Hackl W O, Ammenwerth E
Dr. Werner O. Hackl, Institute of Biomedical Informatics, UMIT - University for Health Sciences, Medical Informatics and Technology, Eduard Wallnöfer Zentrum 1, 6060 Hall in Tirol, Austria, E-mail:
Methods Inf Med. 2016;55(2):114-24. doi: 10.3414/ME15-01-0045. Epub 2016 Jan 15.
Secondary use of clinical routine data is receiving an increasing amount of attention in biomedicine and healthcare. However, building and analysing integrated clinical routine data repositories are nontrivial, challenging tasks. As in most evolving fields, recognized standards, well-proven methodological frameworks, or accurately described best-practice approaches for the systematic planning of solutions for secondary use of routine medical record data are missing.
We propose a conceptual best-practice framework and procedure model for the systematic planning of intelligent reuse of integrated clinical routine data (SPIRIT).
SPIRIT was developed based on a broad literature overview and further refined in two case studies with different kinds of clinical routine data, including process-oriented nursing data from a large hospital group and high-volume multimodal clinical data from a neurologic intensive care unit.
SPIRIT aims at tailoring secondary use solutions to specific needs of single departments without losing sight of the institution as a whole. It provides a general conceptual best-practice framework consisting of three parts: First, a secondary use strategy for the whole organization is determined. Second, comprehensive analyses are conducted from two different viewpoints to define the requirements regarding a clinical routine data reuse solution at the system level from the data perspective (BOTTOM UP) and at the strategic level from the future users perspective (TOP DOWN). An obligatory clinical context analysis (IN BETWEEN) facilitates refinement, combination, and integration of the different requirements. The third part of SPIRIT is dedicated to implementation, which comprises design and realization of clinical data integration and management as well as data analysis solutions.
The SPIRIT framework is intended to be used to systematically plan the intelligent reuse of clinical routine data for multiple purposes, which often was not intended when the primary clinical documentation systems were implemented. SPIRIT helps to overcome this gap. It can be applied in healthcare institutions of any size or specialization and allows a stepwise setup and evolution of holistic clinical routine data reuse solutions.
临床常规数据的二次利用在生物医学和医疗保健领域正受到越来越多的关注。然而，构建和分析综合临床常规数据存储库是一项复杂且具有挑战性的任务。与大多数不断发展的领域一样，缺少用于系统规划常规医疗记录数据二次利用解决方案的公认标准、经过充分验证的方法框架或准确描述的最佳实践方法。
我们提出了一个用于系统规划综合临床常规数据智能再利用（SPIRIT）的概念性最佳实践框架和程序模型。
SPIRIT是基于广泛的文献综述开发的，并在两个涉及不同类型临床常规数据的案例研究中进一步完善，这些数据包括来自大型医院集团的面向流程的护理数据以及来自神经重症监护病房的大量多模式临床数据。
SPIRIT旨在针对单个部门的特定需求定制二次利用解决方案，同时又不忽视整个机构。它提供了一个由三部分组成的通用概念性最佳实践框架：首先，确定整个组织的二次利用策略。其次，从两个不同的视角进行全面分析，以便从数据角度（自下而上）在系统层面以及从未来用户角度（自上而下）在战略层面定义关于临床常规数据再利用解决方案的要求。必要的临床背景分析（中间环节）有助于细化、组合和整合不同的要求。SPIRIT的第三部分致力于实施，包括临床数据集成与管理以及数据分析解决方案的设计和实现。
SPIRIT框架旨在用于系统规划临床常规数据的多用途智能再利用，而这在最初实施临床文档系统时通常并未考虑到。SPIRIT有助于弥补这一差距。它可应用于任何规模或专业的医疗机构，并允许逐步建立和发展整体临床常规数据再利用解决方案。
