ICMCC

the international council on medical & care compunetics

council

28
July, 2014
Monday

architecture

Shifts in the architecture of the Nationwide Health Information Network

Lenert L et al, J Am Med Inform Assoc, 2012

In the midst of a US $30 billion USD investment in the Nationwide Health Information Network (NwHIN) and electronic health records systems, a significant change in the architecture of the NwHIN is taking place. Prior to 2010, the focus of information exchange in the NwHIN was the Regional Health Information Organization (RHIO). Since 2010, the Office of the National Coordinator (ONC) has been sponsoring policies that promote an internet-like architecture that encourages point to-point information exchange and private health information exchange networks.
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14 May 2012 | No Comments »
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Secondary Use of EHR: Data Quality Issues and Informatics Opportunities

Botsis T et al, AMIA Summits Transl Sci Proc. 2010

Given the large-scale deployment of Electronic Health Records (EHR), secondary use of EHR data will be increasingly needed in all kinds of health services or clinical research. This paper reports some data quality issues we encountered in a survival analysis of pancreatic cancer patients. Using the clinical data warehouse at Columbia University Medical Center in the City of New York, we mined EHR data elements collected between 1999 and 2009 for a cohort of pancreatic cancer patients. Of the 3068 patients who had ICD-9-CM diagnoses for pancreatic cancer, only 1589 had corresponding disease documentation in pathology reports.
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27 February 2011 | No Comments »
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Historia Clínica Informatizada en el Área de Salud de Ávila. Arquitectura y Modelo (I)

Nieto Pajares JF. RevistaeSalud, 7(25)

The Complex Care of Avila, has driven the development and implementation of electronic health records system (HCE) of the Regional Health Management of Castilla y León (Sacyl). The project has been implemented based on standard content definition and information hierarchy, integration and interoperability based on standards and the development of a software application called Jimena. The application is currently being upgraded in the four health centers in the area, is integrated with departmental applications and has specialized utilities for navigation, editing and electronic application in each care context.
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26 February 2011 | No Comments »
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Ontology driven health information systems architectures enable pHealth for empowered patients

Blobel B. International Journal of Medical Informatics, 2010

The paradigm shift from organization-centered to managed care and on to personal health settings increases specialization and distribution of actors and services related to the health of patients or even citizens before becoming patients. As a consequence, extended communication and cooperation is required between all principals involved in health services such as persons, organizations, devices, systems, applications, and components. Personal health (pHealth) environments range over many disciplines, where domain experts present their knowledge by using domain-specific terminologies and ontologies.
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8 November 2010 | No Comments »
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Tile-Ippokratis: The Experience of an Ehealth Platform for the Provision of Health Care Services in the Island of Chios and Cyprus

Papadopoulos H. International Journal of Telemedicine and Applications, 2010

Tile-Ippokratis proposed an integrated platform for the provision of low-cost ehealth services to citizens in southeast Mediterranean area (Island of Chios and Cyprus). The aim of the paper is to present the architecture, the design, and the evaluation results of this platform. The platform based on already evaluated state-of-the-art mobile ehealth systems and using wireless and terrestrial telecommunication networks is able to provide the following health care services
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8 September 2010 | No Comments »
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Automatic de-identification of textual documents in the electronic health record: a review of recent research

Meystre SM et al, BMC Medical Research Methodology, 10(1)

Background
In the United States, the Health Insurance Portability and Accountability Act (HIPAA) protects the confidentiality of patient data and requires the informed consent of the patient and approval of the Internal Review Board to use data for research purposes, but these requirements can be waived if data is de-identified. For clinical data to be considered de-identified, the HIPAA “Safe Harbor” technique requires 18 data elements (called PHI: Protected Health Information) to be removed. The de-identification of narrative text documents is often realized manually, and requires significant resources. Well aware of these issues, several authors have investigated automated de-identification of narrative text documents from the electronic health record, and a review of recent research in this domain is presented here.
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5 August 2010 | No Comments »
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Design and implementation of a standards-based interoperable clinical decision support architecture in the context of the Korean EHR

