Konferensartikel

An International Minimal Patient Care Report Exemplified in FHIR to Facilitate Standardisation and Interoperability of Emergency Medical Services Data

Rasmus Guldhammer Blendal
Department of Health Science and Technology, Aalborg University, Aalborg, Denmark

Louise Pape-Haugaard
Department of Health Science and Technology, Aalborg University, Aalborg, Denmark

Ladda ner artikel

Ingår i: Proceedings from The 16th Scandinavian Conference on Health Informatics 2018, Aalborg, Denmark August 28–29, 2018

Linköping Electronic Conference Proceedings 151:15, s. 85-90

Visa mer +

Publicerad: 2018-08-24

ISBN: 978-91-7685-213-2

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

Abstract

Lack of semantic interoperability is a common problem within healthcare IT. In prehospital sector it results in emergency medical service data being stuck in the emergency department, despite being important to clinicians outside the emergency department in treatment of the patient. Steps towards semantic interoperability within the prehospital area, on an international level, was taken by first creating an international common data set by use of two different national data sets and scientific literature. The usability of the created data set was showcased by example of a clinical case from emergency medicine. With common data elements established the next step was profiling the data set in FHIR, to further facilitate interoperability, as a common exchange standard is paramount for systems to interoperate.

Nyckelord

Interoperability, EmergencCare pathways, Clinical communication, Patient-centred EHR, HL7 CDA, Finite State Machine, Variance Report.y Medical Services, Emergency Department, FHIR, Standardization.

Referenser

[1] D. Spaite, R. Benoit, D. Brown, R. Cales, D. Dawson, C. Glass, C. Kaufmann, D. Pollock, S. Ryan, and E. M. Yano, “Uniform prehospital data elements and definitions: a report from the uniform prehospital emergency medical services data conference,” Annals of emergency medicine, vol. 25, no. 4, pp. 525–534, 1995.

[2] K. L. Tataris, M. P. Mercer, and P. Govindarajan, “Prehospital aspirin administration for acute coronary syndrome (ACS) in the USA: an EMS quality assessment using the NEMSIS 2011 database,” Emergency Medicine Journal, vol. 32, no. 11, pp. 876–881, 2015.

[3] James C McClay, Peter J Park, Mark G Janczewski, Laura Heermann Langford, “Standard for improving emergency information interoperability: the HL7 data elements for emergency department systems”, Journal of the American Medical Informatics Association, Volume 22, Issue 3, 1 May 2015, Pages 529–535

[4] Brammen D, Eggert P, Lucas B, Heermann-Langford L, McClay JC., “Comparing the German Emergency Department Medical Record with the US HL7 Data Elements for Emergency Department Systems”,, Studies in health technology and informatics. 2018;247:216-20.

[5] “Fhir overview.” http://www.hl7.org/implement/standards/fhir/overview.html. Accessed: 2018-03-21.

[6] M. Smits, E. Kramer, M. Harthoorn, and R. Cornet, “A comparison of two Detailed Clinical Model representations: FHIR and CDA,” European Journal for Biomedical Informatics, vol. 11, no. 2, p. 11, 2015.

[7] J. P. Benner, J. Hilton, G. Carr, K. Robbins, R. C. chutt, M. P. Borloz, K. Alibertis, B. Sojka, K. Hudson, D. Haugh, and W. Brady, “Information transfer from prehospital to ED healthcare providers,” The American Journal of Emergency Medicine, vol. 26, pp. 233–235, Feb. 2008.

[8] J. T. Finnell and J. M. Overhage, “Emergency Medical Services: The Frontier in Health Information Exchange,” AMIA Annual Symposium Proceedings, pp. 222–226, 2010.

[9] D. J. Laudermilch, M. A. Schiff, A. B. Nathens, and M. R. Rosengart, “Lack of Emergency Medical Services Documentation Is Associated with Poor Patient Outcomes: A Validation of Audit Filters for Prehospital Trauma Care,” Journal of the American College of Surgeons, vol. 210, pp. 220–227, Feb. 2010.

[10] M. Christ, F. Grossmann, D. Winter, R. Bingisser, and E. Platz, “Modern Triage in the Emergency Department,” Deutsches Aerzteblatt Online, Dec. 2010.

[6] S. R. Bruijns, H. R. Guly, O. Bouamra, F. Lecky, and L. A. Wallis, “The value of the difference between ed and prehospital vital signs in predicting outcome in trauma,” Emergency Medicine Journal, vol. 31, no. 7, pp. 579–582, 2014.

[11] “Trillium project.” https://simplifier.net/TrilliumII. Accessed: 2018-04-12.

[12] C. Nickson, “Trauma! pelvic fractures i.” https://lifeinthefastlane.com/trauma-tribulation-027/. Accessed: 2018-05-01
[13] K. G. Ringdal, T. J. Coats, R. Lefering, S. Di Bartolomeo, P. A. Steen, O. Roise, L. Handolin, H. M. Lossius, and U. T. e. p. (Tcd), “The Utstein template for uniform reporting of data following major trauma: a joint revision by SCANTEM, TARN, DGU-TR and RITG,” Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, vol. 16, no. 1, p. 7, 2008.

[14] H. Champion, W. S. Copes, and W. J. Sacco, “The Major Trauma Outcome Study: establishing national norms for trauma care.” The Journal of Trauma, vol. 30, pp. 1356–1365, Nov. 1990.

