J Am Med Inform Assoc - Lessons learned in detailed clinical modeling at Intermountain Healthcare.

Tópicos

{ model(2220) cell(1177) simul(1124) }
{ concept(1167) ontolog(924) domain(897) }
{ implement(1333) system(1263) develop(1122) }
{ clinic(1479) use(1117) guidelin(835) }
{ data(3963) clinic(1234) research(1004) }
{ decis(3086) make(1611) patient(1517) }
{ analysi(2126) use(1163) compon(1037) }
{ health(1844) social(1437) communiti(874) }
{ method(984) reconstruct(947) comput(926) }
{ record(1888) medic(1808) patient(1693) }
{ process(1125) use(805) approach(778) }
{ imag(1947) propos(1133) code(1026) }
{ problem(2511) optim(1539) algorithm(950) }
{ featur(1941) imag(1645) propos(1176) }
{ data(1737) use(1416) pattern(1282) }
{ data(1714) softwar(1251) tool(1186) }
{ health(3367) inform(1360) care(1135) }
{ research(1218) medic(880) student(794) }
{ model(2656) set(1616) predict(1553) }
{ signal(2180) analysi(812) frequenc(800) }
{ structur(1116) can(940) graph(676) }
{ framework(1458) process(801) describ(734) }
{ learn(2355) train(1041) set(1003) }
{ care(1570) inform(1187) nurs(1089) }
{ import(1318) role(1303) understand(862) }
{ data(2317) use(1299) case(1017) }
{ medic(1828) order(1363) alert(1069) }
{ drug(1928) target(777) effect(648) }
{ model(3404) distribut(989) bayesian(671) }
{ can(774) often(719) complex(702) }
{ inform(2794) health(2639) internet(1427) }
{ system(1976) rule(880) can(841) }
{ measur(2081) correl(1212) valu(896) }
{ imag(1057) registr(996) error(939) }
{ bind(1733) structur(1185) ligand(1036) }
{ sequenc(1873) structur(1644) protein(1328) }
{ method(1219) similar(1157) match(930) }
{ featur(3375) classif(2383) classifi(1994) }
{ imag(2830) propos(1344) filter(1198) }
{ network(2748) neural(1063) input(814) }
{ imag(2675) segment(2577) method(1081) }
{ patient(2315) diseas(1263) diabet(1191) }
{ take(945) account(800) differ(722) }
{ studi(2440) review(1878) systemat(933) }
{ motion(1329) object(1292) video(1091) }
{ assess(1506) score(1403) qualiti(1306) }
{ treatment(1704) effect(941) patient(846) }
{ surgeri(1148) surgic(1085) robot(1054) }
{ error(1145) method(1030) estim(1020) }
{ chang(1828) time(1643) increas(1301) }
{ algorithm(1844) comput(1787) effici(935) }
{ extract(1171) text(1153) clinic(932) }
{ method(1557) propos(1049) approach(1037) }
{ design(1359) user(1324) use(1319) }
{ control(1307) perform(991) simul(935) }
{ general(901) number(790) one(736) }
{ search(2224) databas(1162) retriev(909) }
{ case(1353) use(1143) diagnosi(1136) }
{ howev(809) still(633) remain(590) }
{ studi(1410) differ(1259) use(1210) }
{ risk(3053) factor(974) diseas(938) }
{ perform(999) metric(946) measur(919) }
{ research(1085) discuss(1038) issu(1018) }
{ system(1050) medic(1026) inform(1018) }
{ model(2341) predict(2261) use(1141) }
{ visual(1396) interact(850) tool(830) }
{ compound(1573) activ(1297) structur(1058) }
{ perform(1367) use(1326) method(1137) }
{ studi(1119) effect(1106) posit(819) }
{ blood(1257) pressur(1144) flow(957) }
{ spatial(1525) area(1432) region(1030) }
{ model(3480) simul(1196) paramet(876) }
{ monitor(1329) mobil(1314) devic(1160) }
{ ehr(2073) health(1662) electron(1139) }
{ state(1844) use(1261) util(961) }
{ patient(2837) hospit(1953) medic(668) }
{ age(1611) year(1155) adult(843) }
{ cost(1906) reduc(1198) effect(832) }
{ group(2977) signific(1463) compar(1072) }
{ sampl(1606) size(1419) use(1276) }
{ gene(2352) biolog(1181) express(1162) }
{ data(3008) multipl(1320) sourc(1022) }
{ first(2504) two(1366) second(1323) }
{ intervent(3218) particip(2042) group(1664) }
{ activ(1138) subject(705) human(624) }
{ time(1939) patient(1703) rate(768) }
{ patient(1821) servic(1111) care(1106) }
{ use(2086) technolog(871) perceiv(783) }
{ can(981) present(881) function(850) }
{ high(1669) rate(1365) level(1280) }
{ cancer(2502) breast(956) screen(824) }
{ use(976) code(926) identifi(902) }
{ use(1733) differ(960) four(931) }
{ result(1111) use(1088) new(759) }
{ survey(1388) particip(1329) question(1065) }
{ estim(2440) model(1874) function(577) }
{ activ(1452) weight(1219) physic(1104) }
{ method(1969) cluster(1462) data(1082) }