Cho I et al, International Journal of Medical Informatics, 79(2)

Background
In 2000 the Korean government initiated efforts to secure healthcare accessibility and efficiency anytime and anywhere via the nationwide healthcare information system by the end of 2010. According to the master plan, electronic health record (EHR) research and development projects were designed in 2005. One subproject was the design and implementation of standards-based interoperable clinical decision support (CDS) capabilities in the context of the EHR system.
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11 July 2010 | No Comments »
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Quality Evaluation of Health Information System’s Architectures Developed Using the HIS-DF Methodology

López DM et al, Medical and Care Compunetics 6, 2010

Requirement analysis, design, implementation, evaluation, use, and maintenance of semantically interoperable Health Information Systems (HIS) have to be based on eHealth standards. HIS-DF is a comprehensive approach for HIS architectural development based on standard information models and vocabulary. The empirical validity of HIS-DF has not been demonstrated so far.
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17 June 2010 | No Comments »
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Extraction of standardized archetyped data from Electronic Health Record systems based on the Entity-Attribute-Value Model

Duftschmid G et al, International Journal of Medical Informatics, 2010

Objective
The ISO/EN 13606 Electronic Health Record architecture standard permits semantically interoperable exchange of Electronic Health Record data by using archetypes to define the structure and semantics of Electronic Health Record contents. Practical implementations of the ISO/EN 13606 standard have been scarcely reported on, and none of the publications describes in detail an efficient technique of archetype-compliant data extraction from an Electronic Health Record system. We address this research issue in the present report, and focus on a specific class of largely research-oriented Electronic Health Record systems which are internally based on the Entity-Attribute-Value Model.
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13 June 2010 | No Comments »
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Architectural Approaches for HL7-based Health Information Systems Implementation

López, Diego M, and Bernd Blobel, Methods of Information in Medicine, 49(2)

Objective:
Information systems integration is hard, especially when semantic and business process interoperability requirements need to be met. To succeed, a unified methodology, approaching different aspects of systems architecture such as business, information, computational, engineering and technology viewpoints, has to be considered. The paper contributes with an analysis and demonstration on how the HL7 standard set can support health information systems integration.
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21 March 2010 | No Comments »
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Architectural Approach to eHealth for Enabling Paradigm Changes in Health

Blobel B, Methods of Information in Medicine, 49(2)

Objectives:
For improving safety and quality of care as well as efficiency of health delivery under the well-known burdens, health services become specialized, distributed, and therefore collaborative, thereby changing the health service paradigm from organization-centered over process-controlled to personal health (pHealth).
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19 March 2010 | No Comments »
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Putting Health Record Interoperability Standards to Work

Atalag, Koray et al, electronic Journal of Health Informatics, 5(1)

This paper provides a snapshot of the current interoperability standards landscape and investigates how different standards are adopted in different jurisdictions. The aim is to provide useful insights for decision makers by looking from a wider angle to include political, social and business drivers rather than taking a purely technical approach. Semantic interoperability, which is a major bottleneck to achieving eHealth systemic interoperability, is dependent on terminology, content and messaging standards. In particular, the architectural aspects of content and messaging standards seem to be critical and currently the subject of many heated debates. A considerable amount of effort into international harmonisation is underway and evidence shows that it may be possible to use different standards and yet still be able to accomplish semantic interoperability.
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12 March 2010 | No Comments »
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The University of Michigan Honest Broker: a Web-based service for clinical and translational research and practice

Boyd, Andrew D. et al, J Am Med Inform Assoc, 16(6)

For the success of clinical and translational science, a seamless interoperation is required between clinical and research information technology. Addressing this need, the Michigan Clinical Research Collaboratory (MCRC) was created. The MCRC employed a standards-driven Web Services architecture to create the U-M Honest Broker, which enabled sharing of clinical and research data among medical disciplines and separate institutions. Design objectives were to facilitate sharing of data, maintain a master patient index (MPI), deidentification of data, and routing data to preauthorized destination systems for use in clinical care, research, or both.
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15 November 2009 | No Comments »
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A Multi-Modal Health and Activity Monitoring Framework for Elderly People at Home

