Conference article

Efforts on Using Standards for Defining the Structuring of Electronic Health Record Data: A Scoping Review

Kristian Malm-Nicolaisen
Norwegian Centre for E-health Research, University hospital North Norway, Tromsø, Norway

Luis Marco Ruiz
Norwegian Centre for E-health Research, University hospital North Norway, Tromsø, Norway

Emma Rødsjø Evenstad
Norwegian Centre for E-health Research, University hospital North Norway, Tromsø, Norway

Rune Pedersen
Norwegian Centre for E-health Research, University hospital North Norway, Tromsø, Norway / UIT – The Arctic University of Norway, Telemedicine and e-health research group, Tromsø, Norway

Download article

Published in: SHI 2019. Proceedings of the 17th Scandinavian Conference on Health Informatics, November 12-13, 2019, Oslo, Norway

Linköping Electronic Conference Proceedings 161:19, p. 108-115

Show more +

Published: 2019-11-07

ISBN: 978-91-7929-957-6

ISSN: 1650-3686 (print), 1650-3740 (online)

Abstract

Using a scoping review technique, this paper investigates approaches, challenges, and success factors when adopting highly structured Electronic Health Records (EHRs). Our findings are consistent with previous literature that reports that the most common methods for structuring patient data consist of a combination of codes, terminologies, reference information models, and standards. However, the review identified new factors and challenges previously not considered as critical areas for the successful implementation of highly structured EHRs; challenges related to human factors seem to be of paramount importance for the success of standard-based EHR adoption. The review revealed that main challenges are related to maturity of the technologies; methods for governance of clinical models; slow adoption of standards; high cost of running pilots; lack of standard compliance and validation mechanisms; and unclear terminology binding of information models. Key success factors are the availability of validated Clinical Information Models (CIMs) and value sets; properly leveraging and managing the complex technology stack; rapidly coordinating EHR implementers with governance bodies; performing agile requirements management; involvement of all stakeholders in the development of standard specifications; and implementing early pilots evaluating the adoption of structured EHRs.

Keywords

Structured EHR, health information standards, terminologies, decision support, review.

References

No references available

Citations in Crossref