A Two-Level Identity Model To Support Interoperability of Identity Information in Electronic Health Record Systems.

The sharing and retrieval of health information for an electronic health record (EHR) across distributed systems involves a range of identified entities that are possible subjects of documentation (e.g., specimen, clinical analyser). Contemporary EHR specifications limit the types of entities that can be the subject of a record to health professionals and patients, thus limiting the use of two level models in healthcare information systems that contribute information to the EHR. The literature describes several information modelling approaches for EHRs, including so called “two level models”. These models differ in the amount of structure imposed on the information to be recorded, but they generally require the health documentation process for the EHR to focus exclusively on the patient as the subject of care and this definition is often a fixed one. In this thesis, the author introduces a new identity modelling approach to create a generalised reference model for sharing archetype-constrained identity information between diverse identity domains, models and services, while permitting reuse of published standard-based archetypes. The author evaluates its use for expressing the major types of existing demographic reference models in an extensible way, and show its application for standards-compliant two-level modelling alongside heterogeneous demographics models. This thesis demonstrates how the two-level modelling approach that is used for EHRs could be adapted and reapplied to provide a highly-flexible and expressive means for representing subjects of information in allied health settings that support the healthcare process, such as the laboratory domain. By relying on the two level modelling approach for representing identity, the proposed design facilitates cross-referencing and disambiguation of certain demographics standards and information models. The work also demonstrates how it can also be used to represent additional clinical identified entities such as specimen and order as subjects of clinical documentation

ОБРАБОТКА И ПЕРЕДАЧА ДАННЫХ МЕДИЦИНСКОЙ СТАТИСТИКИ НА ОСНОВЕ МЕЖДУНАРОДНОГО СТАНДАРТА ISO 13606

A possibility to unite different healthcare providers in one network was investigated and proved. We developed solution based on ISO 13606 archetype model and service oriented architecture to enable an exchange of semantically meaningful medical data within a network of healthcare providers. Application of a data model of the ISO 13606 standard for data modeling and XML data transformation allowed organizing data exchange in the regional healthcare network.Исследована возможность применения стандарта хранения и передачи медицинских данных для сбора медицинской статистики. На базе стандарта ISO 13606 и сервис-ориентированной архитектуры была реализована система сбора и анализа медицинских данных для обеспечения оперативного сбора и анализа медицинской статистики органами управления здравоохранением региона. Показана эффективность данного решения для оптимизации работы системы здравоохранения в масштабе региона России

Clinical information modeling processes for semantic interoperability of electronic health records: systematic review and inductive analysis

This is a pre-copyedited, author-produced PDF of an article accepted for publication in Journal of the American Medical Informatics Association following peer review. The version of record is available online at: http://dx.doi.org/10.1093/jamia/ocv008[EN] [Objective] This systematic review aims to identify and compare the existing processes and methodologies that have been published in the literature for defining clinical information models (CIMs) that support the semantic interoperability of electronic health record (EHR) systems. [Material and Methods] Following the preferred reporting items for systematic reviews and meta-analyses systematic review methodology, the authors reviewed published papers between 2000 and 2013 that covered that semantic interoperability of EHRs, found by searching the PubMed, IEEE Xplore, and ScienceDirect databases. Additionally, after selection of a final group of articles, an inductive content analysis was done to summarize the steps and methodologies followed in order to build CIMs described in those articles. [Results] Three hundred and seventy-eight articles were screened and thirty six were selected for full review. The articles selected for full review were analyzed to extract relevant information for the analysis and characterized according to the steps the authors had followed for clinical information modeling. [Discussion] Most of the reviewed papers lack a detailed description of the modeling methodologies used to create CIMs. A representative example is the lack of description related to the definition of terminology bindings and the publication of the generated models. However, this systematic review confirms that most clinical information modeling activities follow very similar steps for the definition of CIMs. Having a robust and shared methodology could improve their correctness, reliability, and quality. [Conclusion] Independently of implementation technologies and standards, it is possible to find common patterns in methods for developing CIMs, suggesting the viability of defining a unified good practice methodology to be used by any clinical information modeler.This research has been partially funded by the Instituto de Salud Carlos III (Platform for Innovation in Medical Technologies and Health), grant PT13/0006/0036 and the Spanish Ministry of Economy and Competitiveness, grants TIN2010-21388-C02-01 and PTQ-12-05620.Moreno-Conde, A.; Moner Cano, D.; Da Cruz, WD.; Santos, MR.; Maldonado Segura, JA.; Robles Viejo, M.; Kalra, D. (2015). 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Validating archetypes for the Multiple Sclerosis Functional Composite

