

Nordic countries have a strong track record of investing in biomedical engineering and medical and health informatics research over the years. There’s a tradition of innovation in these fields. Our region boasts a rich history in computer science, and I think that contributes to our forward-thinking approach.

The healthcare system is also organised in relatively large healthcare regions and not single primary care centres of hospitals in Sweden. This means that when initiatives are undertaken, they tend to involve entire healthcare regions or multiple ones working together. While this process may take longer to start, the outcomes are generally more comprehensive and impactful in the long run.

openEHR Netherlands just ran a successful event. Are you planning one? 

As I mentioned earlier, we are organising our Nordic collaboration meetings. We usually arrange them via Teams, but we also arranged a physical meeting in Stockholm around a year ago.

We’ve contemplated expanding, but our ambitions exceed our current resources so right now our focus lies on our other work items.

We’ve engaged in other conferences, showcasing openEHR during half-day presentations to raise awareness. Our parent organisation, the Swedish Federation for Medical Informatics, co-organises the annual Vitalis Conference in Gothenburg, which is a big e-health event in the Nordics. We have organised some events as part of that conference.

openEHR International helps with our electronic infrastructure by providing discussion forums and hosts our wiki pages and to do boards. Our efforts are supported by our employers’ sponsored time and travel expenses. The affiliate is primarily a collaborative platform where contributors invest their own resources, fostering a community spirit.

If you’d like to learn more, visit our openEHR affiliate page





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