Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Ellernholzstr. 1-2, Greifswald, 17475, Germany.
Department of Medical Informatics, University Medical Center Göttingen, Robert-Koch-Str. 40, Göttingen, 37075, Germany.
J Transl Med. 2020 Oct 19;18(1):394. doi: 10.1186/s12967-020-02547-x.
Medical data from family doctors are of great importance to health care researchers but seem to be locked in German practices and, thus, are underused in research. The RADAR project (Routine Anonymized Data for Advanced Health Services Research) aims at designing, implementing and piloting a generic research architecture, technical software solutions as well as procedures and workflows to unlock data from family doctor's practices. A long-term medical data repository for research taking legal requirements into account is established. Thereby, RADAR helps closing the gap between the European countries and to contribute data from primary care in Germany.
The RADAR project comprises three phases: (1) analysis phase, (2) design phase, and (3) pilot. First, interdisciplinary workshops were held to list prerequisites and requirements. Second, an architecture diagram with building blocks and functions, and an ordered list of process steps (workflow) for data capture and storage were designed. Third, technical components and workflows were piloted. The pilot was extended by a data integration workflow using patient-reported outcomes (paper-based questionnaires).
The analysis phase resulted in listing 17 essential prerequisites and guiding requirements for data management compliant with the General Data Protection Regulation (GDPR). Based on this list existing approaches to fulfil the RADAR tasks were evaluated-for example, re-using BDT interface for data exchange and Trusted Third Party-approach for consent management and record linkage. Consented data sets of 100 patients were successfully exported, separated into person-identifying and medical data, pseudonymised and saved. Record linkage and data integration workflows for patient-reported outcomes in the RADAR research database were successfully piloted for 63 responders.
The RADAR project successfully developed a generic architecture together with a technical framework of tools, interfaces, and workflows for a complete infrastructure for practicable and secure processing of patient data from family doctors. All technical components and workflows can be reused for further research projects. Additionally, a Trusted Third Party-approach can be used as core element to implement data privacy protection in such heterogeneous family doctor's settings. Optimisations identified comprise a fully-electronic consent recording using tablet computers, which is part of the project's extension phase.
家庭医生提供的医疗数据对于医疗保健研究人员非常重要,但这些数据似乎被锁定在德国的医疗实践中,因此在研究中未得到充分利用。RADAR 项目(常规匿名数据用于高级医疗服务研究)旨在设计、实施和试点通用研究架构、技术软件解决方案以及解锁家庭医生实践数据的程序和工作流程。建立了一个长期的医疗数据存储库,用于考虑法律要求的研究。RADAR 有助于弥合欧洲国家之间的差距,并为德国的初级保健提供数据。
RADAR 项目包括三个阶段:(1)分析阶段,(2)设计阶段和(3)试点阶段。首先,举行了跨学科研讨会,列出了先决条件和要求。其次,设计了具有构建块和功能的架构图,以及数据捕获和存储的有序过程步骤列表(工作流程)。第三,对技术组件和工作流程进行了试点。试点阶段通过使用患者报告的结果(纸质问卷)的数据集成工作流程得到了扩展。
分析阶段列出了 17 项基本前提条件和符合《通用数据保护条例》(GDPR)的数据管理指导要求。在此清单的基础上,评估了现有方法来完成 RADAR 任务,例如,重新使用 BDT 接口进行数据交换以及使用可信第三方方法进行同意管理和记录链接。成功地导出了 100 名患者的同意数据集,将其分为个人识别和医疗数据,进行假名化并保存。成功试点了 RADAR 研究数据库中患者报告结果的记录链接和数据集成工作流程,有 63 名应答者参与。
RADAR 项目成功开发了一种通用架构,以及一套工具、接口和工作流程的技术框架,为家庭医生提供的患者数据的实用和安全处理提供了完整的基础设施。所有技术组件和工作流程都可以重复用于进一步的研究项目。此外,可信第三方方法可用作实施此类异构家庭医生环境中数据隐私保护的核心要素。已确定的优化措施包括使用平板电脑进行完全电子化的同意记录,这是项目扩展阶段的一部分。