Marsh, Andrew J et al, Handbook of Digital Homecare, 2009

Since the population of elderly people grows absolutely and in relation to the overall population in the world, the improvement of the quality of life of elderly people at home is of a great importance. This can be achieved through the development of generic technologies for managing their domestic ambient environment consisting of medical sensors, entertainment equipment, home automation systems and white goods, increasing their autonomy and safety.
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5 October 2009 | No Comments »
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VirtualECare: Group Support in Collaborative Networks Organizations for Digital Homecare

Costa, Ricardo et al, Handbook of Digital Homecare, 2009

Collaborative Work plays an important role in today’s organizations, especially in areas where decisions must be made. However, any decision that involves a collective or group of decision makers is, by itself complex, but is becoming recurrent in recent years. In this work we present the VirtualECare project, an intelligent multi-agent system able to monitor, interact and serve its customers, which are, normally, in need of care services. In last year’s there has been a substantially increase on the number of people needed of intensive care, especially among the elderly, a phenomenon that is related to population ageing. However, this is becoming not exclusive of the elderly, as diseases like obesity, diabetes and blood pressure have been increasing among young adults.
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5 October 2009 | No Comments »
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Personalizing Care: Integration of Hospital and Homecare

Román, Isabel et al, Handbook of Digital Homecare, 2009

Hospital and homecare must be understood as a necessary conjunction to accomplish efficient personalized care. In this sense, the integration of hospital and homecare protocols and technologies should be considered from the moment that they begin to be designed. The proliferation of healthcare units and services complicates this task, as multiple administrative domains can be found, usually spread out in multiple technology domains, difficult to integrate.
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5 October 2009 | No Comments »
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The Shared Health Research Information Network (SHRINE): A prototype federated query tool for clinical data repositories

Weber, Griffin M. et al, J Am Med Inform Assoc, 16(5)

We developed a prototype Shared Health Research Information Network (SHRINE) to identify the technical, regulatory, and political challenges of creating a federated query tool for clinical data repositories. Separate Institutional Review Boards (IRBs) at Harvard’s three largest affiliated health centers approved use of their data, and the Harvard Medical School IRB approved building a Query Aggregator Interface that can simultaneously send queries to each hospital and display aggregate counts of the number of matching patients.
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13 September 2009 | No Comments »
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The role of ontologies for sustainable, semantically interoperable and trustworthy EHR solutions

Blobel, Bernd et al, Medical Informatics in a United and Healthy Europe, 2009

As health systems around the world turn towards highly distributed, specialized and cooperative structures to increase quality and safety of care as well as efficiency and efficacy of delivery processes, there is a growing need for supporting communication and collaboration of all parties involved with advanced ICT solutions. The Electronic Health Record (EHR) provides the information platform which is maturing towards the eHealth core application. To meet the requirements for sustainable, semantically interoperable, and trustworthy EHR solutions, different standards and different national strategies have been established.
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12 September 2009 | No Comments »
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Design and Implementation of Web-Based Mobile Electronic Medication Administration Record

Hsieh, Sung-Huai et al, Journal of Medical Systems, online first

Patients’ safety is the most essential, critical issue, however, errors can hardly prevent, especially for human faults. In order to reduce the errors caused by human, we construct Electronic Health Records (EHR) in the Health Information System (HIS) to facilitate patients’ safety and to improve the quality of medical care. During the medical care processing, all the tasks are based upon physicians’ orders.
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26 May 2009 | No Comments »
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The Effects of Redesigning the IDEATel Architecture on Glucose Uploads

Hilliman CA et al, Telemedicine and e-Health. 15(3)

The Informatics for Diabetes Education and Telemedicine (IDEATel) project has demonstrated significant changes in clinical outcome measures over the past years. This report describes upgrades and innovations in the system that allow a much more rapid upload of data and thus significant system improvement.
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22 April 2009 | No Comments »
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