{ method(2212) result(1239) propos(1039) }
{ detect(2391) sensit(1101) algorithm(908) }

Resumo

CKGROUND AND OBJECTIVE: Intermountain Healthcare has a long history of using coded terminology and detailed clinical models (DCMs) to govern storage of clinical data to facilitate decision support and semantic interoperability. The latest iteration of DCMs at Intermountain is called the clinical element model (CEM). We describe the lessons learned from our CEM efforts with regard to subjective decisions a modeler frequently needs to make in creating a CEM. We present insights and guidelines, but also describe situations in which use cases conflict with the guidelines. We propose strategies that can help reconcile the conflicts. The hope is that these lessons will be helpful to others who are developing and maintaining DCMs in order to promote sharing and interoperability.METHODS: We have used the Clinical Element Modeling Language (CEML) to author approximately 5000 CEMs.RESULTS: Based on our experience, we have formulated guidelines to lead our modelers through the subjective decisions they need to make when authoring models. Reported here are guidelines regarding precoordination/postcoordination, dividing content between the model and the terminology, modeling logical attributes, and creating iso-semantic models. We place our lessons in context, exploring the potential benefits of an implementation layer, an iso-semantic modeling framework, and ontologic technologies.CONCLUSIONS: We assert that detailed clinical models can advance interoperability and sharing, and that our guidelines, an implementation layer, and an iso-semantic framework will support our progress toward that goal.

Resumo Limpo

ckground object intermountain healthcar long histori use code terminolog detail clinic model dcms govern storag clinic data facilit decis support semant interoper latest iter dcms intermountain call clinic element model cem describ lesson learn cem effort regard subject decis model frequent need make creat cem present insight guidelin also describ situat use case conflict guidelin propos strategi can help reconcil conflict hope lesson will help other develop maintain dcms order promot share interoperabilitymethod use clinic element model languag ceml author approxim cemsresult base experi formul guidelin lead model subject decis need make author model report guidelin regard precoordinationpostcoordin divid content model terminolog model logic attribut creat isosemant model place lesson context explor potenti benefit implement layer isosemant model framework ontolog technologiesconclus assert detail clinic model can advanc interoper share guidelin implement layer isosemant framework will support progress toward goal

Resumos Similares

AMIA Annu Symp Proc - An OWL meta-ontology for representing the Clinical Element Model. ( 0,66176304811475 )
J Biomed Inform - The ACGT Master Ontology and its applications--towards an ontology-driven cancer research and management system. ( 0,641119945887284 )
Int J Med Inform - Applying the archetype approach to the database of a biobank information management system. ( 0,636777149205588 )
AMIA Annu Symp Proc - Design and evaluation of a bacterial clinical infectious diseases ontology. ( 0,608208135233724 )
J Am Med Inform Assoc - Computerization of workflows, guidelines, and care pathways: a review of implementation challenges for process-oriented health information systems. ( 0,59734410587319 )
Methods Inf Med - Architectural approach to eHealth for enabling paradigm changes in health. ( 0,576741690684941 )
J Am Med Inform Assoc - A multi-layered framework for disseminating knowledge for computer-based decision support. ( 0,567903731316761 )
AMIA Annu Symp Proc - Adapting a Clinical Data Repository to ICD-10-CM through the use of a Terminology Repository. ( 0,567268885693782 )
AMIA Annu Symp Proc - Evaluation of need for ontologies to manage domain content for the Reportable Conditions Knowledge Management System. ( 0,561818836640309 )
Int J Med Inform - Changing course to make clinical decision support work in an HIV clinic in Kenya. ( 0,558054446197274 )
