迈向最佳实践:将电子病历用作临床数据仓库
Toward best practice: leveraging the electronic patient record as a clinical data warehouse.
作者信息
Ledbetter C S, Morgan M W
机构信息
Department of Medicine, University of Toronto.
出版信息
J Healthc Inf Manag. 2001 Summer;15(2):119-31.
Automating clinical and administrative processes via an electronic patient record (EPR) gives clinicians the point-of-care tools they need to deliver better patient care. However, to improve clinical practice as a whole and then evaluate it, healthcare must go beyond basic automation and convert EPR data into aggregated, multidimensional information. Unfortunately, few EPR systems have the established, powerful analytical clinical data warehouses (CDWs) required for this conversion. This article describes how an organization can support best practice by leveraging a CDW that is fully integrated into its EPR and clinical decision support (CDS) system. The article (1) discusses the requirements for comprehensive CDS, including on-line analytical processing (OLAP) of data at both transactional and aggregate levels, (2) suggests that the transactional data acquired by an OLTP EPR system must be remodeled to support retrospective, population-based, aggregate analysis of those data, and (3) concludes that this aggregate analysis is best provided by a separate CDW system.
通过电子病历(EPR)实现临床和管理流程的自动化,可为临床医生提供提供更好患者护理所需的即时医疗工具。然而,为了全面改善临床实践并进行评估,医疗保健必须超越基本自动化,将EPR数据转化为聚合的多维信息。不幸的是,很少有EPR系统具备进行这种转化所需的成熟、强大的分析型临床数据仓库(CDW)。本文介绍了一个组织如何通过利用完全集成到其EPR和临床决策支持(CDS)系统中的CDW来支持最佳实践。本文(1)讨论了全面CDS的要求,包括事务级和聚合级数据的在线分析处理(OLAP),(2)建议必须对OLTP EPR系统获取的事务数据进行重塑,以支持对这些数据进行回顾性、基于人群的聚合分析,以及(3)得出结论,这种聚合分析最好由单独的CDW系统提供。