Representing Knowledge Consistently Across Health Systems

Objectives: Electronic health records (EHRs) have increasingly emerged as a powerful source of clinical data that can be leveraged for reuse in research and in modular health apps that integrate into diverse health information technologies. A key challenge to these use cases is representing the knowledge contained within data from different EHR systems in a uniform fashion. Method: We reviewed several recent studies covering the knowledge representation in the common data models for the Observational Medical Outcomes Partnership (OMOP) and its Observational Health Data Sciences and Informatics program, and the United States Patient Centered Outcomes Research Network (PCORNet). We also reviewed the Health Level 7 Fast Healthcare Interoperability Resource standard supporting app-like programs that can be used across multiple EHR and research systems. Results: There has been a recent growth in high-impact efforts to support quality-assured and standardized clinical data sharing across different institutions and EHR systems. We focused on three major efforts as part of a larger landscape moving towards shareable, transportable, and computable clinical data. Conclusion: The growth in approaches to developing common data models to support interoperable knowledge representation portends an increasing availability of high-quality clinical data in support of research. Building on these efforts will allow a future whereby significant portions of the populations in the world may be able to share their data for research.

[1]  Gil Alterovitz,et al.  SMART on FHIR Genomics: facilitating standardized clinico-genomic apps , 2015, J. Am. Medical Informatics Assoc..

[2]  Douglas MacFadden,et al.  Application of Information Technology The Shared Health Research Information Network ( SHRINE ) : A Prototype Federated Query Tool for Clinical Data Repositories , 2014 .

[3]  Christophe G. Lambert,et al.  Bridging Islands of Information to Establish an Integrated Knowledge Base of Drugs and Health Outcomes of Interest , 2014, Drug Safety.

[4]  Rae Woong Park,et al.  Characterizing treatment pathways at scale using the OHDSI network , 2016, Proceedings of the National Academy of Sciences.

[5]  Christopher G. Chute,et al.  Using Semantic Web technologies for the generation of domain-specific templates to support clinical study metadata standards , 2016, J. Biomed. Semant..

[6]  D. Blumenthal,et al.  The "meaningful use" regulation for electronic health records. , 2010, The New England journal of medicine.

[7]  Stuart J. Nelson,et al.  Normalized names for clinical drugs: RxNorm at 6 years , 2011, J. Am. Medical Informatics Assoc..

[8]  Richard Platt,et al.  Launching PCORnet, a national patient-centered clinical research network , 2014, Journal of the American Medical Informatics Association : JAMIA.

[9]  Yu-Chuan Li,et al.  Observational Health Data Sciences and Informatics (OHDSI): Opportunities for Observational Researchers , 2015, MedInfo.

[10]  Philipp Neuhaus,et al.  Converting ODM Metadata to FHIR Questionnaire Resources , 2016, MIE.

[11]  George Hripcsak,et al.  Birth month affects lifetime disease risk: a phenome-wide method , 2015, J. Am. Medical Informatics Assoc..

[12]  Mohammed Saeed,et al.  Open-access MIMIC-II database for intensive care research , 2011, 2011 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[13]  Patrick B. Ryan,et al.  Validation of a common data model for active safety surveillance research , 2012, J. Am. Medical Informatics Assoc..

[14]  Melissa A. Basford,et al.  The Electronic Medical Records and Genomics (eMERGE) Network: past, present, and future , 2013, Genetics in Medicine.

[15]  Kavishwar B. Wagholikar,et al.  SMART-on-FHIR implemented over i2b2 , 2017, J. Am. Medical Informatics Assoc..

[16]  Joshua C. Mandel,et al.  Driving Innovation in Health Systems through an Apps-Based Information Economy. , 2015, Cell systems.

[17]  Hannes Ulrich,et al.  Metadata Repository for Improved Data Sharing and Reuse Based on HL7 FHIR , 2016, MIE.

[18]  Marsha A Raebel,et al.  Design considerations, architecture, and use of the Mini‐Sentinel distributed data system , 2012, Pharmacoepidemiology and drug safety.

[19]  Paul G. Biondich,et al.  Enabling Better Interoperability for HealthCare: Lessons in Developing a Standards Based Application Programing Interface for Electronic Medical Record Systems , 2015, Journal of Medical Systems.

[20]  Sarah M. Greene,et al.  The Role of Research in Integrated Health Care Systems: The HMO Research Network. , 2004, The Permanente journal.

[21]  Adrian F. Hernandez,et al.  The ADAPTABLE Trial and Aspirin Dosing in Secondary Prevention for Patients with Coronary Artery Disease , 2016, Current Cardiology Reports.

