RESUMEN
This paper explores the challenges and lessons learned during the mapping of HL7 v2 messages structured using custom schema to openEHR for the Medical Data Integration Center (MeDIC) of the University Hospital, Schleswig-Holstein (UKSH). Missing timestamps in observations, missing units of measurement, inconsistencies in decimal separators and unexpected datatypes were identified as critical inconsistencies in this process. These anomalies highlight the difficulty of automating the transformation of HL7 v2 data to any standard, particularly openEHR, using off-the-shelf tools. Addressing these anomalies is crucial for enhancing data interoperability, supporting evidence-based research, and optimizing clinical decision-making. Implementing proper data quality measures and governance will unlock the potential of integrated clinical data, empowering clinicians and researchers and fostering a robust healthcare ecosystem.
Asunto(s)
Estándar HL7 , Registros Electrónicos de Salud , Interoperabilidad de la Información en Salud , Alemania , Integración de Sistemas , Humanos , Registro Médico Coordinado/métodosRESUMEN
This comparative study examines the transition from isolated registries to a consolidated data-centric approach at University Hospital Schleswig-Holstein, focusing on migrating the Atrioventricular Valve Intervention Registry (AVIR) from REDCap to a Medical Data Integration Center based openEHR registry. Through qualitative analysis, we identify key disparities and strategic decisions guiding this transition. While REDCap has historical utility, its limitations in automated data integration and traceability highlight the advantages of a data-centric approach, which include streamlined data (integration) management at a single-point-of-truth based on e.g., centralized consent management. Our findings lay the groundwork for the AVIR project and a proof-of-concept data-centric registry, reflecting a broader industry trend towards data-centric healthcare initiatives.
Asunto(s)
Sistema de Registros , Humanos , Registros Electrónicos de Salud , Alemania , Enfermedades de las Válvulas CardíacasRESUMEN
Imaging techniques are a cornerstone of today's medicine and can be crucial for a successful therapy. But in addition, the generated imaging series are an important resource for new informatics' methods, especially in the field of artificial intelligence. This paper describes the success of integrating clinical routine imaging data into a standardized format for research purposes. Thus, we designed an integration flow and successfully implemented it in the local data integration center of University Hospital Schleswig-Holstein. The flow integrates imaging series and radiological reports from the primary system into an openEHR repository with enrichment by semantic codes for better findability and retrieval using HL7 FHIR. As a result, 6.6 million radiological studies with 29 million image series are now available for further medical (informatics) research.
Asunto(s)
Inteligencia Artificial , Medicina , Humanos , Hospitales Universitarios , SemánticaRESUMEN
The use and shareability of Clinical Quality Language (CQL) artefacts is an important aspect in enabling the exchange and interoperability of clinical data to support both clinical decisions and research in the medical informatics field. This paper, while basing on use cases and synthetic data, developed purposeful CQL reusable libraries to showcase the possibilities of multidisciplinary teams and how CQLs could be best used to support clinical decision making.
Asunto(s)
Registros Electrónicos de Salud , Informática Médica , Lenguaje , Toma de Decisiones Clínicas , ArtefactosRESUMEN
Interoperability and portability of healthcare data to enable research in the healthcare sector is an important factor towards precision medicine and a learning health system. With many safety-nets put in place like the European General Data Protection Regulation, and local standards like the broad consent set up by the German Medical Informatics Initiative, management and compliance to these standards across all systems and clinical data repositories becomes a daunting task. An appropriate process needs to be established especially when patient data is transferred to and from different systems and standards. On extraction and transforming, an appropriate method of loading the modified data to a destination where it can be read and accessed needs to be established besides functional compliance by the repository systems. This paper makes recommendations in relation to data load strategies while working with FHIR server-based data marts.