Eguzkiza Aitor, Trigo Jesús Daniel, Martínez-Espronceda Miguel, Serrano Luis, Andonegui José
Department of Electrical and Electronic Engineering, Public University of Navarra, Campus de Arrosadia, 31006 Pamplona, Spain.
Department of Electrical and Electronic Engineering, Public University of Navarra, Campus de Arrosadia, 31006 Pamplona, Spain; Institute of Smart Cities - ISC, Public University of Navarra, Campus de Arrosadia, 31006 Pamplona, Spain.
J Biomed Inform. 2015 Aug;56:112-26. doi: 10.1016/j.jbi.2015.05.017. Epub 2015 Jun 3.
Most healthcare services use information and communication technologies to reduce and redistribute the workload associated with follow-up of chronic conditions. However, the lack of normalization of the information handled in and exchanged between such services hinders the scalability and extendibility. The use of medical standards for modelling and exchanging information, especially dual-model based approaches, can enhance the features of screening services. Hence, the approach of this paper is twofold. First, this article presents a generic methodology to model patient-centered clinical processes. Second, a proof of concept of the proposed methodology was conducted within the diabetic retinopathy (DR) screening service of the Health Service of Navarre (Spain) in compliance with a specific dual-model norm (openEHR). As a result, a set of elements required for deploying a model-driven DR screening service has been established, namely: clinical concepts, archetypes, termsets, templates, guideline definition rules, and user interface definitions. This model fosters reusability, because those elements are available to be downloaded and integrated in any healthcare service, and interoperability, since from then on such services can share information seamlessly.
大多数医疗服务都使用信息通信技术来减少和重新分配与慢性病随访相关的工作量。然而，此类服务内部处理和交换的信息缺乏标准化，这阻碍了其可扩展性和可延伸性。使用医学标准对信息进行建模和交换，尤其是基于双模型的方法，可以增强筛查服务的功能。因此，本文的方法有两个方面。首先，本文提出了一种对以患者为中心的临床过程进行建模的通用方法。其次，在西班牙纳瓦拉卫生服务局的糖尿病视网膜病变（DR）筛查服务中，依据特定的双模型规范（openEHR）对所提出的方法进行了概念验证。结果，已建立了部署模型驱动的DR筛查服务所需的一组要素，即：临床概念、原型、术语集、模板、指南定义规则和用户界面定义。该模型促进了可重用性，因为这些要素可供下载并集成到任何医疗服务中；同时也促进了互操作性，因为从那时起此类服务可以无缝共享信息。
