Ammon, Danny

Besting, Andreas

Faulbrück-Röhr, Sebastian

Herre, Heinrich

Kaeding, André

Neumann, Juliane

Neumuth, Thomas

Portheine, Frank

Saleh, Kutaiba

Schmidt, Tobias

Specht, Martin

Stucke, Stephan

Tahar, Kais

Uciteli, Alexandr

Digitale Bibliothek Thüringen

TU Ilmenau | Universitätsbibliothek | ilmedia, 2019 http://www.tu-ilmenau.de/ilmedia Saleh, Kutaiba; Saleh, Kutaiba; Stucke, Stephan; Uciteli, Alexandr; Faulbrück-Röhr, Sebastian; Neumann, Juliane; Tahar, Kais; Ammon, Danny; Schmidt, Tobias; Neumuth, Thomas; Besting, Andreas; Portheine, Frank; Herre, Heinrich; Kaeding, André; Specht, Martin: Using fast healthcare interoperability resources (FHIR) for the integration of risk minimization systems in hospitals Original published in: MEDINFO 2017 / World Congress on Medical and Health Informatics Original published: ISSN (online): ISSN (print): DOI: [Visited: 16. 2017 Hangzhou, ISBN 978-1-61499-830-3. - Amsterdam : IOS Press, 2017. -  p. 1378.(Studies in health technology and informatics ; 245)20171879-83650926-963010.3233/978-1-61499-830-3-13782019-08-05]This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. To view a copy of this license, visit  http://creativecommons.org/licenses/by-nc/4.0/ Using Fast Healthcare Interoperability Resources (FHIR) for theIntegration of Risk Minimization Systems in HospitalsKutaiba Saleha, Stephan Stuckeb, Alexandr Ucitelic, Sebastian Faulbrück-Röhrb, Juliane Neumannd,Kais Tah r , Danny Ammon , Tobias Schmidt , Thomas Neumuth , Andreas Besting , Frank Portheine ,c a a d e eHeinrich Herrec, André Kaedingb and Martin Spechtaa Jena University Hospital, Jena, Germany,  b GMC Systems mbH, Ilmenau, Germany c Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germanyd Innovation Center Computer Assisted Surgery (ICCAS), University of Leipzig, Leipzig, Germanye SurgiTAIX AG, Herzogenrath, GermanyAbstractWith the growing strain of medical staff and complexity of patient care, the risk of medical errors increases. In this work we present the use of Fast Healthcare Interoperability Resources (FHIR) as communication standard for the integration of an ontology- and agent-based system to identifyrisks across medical processes in a clinical environment.Keywords:Standards; Decision Support Systems, Clinical; Harm ReductionIntroductionCurrent studies provide an estimation of more than 400,000 lethal harms due to preventable medical errors during hospital treatment per year, with 10- to 20-fold serious harms occuring[1]. Clinical decision support systems (CDSS) can assist in preventing such errors, but have not yet integrated the new messaging standard Fast Healthcare Interoperability Resources (HL7 FHIR [2]). In the research project “OntoMedRisk”, we developed an agent-based system to identify risks based on a special ontology [3]. This systemaims at supporting medical staff with risk detection and error prevention. A requirement for practical demonstration is the integration of this system into an existing hospital IT infrastructure, which was carried out at Jena University Hospital (JUH).MethodsCochlear Implantation (CI) has been chosen as a first exemplary clinical treatment process. To detect risks during CI treatment, relevant medical information from clinical subsystems must be extracted and processed by the system. In our concept, we combined the data retrieval agent of the DSS with a FHIR server to extract data either directly from the clinical subsystems or via communication server to systems which do not yet support FHIR.ResultsWe implemented a FHIR server at JUH for medical datacollection for risk detection in the CI treatment process, where singular data is extracted and processed in a timely manner. For communication and storage, certain clinical data key performance indicators relevant for risk detection like age of the patient, cranial thickness, or duration of deafness, weremodeled using FHIR resources like “patient”, “observation”, “encounter” and processed by the agent system. Through the use of an ontology, alerts are generated during treatment as a support to the clinical staff. Since FHIR is a new standard, many relevant clinical systems might not be providing a correspondent interface. In these cases, the use of a communication server is a transitional solution.ConclusionsWe obtained as findings that CDSS can collect medical data from existing clinical information systems through the use of modern communication standards like FHIR. The “OntoMedRisk” system relies on real-time access to discrete data generated in different subsystems, and we could providethese as FHIR resources for risk detection and presentation of the results to clinical staff. Further investigation on the usability of this software at JUH is planned. In the future, we plan to extend system functions to other treatment processes.AcknowledgementsThis work has been funded by the BMBF under the project“OntoMedRisk” (grant no. 01IS14022).References[1] J.T. James, A new, evidence-based estimate of patient harms associatedwith hospital care, J Patient Saf 9 (2013), 122-128.[2] HL7. FHIR [Internet]. 2016. Available from: https://www.hl7.org/fhir/[3] A. Uciteli, J. Neumann, K. Tahar, K. Saleh, S. Stucke, S. Faulbrück-Röhr, et. al., Risk Identification Ontology (RIO): An on-tology for specification and identification of perioperative risks, in: 7th Workshop on Ontologies and Data in Life Sciences, Halle (Saale), Ger-many, 2016.Address for correspondenceKutaiba Saleh - kutaiba.saleh@med.uni-jena.de.aMEDINFO 2017: Precision Healthcare through InformaticsA.V. Gundlapalli et al. (Eds.)© 2017 International Medical Informatics Association (IMIA) and IOS Press.This article is published online with Open Access by IOS Press and distributed under the termsof the Creative Commons Attribution Non-Commercial License 4.0 (CC BY-NC 4.0).doi:10.3233/978-1-61499-830-3-13781378

Using fast healthcare interoperability resources (FHIR) for the integration of risk minimization systems in hospitals

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Using fast healthcare interoperability resources (FHIR) for the integration of risk minimization systems in hospitals

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