Background Numerous information models for electronic health records, such as openEHR archetypes are available. The quality of such clinical models is important to guarantee standardised semantics and to facilitate their interoperability. However, validation aspects are not regarded sufficiently yet. The objective of this report is to investigate the feasibility of archetype development and its community-based validation process, presuming that this review process is a practical way to ensure high-quality information models amending the formal reference model definitions. Methods A standard archetype development approach was applied on a case set of three clinical tests for multiple sclerosis assessment: After an analysis of the tests, the obtained data elements were organised and structured. The appropriate archetype class was selected and the data elements were implemented in an iterative refinement process. Clinical and information modelling experts validated the models in a structured review process. Results Four new archetypes were developed and publicly deployed in the openEHR Clinical Knowledge Manager, an online platform provided by the openEHR Foundation. Afterwards, these four archetypes were validated by domain experts in a team review. The review was a formalised process, organised in the Clinical Knowledge Manager. Both, development and review process turned out to be time- consuming tasks, mostly due to difficult selection processes between alternative modelling approaches. The archetype review was a straightforward team process with the goal to validate archetypes pragmatically. Conclusions The quality of medical information models is crucial to guarantee standardised semantic representation in order to improve interoperability. The validation process is a practical way to better harmonise models that diverge due to necessary flexibility left open by the underlying formal reference model definitions. This case study provides evidence that both community- and tool- enabled review processes, structured in the Clinical Knowledge Manager, ensure archetype quality. It offers a pragmatic but feasible way to reduce variation in the representation of clinical information models towards a more unified and interoperable model

Design and Development of a Knowledge Modelling Approach to Govern the Use of Electronic Health Records for Research

There is now increasing commitment internationally to using electronic healthcare records collected during routine care delivery to conduct clinical research. This must be rigorously controlled by an extensive set of information governance requirements defining the legal, ethical and practical guidelines to respect the privacy rights of the people about whom the records are kept, uphold the clinical profession’s duty of confidentiality and protect the interests of participants, practitioners and researchers. The development of information security policies is a highly regarded method of meeting these requirements. This is hampered by the need to interpret a complex framework of legislation and guidelines, lack of clear advice and inconsistency in authoring, interpretation and understanding amongst the people whose behaviour they are expected to guide. By using the results of several UK and European research and information platform development projects in which the author has participated and by gathering requirements from stakeholders in the clinical and research communities, this thesis defines a knowledge management representation to specify policy requirements in a computable form. The work provides the first set of knowledge requirements for governing research uses of electronic healthcare records, and a knowledge model that describes information security policies and generates a web application tool. The tool allows policy control authoring that provides a consistent, clear and unambiguous view of governance requirements to researchers and service providers. The model and tool have been evaluated in a laboratory setting to explore their effects on behaviour and understanding of invited participants when authoring policy about handling healthcare records in research and making decisions about sharing information. The work has resulted in a validation of the model and demonstrated the potential positive effects of this new approach on practice. It makes recommendations about how it should be used in working practice and for educating people about information governance when performing clinical research to improve care provision

Базы данных коллекций биологического материала: организация сопроводительной информации

The review discusses problem of organization and storage of associated information for biological collection. Basic principles of database structure development are presented. Databases for biological collections and biobanks in Russiaand other countries are reviewed. Structure of database of Biobank of Institute of Medical Genetics SB RAMS is described.Данный обзор посвящен проблеме организации и хранения сопроводительной информации для биологических коллекций. Рассмотрены основные принципы разработки структуры баз данных для этих целей. Проведен обзор баз данных биологических коллекций и биобанков в России и мире. Представлена структура базы данных биобанка НИИ медицинской генетики СО РАМН (г. Томск)