Kennell Timothy I, Willig James H, Cimino James J
Informatics Institute, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States.
Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States.
Appl Clin Inform. 2017 Oct;8(4):1159-1172. doi: 10.4338/ACI-2017-06-R-0101. Epub 2017 Dec 21.
Clinical informatics researchers depend on the availability of high-quality data from the electronic health record (EHR) to design and implement new methods and systems for clinical practice and research. However, these data are frequently unavailable or present in a format that requires substantial revision. This article reports the results of a review of informatics literature published from 2010 to 2016 that addresses these issues by identifying categories of data content that might be included or revised in the EHR.
We used an iterative review process on 1,215 biomedical informatics research articles. We placed them into generic categories, reviewed and refined the categories, and then assigned additional articles, for a total of three iterations.
Our process identified eight categories of data content issues: Adverse Events, Clinician Cognitive Processes, Data Standards Creation and Data Communication, Genomics, Medication List Data Capture, Patient Preferences, Patient-reported Data, and Phenotyping.
These categories summarize discussions in biomedical informatics literature that concern data content issues restricting clinical informatics research. These barriers to research result from data that are either absent from the EHR or are inadequate (e.g., in narrative text form) for the downstream applications of the data. In light of these categories, we discuss changes to EHR data storage that should be considered in the redesign of EHRs, to promote continued innovation in clinical informatics.
Based on published literature of clinical informaticians' reuse of EHR data, we characterize eight types of data content that, if included in the next generation of EHRs, would find immediate application in advanced informatics tools and techniques.
临床信息学研究人员依赖电子健康记录(EHR)中的高质量数据来设计和实施用于临床实践与研究的新方法及系统。然而,这些数据常常无法获取,或者以需要大量修订的格式呈现。本文报告了对2010年至2016年发表的信息学文献进行综述的结果,该综述通过识别EHR中可能包含或修订的数据内容类别来解决这些问题。
我们对1215篇生物医学信息学研究文章采用了迭代式综述过程。我们将它们归入一般类别,对这些类别进行审查和完善,然后分配额外的文章,总共进行了三轮迭代。
我们的过程确定了八类数据内容问题:不良事件、临床医生认知过程、数据标准创建与数据通信、基因组学、用药清单数据捕获、患者偏好、患者报告数据和表型分析。
这些类别总结了生物医学信息学文献中有关限制临床信息学研究的数据内容问题的讨论。这些研究障碍源于EHR中缺失的数据,或者是对于数据的下游应用而言不充分的数据(例如,以叙述文本形式存在的数据)。鉴于这些类别,我们讨论了在EHR重新设计中应考虑的EHR数据存储方面的变化,以促进临床信息学的持续创新。
基于临床信息学家对EHR数据再利用的已发表文献,我们描述了八类数据内容,如果将其纳入下一代EHR中,将可立即应用于先进的信息学工具和技术。