[22]  Joshua C. Mandel,et al.  Opening the Duke electronic health record to apps: Implementing SMART on FHIR , 2017, Int. J. Medical Informatics.

[23]  Hyeon-Eui Kim,et al.  Identifying Appropriate Reference Data Models for Comparative Effectiveness Research (CER) Studies Based on Data from Clinical Information Systems , 2013, Medical care.

[24]  Harry Hochheiser,et al.  An information model for computable cancer phenotypes , 2016, BMC Medical Informatics and Decision Making.

[25]  Eizen Kimura,et al.  Internal domain-specific language based on Arden Syntax and FHIR , 2015, MedInfo.

[26]  Kenneth D. Mandl,et al.  Are Meaningful Use Stage 2 certified EHRs ready for interoperability? Findings from the SMART C-CDA Collaborative , 2014, J. Am. Medical Informatics Assoc..

[27]  Guilherme Del Fiol,et al.  Evaluating common data models for use with a longitudinal community registry , 2016, J. Biomed. Informatics.

[28]  M E Matheny,et al.  Creating a Common Data Model for Comparative Effectiveness with the Observational Medical Outcomes Partnership , 2015, Applied Clinical Informatics.

[29]  Heinz U. Lemke,et al.  Accessing Patient Information for Probabilistic Patient Models Using Existing Standards , 2016, eHealth.

[30]  Joel Carter,et al.  Meaningful Use. , 2016, Journal of palliative medicine.

[31]  Anne C. Beal,et al.  The Patient-Centered Outcomes Research Institute (PCORI) national priorities for research and initial research agenda. , 2012, Journal of the American Medical Association (JAMA).

[32]  Georg Duftschmid,et al.  Bridging the Gap between HL7 CDA and HL7 FHIR: A JSON Based Mapping , 2016, eHealth.

[33]  Jimeng Sun,et al.  Clinical Predictive Modeling Development and Deployment through FHIR Web Services , 2015, AMIA.

[34]  Pascal B. Pfiffner,et al.  C3-PRO: Connecting ResearchKit to the Health System Using i2b2 and FHIR , 2016, PloS one.

[35]  Gil Alterovitz,et al.  SMART precision cancer medicine: a FHIR-based app to provide genomic information at the point of care , 2016, J. Am. Medical Informatics Assoc..

[36]  Kamran Sartipi,et al.  HL7 FHIR: An Agile and RESTful approach to healthcare information exchange , 2013, Proceedings of the 26th IEEE International Symposium on Computer-Based Medical Systems.

[37]  Kenneth D. Mandl,et al.  Data interchange using i2b2 , 2016, J. Am. Medical Informatics Assoc..

[38]  Kenneth D. Mandl,et al.  SMART on FHIR: a standards-based, interoperable apps platform for electronic health records , 2016, J. Am. Medical Informatics Assoc..

[39]  Isaac S Kohane,et al.  Time for a Patient-Driven Health Information Economy? , 2016, The New England journal of medicine.

[40]  HL7 launches Argonaut Project to advance FHIR interoperability standard. , 2015, Health management technology.

[41]  Perry L. Miller,et al.  Application of Information Technology: Organization of Heterogeneous Scientific Data Using the EAV/CR Representation , 1999, J. Am. Medical Informatics Assoc..

[42]  Francis S. Collins,et al.  PCORnet: turning a dream into reality , 2014, J. Am. Medical Informatics Assoc..

[43]  C. Friedman,et al.  A Method to Combine Signals from Spontaneous Reporting Systems and Observational Healthcare Data to Detect Adverse Drug Reactions , 2015, Drug Safety.

[44]  C. Chute,et al.  Electronic Medical Records for Genetic Research: Results of the eMERGE Consortium , 2011, Science Translational Medicine.

[45]  Subashan Perera,et al.  Preparing Nursing Home Data from Multiple Sites for Clinical Research – A Case Study Using Observational Health Data Sciences and Informatics , 2016, EGEMS.

[46]  Patrick B. Ryan,et al.  Accuracy of an automated knowledge base for identifying drug adverse reactions , 2017, J. Biomed. Informatics.

[47]  Paul G. Biondich,et al.  Towards Standardized Patient Data Exchange: Integrating a FHIR Based API for the Open Medical Record System , 2015, MedInfo.

[48]  Martijn J. Schuemie,et al.  Conversion and Data Quality Assessment of Electronic Health Record Data at a Korean Tertiary Teaching Hospital to a Common Data Model for Distributed Network Research , 2016, Healthcare informatics research.

[49]  王德伦 英语-翻译-Internet , 2000 .