AMIA Annu Symp Proc - Constructing Clinical Decision Support Systems for Adverse Drug Event Prevention: A Knowledge-based Approach. ( 0,558029993757057 )
Perspect Health Inf Manag - Personal health records: is rapid adoption hindering interoperability? ( 0,557041907394639 )
AMIA Annu Symp Proc - Integration of heterogeneous clinical decision support systems and their knowledge sets: feasibility study with Drug-Drug Interaction alerts. ( 0,553969248941876 )
J Med Syst - Thermal shock resistance of skin tissue. ( 0,551569774748941 )
J Am Med Inform Assoc - A unified structural/terminological interoperability framework based on LexEVS: application to TRANSFoRm. ( 0,549335418010794 )
Int J Med Inform - A framework of a patient safety information system for Iranian hospitals: lessons learned from Australia, England and the US. ( 0,549130236874884 )
J. Med. Internet Res. - Can social semantic web techniques foster collaborative curriculum mapping in medicine? ( 0,543313546148303 )
Comput. Biol. Med. - Evaluation of personal health record systems through the lenses of EC research projects. ( 0,540129771569787 )
BMC Med Inform Decis Mak - Validating archetypes for the Multiple Sclerosis Functional Composite. ( 0,53854604316993 )
Comput Methods Programs Biomed - Local identifiability and sensitivity analysis of neuromuscular blockade and depth of hypnosis models. ( 0,537279409821378 )
Comput Methods Programs Biomed - Five-year experience with setup and implementation of an integrated database system for clinical documentation and research. ( 0,535399426022066 )
Artif Intell Med - Intra-axiom redundancies in SNOMED CT. ( 0,534952409949329 )
AMIA Annu Symp Proc - OPIC: Ontology-driven Patient Information Capturing system for epilepsy. ( 0,531966499932517 )
J Am Med Inform Assoc - Development of an optical character recognition pipeline for handwritten form fields from an electronic health record. ( 0,531905700286632 )
Int J Med Inform - Using ontologies for structuring organizational knowledge in Home Care assistance. ( 0,531652400483175 )
Int J Med Inform - Towards an ontology for data quality in integrated chronic disease management: a realist review of the literature. ( 0,53083569016584 )
J Am Med Inform Assoc - Electronic health records based phenotyping in next-generation clinical trials: a perspective from the NIH Health Care Systems Collaboratory. ( 0,530737954651947 )
Int J Med Inform - A modified Delphi translation strategy and challenges of International Classification for Nursing Practice (ICNP?). ( 0,529154517295712 )
J Biomed Inform - An ontological modeling approach to cerebrovascular disease studies: the NEUROWEB case. ( 0,528706252585062 )
Comput. Biol. Med. - Computer-aided design of the human aortic root. ( 0,528510888838652 )
Med Biol Eng Comput - A new method to include the gravitational forces in a finite element model of the scoliotic spine. ( 0,524593453032159 )
Comput. Biol. Med. - Modeling porous scaffold microstructure by a reaction-diffusion system and its degradation by hydrolysis. ( 0,524042458963397 )
BMC Med Inform Decis Mak - Requirements for guidelines systems: implementation challenges and lessons from existing software-engineering efforts. ( 0,524006645498368 )
J Biomed Inform - Authoring and verification of clinical guidelines: a model driven approach. ( 0,523571592211847 )
Int J Comput Assist Radiol Surg - AneuSearch: a software prototype for intracranial aneurysm searching and clinical decision support. ( 0,523327125920729 )
Methods Inf Med - Toward a view-oriented approach for aligning RDF-based biomedical repositories. ( 0,522370604785788 )
IEEE Trans Image Process - Structure-preserving sparse decomposition for facial expression analysis. ( 0,522297572252977 )
Comput Math Methods Med - A literature review of the numerical analysis of abdominal aortic aneurysms treated with endovascular stent grafts. ( 0,519531126600097 )
J Biomed Inform - Discovering beaten paths in collaborative ontology-engineering projects using Markov chains. ( 0,517109705644441 )
AMIA Annu Symp Proc - Collaborative development and maintenance of health terminologies. ( 0,51548966604919 )
