Int J Med Inform - The EHR-ARCHE project: satisfying clinical information needs in a Shared Electronic Health Record system based on IHE XDS and Archetypes.

Tópicos

{ system(1050) medic(1026) inform(1018) }
{ ehr(2073) health(1662) electron(1139) }
{ implement(1333) system(1263) develop(1122) }
{ search(2224) databas(1162) retriev(909) }
{ method(1557) propos(1049) approach(1037) }
{ patient(2315) diseas(1263) diabet(1191) }
{ assess(1506) score(1403) qualiti(1306) }
{ time(1939) patient(1703) rate(768) }
{ concept(1167) ontolog(924) domain(897) }
{ health(3367) inform(1360) care(1135) }
{ studi(2440) review(1878) systemat(933) }
{ treatment(1704) effect(941) patient(846) }
{ design(1359) user(1324) use(1319) }
{ result(1111) use(1088) new(759) }
{ activ(1452) weight(1219) physic(1104) }
{ can(774) often(719) complex(702) }
{ surgeri(1148) surgic(1085) robot(1054) }
{ clinic(1479) use(1117) guidelin(835) }
{ general(901) number(790) one(736) }
{ import(1318) role(1303) understand(862) }
{ perform(1367) use(1326) method(1137) }
{ patient(2837) hospit(1953) medic(668) }
{ first(2504) two(1366) second(1323) }
{ activ(1138) subject(705) human(624) }
{ use(2086) technolog(871) perceiv(783) }
{ high(1669) rate(1365) level(1280) }
{ detect(2391) sensit(1101) algorithm(908) }
{ system(1976) rule(880) can(841) }
{ imag(1057) registr(996) error(939) }
{ take(945) account(800) differ(722) }
{ problem(2511) optim(1539) algorithm(950) }
{ chang(1828) time(1643) increas(1301) }
{ algorithm(1844) comput(1787) effici(935) }
{ perform(999) metric(946) measur(919) }
{ studi(1119) effect(1106) posit(819) }
{ monitor(1329) mobil(1314) devic(1160) }
{ medic(1828) order(1363) alert(1069) }
{ cost(1906) reduc(1198) effect(832) }
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{ cancer(2502) breast(956) screen(824) }
{ decis(3086) make(1611) patient(1517) }
{ process(1125) use(805) approach(778) }
{ method(2212) result(1239) propos(1039) }
{ model(3404) distribut(989) bayesian(671) }
{ imag(1947) propos(1133) code(1026) }
{ data(1737) use(1416) pattern(1282) }
{ inform(2794) health(2639) internet(1427) }
{ measur(2081) correl(1212) valu(896) }
{ bind(1733) structur(1185) ligand(1036) }
{ sequenc(1873) structur(1644) protein(1328) }
{ method(1219) similar(1157) match(930) }
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{ imag(2830) propos(1344) filter(1198) }
{ network(2748) neural(1063) input(814) }
{ imag(2675) segment(2577) method(1081) }
{ motion(1329) object(1292) video(1091) }
{ framework(1458) process(801) describ(734) }
{ error(1145) method(1030) estim(1020) }
{ learn(2355) train(1041) set(1003) }
{ extract(1171) text(1153) clinic(932) }
{ data(1714) softwar(1251) tool(1186) }
{ control(1307) perform(991) simul(935) }
{ model(2220) cell(1177) simul(1124) }
{ care(1570) inform(1187) nurs(1089) }
{ method(984) reconstruct(947) comput(926) }
{ featur(1941) imag(1645) propos(1176) }
{ case(1353) use(1143) diagnosi(1136) }
{ howev(809) still(633) remain(590) }
{ data(3963) clinic(1234) research(1004) }
{ studi(1410) differ(1259) use(1210) }
{ risk(3053) factor(974) diseas(938) }
{ research(1085) discuss(1038) issu(1018) }
{ model(2341) predict(2261) use(1141) }
{ visual(1396) interact(850) tool(830) }
{ compound(1573) activ(1297) structur(1058) }
{ blood(1257) pressur(1144) flow(957) }
{ spatial(1525) area(1432) region(1030) }
{ record(1888) medic(1808) patient(1693) }
{ model(3480) simul(1196) paramet(876) }
{ state(1844) use(1261) util(961) }
{ research(1218) medic(880) student(794) }
{ model(2656) set(1616) predict(1553) }
{ data(2317) use(1299) case(1017) }
{ age(1611) year(1155) adult(843) }
{ signal(2180) analysi(812) frequenc(800) }
{ group(2977) signific(1463) compar(1072) }
{ sampl(1606) size(1419) use(1276) }
{ data(3008) multipl(1320) sourc(1022) }
{ intervent(3218) particip(2042) group(1664) }
{ patient(1821) servic(1111) care(1106) }
{ analysi(2126) use(1163) compon(1037) }
{ health(1844) social(1437) communiti(874) }
{ structur(1116) can(940) graph(676) }
{ use(976) code(926) identifi(902) }
{ use(1733) differ(960) four(931) }
{ drug(1928) target(777) effect(648) }
{ survey(1388) particip(1329) question(1065) }
{ estim(2440) model(1874) function(577) }
{ method(1969) cluster(1462) data(1082) }

