Valentic Maja, Plese Borna, Pristas Ivan, Ivankovic Damir
Methods Inf Med. 2017;56(5):407-413. doi: 10.3414/ME16-02-0029. Epub 2018 Jan 24.
PARENT JA (cross-border Patient Registries iNiTiative Joint Action), a joint EU and Member States project, has conducted a research among EU patient registries aimed at gathering information on the registries' interoperability readiness. Leaning on the information and data collected through the previous PARENT JA research, this study aims to provide more detailed view into the registry holders' practical challenges with data linking. Since the studies which dealt with patient data exchange have often neglected the registry holders' performance of data exchange, we wanted to put a spotlight on various EU registry holders' practices and operations, aiming to detect their needs and concerns in the process of running an interoperable registry. The focus of this study was identifying the main practices and challenges in patient registries interoperability improvement.
The basis for this analysis were the data collected in the series of structured interviews. The size of the interview sample was 13 patient registries, each from a different EU country. The structured interview consisted of nine questions and was conducted in two parts: oral and written. The answers were analysed using open coding.
Results are interpreted in the context of the six main themes that emerged through a comprehensive analysis. (1) Examples of data exchange: The most common reported data exchange practices were seen only as a way to achieve the most immediate needs and interests of the individual registries. (2) Awareness and use of international standards: International data and clinical standards were not widely used by the interviewed registries. (3) Use of data models and formats: In the area of data models and formats there is no universally used practice. (4) Data request protocols and procedures: Procedures and protocols varied, mostly depending on the national legal systems in which the patient registries operated. (5) Data security and integrity: Security of personal data was a universal concern for all registry holders that were interviewed; identifiable individual data was shared only in one case. (6) Opportunities and challenges of registry interoperability: most registry holders responded that their registries were well prepared for interoperability practices and that data exchange has never been their primary operative concern.
Most of the difficulties regarding data linking were not necessarily associated with technical issues, which registry holders listed outright. Our analysis showed that the lack of interoperability came as a result of organizational or legal constraints that made the registries unable to process and conduct data linking quickly and effectively with other sources.
跨境患者登记联合行动(PARENT JA)是欧盟及其成员国的一个联合项目,该项目针对欧盟患者登记机构开展了一项研究,旨在收集有关登记机构互操作性准备情况的信息。基于此前PARENT JA研究收集的信息和数据,本研究旨在更详细地了解登记机构管理者在数据链接方面面临的实际挑战。由于以往涉及患者数据交换的研究往往忽视了登记机构管理者的数据交换工作,我们希望关注欧盟各登记机构管理者的实践和操作,旨在发现他们在运营可互操作登记机构过程中的需求和担忧。本研究的重点是确定患者登记机构互操作性改进中的主要实践和挑战。
本分析的基础是在一系列结构化访谈中收集的数据。访谈样本包括13个患者登记机构,每个机构来自不同的欧盟国家。结构化访谈由九个问题组成,分为口头和书面两个部分。使用开放式编码对答案进行分析。
在通过全面分析得出的六个主要主题的背景下对结果进行了解释。(1)数据交换示例:报告的最常见数据交换实践仅被视为满足各个登记机构最直接需求和利益的一种方式。(2)国际标准的认知与使用:受访登记机构并未广泛使用国际数据和临床标准。(3)数据模型和格式的使用:在数据模型和格式领域,没有普遍适用的做法。(4)数据请求协议和程序:程序和协议各不相同,主要取决于患者登记机构所在的国家法律体系。(5)数据安全与完整性:个人数据安全是所有受访登记机构管理者普遍关注的问题;只有一个案例中共享了可识别的个人数据。(6)登记机构互操作性的机遇与挑战:大多数登记机构管理者表示,他们的登记机构已为互操作性实践做好充分准备,数据交换从未成为他们主要的业务关注点。
数据链接方面的大多数困难不一定与登记机构管理者直接列出的技术问题相关。我们的分析表明,缺乏互操作性是由组织或法律限制导致的,这些限制使得登记机构无法快速有效地与其他来源进行数据处理和链接。