Methods Inf Med - Modeling problem-oriented clinical notes. ( 0,512249048487123 )
J Med Syst - Customer-centered careflow modeling based on guidelines. ( 0,511547955012828 )
J Am Med Inform Assoc - Mapping clinical phenotype data elements to standardized metadata repositories and controlled terminologies: the eMERGE Network experience. ( 0,511245773164888 )
Comput Methods Programs Biomed - 2D and 3D finite element analysis of central incisor generated by computerized tomography. ( 0,509321396151154 )
J Biomed Inform - Terminology representation guidelines for biomedical ontologies in the semantic web notations. ( 0,509031412531983 )
AMIA Annu Symp Proc - Creating shareable decision support services: an interdisciplinary challenge. ( 0,507842924011722 )
BMC Med Inform Decis Mak - Towards computerizing intensive care sedation guidelines: design of a rule-based architecture for automated execution of clinical guidelines. ( 0,507037002001144 )
AMIA Annu Symp Proc - Mapping ASTI patient's therapeutic-data model to virtual Medical Record: can VMR represent therapeutic data elements used by ASTI in clinical guideline implementations? ( 0,505760984542094 )
Brief. Bioinformatics - Translational research platforms integrating clinical and omics data: a review of publicly available solutions. ( 0,505629908854038 )
Appl Clin Inform - Towards meaningful medication-related clinical decision support: recommendations for an initial implementation. ( 0,504721655735206 )
J Am Med Inform Assoc - Practices and perspectives on building integrated data repositories: results from a 2010 CTSA survey. ( 0,503570691302047 )
J Integr Bioinform - An ontology for description of drug discovery investigations. ( 0,503353239958568 )
Comput Methods Programs Biomed - A simple versatile solution for collecting multidimensional clinical data based on the CakePHP web application framework. ( 0,502259946361489 )
Med Biol Eng Comput - Biomechanical comparison of fusionless growth modulation corrective techniques in pediatric scoliosis. ( 0,501963147092663 )
Wiley Interdiscip Rev Syst Biol Med - Reprogramming cells and tissue patterning via bioelectrical pathways: molecular mechanisms and biomedical opportunities. ( 0,501418985259293 )
J Biomed Inform - An Integrated Model for Patient Care and Clinical Trials (IMPACT) to support clinical research visit scheduling workflow for future learning health systems. ( 0,50095796358254 )
J Biomed Inform - Mitigation of adverse interactions in pairs of clinical practice guidelines using constraint logic programming. ( 0,500349493849595 )
Wiley Interdiscip Rev Syst Biol Med - Computational and experimental characterization of skin mechanics: identifying current challenges and future directions. ( 0,497029275673302 )
Telemed J E Health - Provider barriers to telemental health: obstacles overcome, obstacles remaining. ( 0,496073085284334 )
Comput. Biol. Med. - Design of a smart biomarker for bioremediation: a machine learning approach. ( 0,495788646563466 )
AMIA Annu Symp Proc - Standardized mapping of nursing assessments across 59 U.S. military treatment facilities. ( 0,494260407256147 )
J Biomed Inform - Deriving a probabilistic syntacto-semantic grammar for biomedicine based on domain-specific terminologies. ( 0,494247401342255 )
J Biomed Inform - Research-IQ: development and evaluation of an ontology-anchored integrative query tool. ( 0,49341986616249 )
J Med Syst - Automated mapping of clinical terms into SNOMED-CT. An application to codify procedures in pathology. ( 0,493405743165702 )
J Med Syst - Online treatment compliance checking for clinical pathways. ( 0,493030479572374 )
Methods Inf Med - Putting biomedical ontologies to work. ( 0,489679331266356 )
Med Biol Eng Comput - Can common adhesion molecules and microtopography affect cellular elasticity? A combined atomic force microscopy and optical study. ( 0,488428365176337 )
Neural Comput - Diffusive feedback influences on hierarchical information processing. ( 0,487890087511811 )
Appl Clin Inform - An empiric analysis of omaha system targets. ( 0,487861056653072 )
