Johnson S B
Department of Medical Informatics, Columbia University, New York, NY 10032, USA.
J Am Med Inform Assoc. 1996 Sep-Oct;3(5):328-39. doi: 10.1136/jamia.1996.97035024.
To construct a large-scale clinical repository that accurately captures a detailed understanding of the data vital to the process of health care and that provides highly efficient access to patient information for the users of a clinical information system.
Conventional approaches to data modeling encourage the development of a highly specific data schema in order to capture as much information as possible about a given domain. In contrast, current database technology functions most effectively for clinical databases when a generic data schema is used. The technique of "generic data modeling" is presented as a method of reconciling these opposing views of clinical data, using formal operations to transform a detailed schema into a generic one.
A complex schema consisting of hundreds of entities and representing a rich set of constraints about the patient care domain is transformed into a generic schema consisting of roughly two dozen tables. The resulting database design is efficient for patient-oriented queries and is highly flexible in adapting to the changing information needs of a health care institution, particularly changes involving the collection of new data elements.
Conventional approaches to data modeling can be used to develop rich, complex models of clinical data that are useful for understanding and managing the process of patient care. Generic data modeling techniques can successfully transform a detailed design into an efficient generic design that is flexible enough to meet the needs of an operational clinical information system.
构建一个大规模临床知识库,准确获取对医疗保健过程至关重要的数据的详细理解,并为临床信息系统的用户提供对患者信息的高效访问。
传统的数据建模方法鼓励开发高度特定的数据模式,以便尽可能多地获取关于给定领域的信息。相比之下,当使用通用数据模式时,当前数据库技术在临床数据库中运行最为有效。“通用数据建模”技术作为一种调和临床数据这两种对立观点的方法被提出,它使用形式化操作将详细模式转换为通用模式。
一个由数百个实体组成、代表关于患者护理领域丰富约束集的复杂模式被转换为一个由大约二十几个表组成的通用模式。所得的数据库设计对于面向患者的查询是高效的,并且在适应医疗机构不断变化的信息需求(特别是涉及新数据元素收集的变化)方面具有高度灵活性。
传统的数据建模方法可用于开发丰富、复杂的临床数据模型,这些模型有助于理解和管理患者护理过程。通用数据建模技术可以成功地将详细设计转换为高效的通用设计,该设计足够灵活以满足运营临床信息系统的需求。