Resumo

RPOSE: While contributing to an improved continuity of care, Shared Electronic Health Record (EHR) systems may also lead to information overload of healthcare providers. Document-oriented architectures, such as the commonly employed IHE XDS profile, which only support information retrieval at the level of documents, are particularly susceptible for this problem. The objective of the EHR-ARCHE project was to develop a methodology and a prototype to efficiently satisfy healthcare providers' information needs when accessing a patient's Shared EHR during a treatment situation. We especially aimed to investigate whether this objective can be reached by integrating EHR Archetypes into an IHE XDS environment.METHODS: Using methodical triangulation, we first analysed the information needs of healthcare providers, focusing on the treatment of diabetes patients as an exemplary application domain. We then designed ISO/EN 13606 Archetypes covering the identified information needs. To support a content-based search for fine-grained information items within EHR documents, we extended the IHE XDS environment with two additional actors. Finally, we conducted a formative and summative evaluation of our approach within a controlled study.RESULTS: We identified 446 frequently needed diabetes-specific information items, representing typical information needs of healthcare providers. We then created 128 Archetypes and 120 EHR documents for two fictive patients. All seven diabetes experts, who evaluated our approach, preferred the content-based search to a conventional XDS search. Success rates of finding relevant information was higher for the content-based search (100% versus 80%) and the latter was also more time-efficient (8-14min versus 20min or more).CONCLUSIONS: Our results show that for an efficient satisfaction of health care providers' information needs, a content-based search that rests upon the integration of Archetypes into an IHE XDS-based Shared EHR system is superior to a conventional metadata-based XDS search.

Resumo Limpo

rpose contribut improv continu care share electron health record ehr system may also lead inform overload healthcar provid documentori architectur common employ ihe xds profil support inform retriev level document particular suscept problem object ehrarch project develop methodolog prototyp effici satisfi healthcar provid inform need access patient share ehr treatment situat especi aim investig whether object can reach integr ehr archetyp ihe xds environmentmethod use method triangul first analys inform need healthcar provid focus treatment diabet patient exemplari applic domain design isoen archetyp cover identifi inform need support contentbas search finegrain inform item within ehr document extend ihe xds environ two addit actor final conduct format summat evalu approach within control studyresult identifi frequent need diabetesspecif inform item repres typic inform need healthcar provid creat archetyp ehr document two fictiv patient seven diabet expert evalu approach prefer contentbas search convent xds search success rate find relev inform higher contentbas search versus latter also timeeffici min versus min moreconclus result show effici satisfact health care provid inform need contentbas search rest upon integr archetyp ihe xdsbase share ehr system superior convent metadatabas xds search

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