Appl Clin Inform - Ontology content patterns as bridge for the semantic representation of clinical information. ( 0,487210752735716 )
J Biomed Inform - An approach for the semantic interoperability of ISO EN 13606 and OpenEHR archetypes. ( 0,486378807767171 )
Methods Inf Med - Bridging data models and terminologies to support adverse drug event reporting using EHR data. ( 0,486008874463864 )
J Am Med Inform Assoc - Applying knowledge-anchored hypothesis discovery methods to advance clinical and translational research: the OAMiner project. ( 0,485561250854284 )
Comput Methods Programs Biomed - Subject-specific finite element simulation of the human femur considering inhomogeneous material properties: a straightforward method and convergence study. ( 0,485487177040966 )
J Biomed Inform - Integrating reasoning and clinical archetypes using OWL ontologies and SWRL rules. ( 0,485388625213888 )
BMC Med Inform Decis Mak - Semantic text mining support for lignocellulose research. ( 0,485079004991443 )
AMIA Annu Symp Proc - Clinical information system services and capabilities desired for scalable, standards-based, service-oriented decision support: consensus assessment of the Health Level 7 clinical decision support Work Group. ( 0,484749930439867 )
Comput Methods Programs Biomed - Physical modeling with orthotropic material based on harmonic fields. ( 0,484631648820822 )
J. Med. Internet Res. - Computing health quality measures using Informatics for Integrating Biology and the Bedside. ( 0,484629420533819 )
J Am Med Inform Assoc - Exchanging care records using HL7 V3 care provision messages. ( 0,484489075289746 )
Appl Clin Inform - Understanding why clinicians answer or ignore clinical decision support prompts. ( 0,483733371951129 )
J Biomed Inform - A set of ontologies to drive tools for the control of vector-borne diseases. ( 0,483224400744389 )
J Biomed Inform - A survey of SNOMED CT implementations. ( 0,483032689295982 )
J Am Med Inform Assoc - Evaluating standard terminologies for encoding allergy information. ( 0,481436996664491 )
J Biomed Inform - Facilitating pre-operative assessment guidelines representation using SNOMED CT. ( 0,481165188129193 )
AMIA Annu Symp Proc - Evaluation of RxNorm for Medication Clinical Decision Support. ( 0,480991831625579 )
J Am Med Inform Assoc - Executing medical logic modules expressed in ArdenML using Drools. ( 0,480838103545612 )
J. Med. Internet Res. - Sociotechnical challenges and progress in using social media for health. ( 0,480305135056683 )
Med Biol Eng Comput - Biomechanics of thoracolumbar junction vertebral fractures from various kinematic conditions. ( 0,480225865989969 )
J Med Syst - Developing a semantic web model for medical differential diagnosis recommendation. ( 0,479974898226914 )
Artif Intell Med - Aggregating evidence about the positive and negative effects of treatments. ( 0,47996918815222 )
J Am Med Inform Assoc - WHO guidance on electronic systems to manage data for tuberculosis care and control. ( 0,479788779546809 )
J Biomed Inform - Natural Language Processing methods and systems for biomedical ontology learning. ( 0,479758799876301 )
Med Biol Eng Comput - Finite element analysis of the influence of loading rate on a model of the full lumbar spine under dynamic loading conditions. ( 0,479627092971176 )
J Clin Monit Comput - The evolution of eProtocols that enable reproducible clinical research and care methods. ( 0,47920926403383 )
AMIA Annu Symp Proc - Modeling and executing electronic health records driven phenotyping algorithms using the NQF Quality Data Model and JBoss? Drools Engine. ( 0,47686569258039 )
Comput Methods Programs Biomed - Computer-aided optimal design of custom scoliosis braces considering clinical and patient evaluations. ( 0,476833186293698 )
AMIA Annu Symp Proc - Ontological approach to reduce complexity in polypharmacy. ( 0,47617045482459 )
Med Biol Eng Comput - Parameter estimation of the copernicus decompression model with venous gas emboli in human divers. ( 0,475971109105902 )
J Biomed Inform - Transforming semi-structured life science diagrams into meaningful domain ontologies with DiDOn. ( 0,475527966445069 )