van Ginneken A M, de Wilde M, van Mulligen E M, Stam H
Department of Medical Informatics, Erasmus University, Rotterdam, The Netherlands.
Proc AMIA Annu Fall Symp. 1997:779-83.
Research in the domain of computer-based patient records had always faced the conflicting demands of efficiency for the practicing physician and suitability of the record contents for data analysis in view of decision support, research, and quality assessment. Interface and contents pose different demands on the data model underlying the record. The challenge is to combine the most suitable model for data representation with the interface that best fits the clinical setting. ORCA (Open Record for CAre) provides a solution by making the distinction between domain dependent and domain independent data and letting domain dependence be decisive for the choice of model. Interactive definition of custom-views provides interface flexibility for domain dependent data. Views on domain independent data need not cope with the limitations of multiple table views in relational DBMSs. A standard set of single table queries can support recording of domain independent data, irrespective of the clinical setting.
一方面要满足执业医师的效率要求，另一方面要使记录内容适合用于决策支持、研究和质量评估的数据分析。界面和内容对记录所基于的数据模型提出了不同的要求。挑战在于将最适合数据表示的模型与最适合临床环境的界面结合起来。ORCA（开放式医疗记录）通过区分领域相关数据和领域无关数据，并让领域相关性决定模型的选择，提供了一种解决方案。自定义视图的交互式定义为领域相关数据提供了界面灵活性。对于领域无关数据的视图无需应对关系型数据库管理系统中多表视图的局限性。一组标准的单表查询可以支持领域无关数据的记录，而无需考虑临床环境。
