评估快速医疗互操作性资源在临床注册表数据提交方面的潜力
James E Tcheng1, David Finney2, Keith Boone3
1Department of Medicine, Duke University School of Medicine, Durham, NC 27705, United States.
概括
临床注册表提取和数据提交 (CREDS) 项目使用HL7快速医疗互操作资源 (FHIR) 探索注册表数据. 虽然展示了潜力,但在数据标准化和大规模采用基础设施方面仍然存在挑战.
科学领域:
- 医疗信息学 医疗信息学
- 临床数据管理 临床数据管理
- 医疗保健互操作性标准 医疗保健互操作性标准
背景情况:
- 美国心脏病学会心脏导管透皮冠状动脉干预 (CathPCI) 登记需要有效的数据提交.
- HL7 快速医疗互操作性资源 (FHIR) 为健康数据交换提供了现代标准.
- 评估FHIR对临床注册数据提供准备情况对于改善数据提交流程至关重要.
研究的目的:
- 评估使用HL7 FHIR向CathPCI注册表提供数据的可行性.
- 评估临床文档的准备情况,并开发基于FHIR的注册数据提交工作流程.
- 为了证明CREDS FHIR实现的注册表数据提交.
主要方法:
- 临床注册表提取和数据提交 (CREDS) 项目涉及三个工作流:评估文档准备,建模基于FHIR的工作流,并开发FHIR实现.
- 来自CathPCI注册表的数据概念被评估为离散数据和术语映射.
- 创建了一个FHIR结构定义文物,并纳入了FHIR实施指南.
主要成果:
- 只有32%的CathPCI注册表数据概念足够离散以进行直接映射;另外42个概念通过FHIR被确定为可提供.
- 开发了一种混合工作流,将FHIR数据组装与复杂概念的手动抽象相结合.
- 一个CathPCI FHIR结构定义达到标准的试用状态.
结论:
- 该CREDS项目展示了使用FHIR提交注册表数据的潜力和局限性.
- 重要的技术障碍包括FHIR结构定义的复杂性,缺乏标准化的临床词汇,以及需要FHIR基础设施.
- 开源文物可用于支持未来的开发和采用FHIR用于类似的注册计划.
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