[15] N. Gilboy, P. Tanabe, and D. A. Travers, “The emergency severity index version 4: Changes to esi level 1 and pediatric fever criteria,” Journal of Emergency Nursing, vol. 31, no. 4, pp. 357 – 362, 2005

[16] M. Christ, F. Grossmann, D. Winter, R. Bingisser, and E. Platz, “Modern Triage in the Emergency Department,” Deutsches Aerzteblatt Online, Dec. 2010.

[17] N. A. Green, Y. Durani, D. Brecher, A. DePiero, J. Loiselle, and M. Attia, “Emergency Severity Index Version 4: A Valid and Reliable Tool in Pediatric Emergency Department Triage,” Pediatric Emergency Care, vol. 28, pp. 753–757, Aug. 2012.

[18] T. Thim, Krarup, Grove, Rohde, and Lofgren, “Initial assessment and treatment with the Airway, Breathing, Circulation, Disability, Exposure (ABCDE) approach,” International Journal of General Medicine, p. 117, Jan. 2012.

[19] J. Soar, J. P. Nolan, B. W. Böttiger, G. D. Perkins, C. Lott, P. Carli, T. Pellis, C. Sandroni, M. B. Skrifvars, G. B. Smith, K. Sunde, C. D. Deakin, R. W. Koster, K. G. Monsieurs, and N. I. Nikolaou, “European Resuscitation Council Guidelines for Resuscitation 2015,” Resuscitation, vol. 95, pp. 100–147, Oct. 2015.

[20] I. Jacobs, V. Nadkarni, J. Bahr, R. A. Berg, J. E. Billi, L. Bossaert, P. Cassan, A. Coovadia, K. D’Este, J. Finn, H. Halperin, A. Handley, J. Herlitz, R. Hickey, A. Idris, W. Kloeck, G. L. Larkin, M. E. Mancini, P. Mason, G. Mears, K. Monsieurs, W. Montgomery, P. Morley, G. Nichol, J. Nolan, K. Okada, J. Perlman, M. Shuster, P. A. Steen, F. Sterz, J. Tibballs, S. Timerman, T. Truitt, and D. Zideman, “Cardiac arrest and cardiopulmonary resuscitation outcome reports: update and simplification of the Utstein templates for resuscitation registries.,” Resuscitation, vol. 63, pp. 233–249, Dec. 2004.

[21] H. J. Tange, H. C. Schouten, A. D. M. Kester, and A. Hasman, “The Granularity of Medical Narratives and Its Effect on the Speed and Completeness of Information Retrieval,” Journal of the American Medical Informatics Association, vol. 5, pp. 571– 582, Nov. 1998

[22] S. E. Lamb, E. C. Jørstad-Stein, K. Hauer, C. Becker, and on behalf of the Prevention of Falls Network Europe and Outcomes Consensus Group, “Development of a Common Outcome Data Set for Fall Injury Prevention Trials: The Prevention of Falls Network Europe Consensus: PROFANE COMMON OUTCOME DATA SET,” Journal of the American Geriatrics Society, vol. 53, pp. 1618–1622, Sept. 2005.

[23] M. Fischer, J. Kamp, L. Garcia-Castrillo Riesgo, I. Robertson- Steel, J. Overton, A. Ziemann, and T. Krafft, “Comparing emergency medical service systems—A project of the European Emergency Data (EED) Project,” Resuscitation, vol. 82, pp. 285–293, Mar. 2011.

[24] W. R. Hersh, M. G. Weiner, P. J. Embi, J. R. Logan, P. R. Payne, E. V. Bernstam, H. P. Lehmann, G. Hripcsak, T. H. Hartzog, J. J. Cimino, and J. H. Saltz, “Caveats for the Use of Operational Electronic Health Record Data in Comparative Effectiveness Research:,” Medical Care, vol. 51, pp. S30–S37, Aug. 2013.

[25] A. Ryan, “Towards semantic interoperability in healthcare: ontology mapping from SNOMED-CT to HL7 version 3,” in Proceedings of the second Australasian workshop on Advances in ontologies-Volume 72, pp. 69–74, Australian Computer Society, Inc., 2006.

[26] C. N. Mead, “Data interchange standards in healthcare it-computable semantic interoperability: Now possible but still difficult. do we really need a better mousetrap?”, Journal of Healthcare Information Management, vol. 20, no. 1, p. 71, 2006.

[27] W. T. Goossen, “Intelligent semantic interoperability: integrating knowledge, terminology and information models to support stroke care,” Consumer-Centered Computer-Supported Care for Healthy People, p. 6, 2006.

[28] D. Bender and K. Sartipi, “HL7 FHIR: An Agile and RESTful approach to healthcare information exchange,” Proceedings of the 26th IEEE International Symposium on Computer-Based Medical Systems, pp. 326–331, June 2013.

[29] H. Ulrich, A.-K. Kock, P. Duhm-Harbeck, J. K. Habermann, and J. Ingenerf, “Metadata Repository for Improved Data Sharing and Reuse Based on HL7 FHIR.,” in MIE, pp. 162–166, 2016.

[30] J. C. Mandel, D. A. Kreda, K. D. Mandl, I. S. Kohane, and R. B. Ramoni, “SMART on FHIR: a standardsbased, interoperable apps platform for electronic health records,” Journal of the American Medical Informatics Association, vol. 23, pp. 899–908, Sept. 2016.

[31] Argonaut, “Argonaut project, presentation feb. 2017.” https://www.hl7.org/documentcenter/public/calendarofevents/himss/2017/TheArgonautProjectandHL7FHIR.pdf, February 2017. Accessed: 2018-05-31.

[32] Argonaut, “Argonaut project.” http://argonautwiki.hl7. org/index.php?title=Main_Page. Accessed: 2018-05-31.

Citeringar i Crossref