Harmonizing and extending standards from a domain-specific and bottom-up approach: an example from development through use in clinical applications

Harris, Marcelline R.; Langford, Laura Heermann; Miller, Holly; Hook, Mary L; Dykes, Patricia C.; Matney, Susan

doi:10.1093/jamia/ocu020

Cited by 33 publications

(28 citation statements)

References 4 publications

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“…For optimal management of CKD, all three data categories should be incorporated within EHRs using standard code systems and units (18). Challenges to implementation include legacy local coding systems and implementation of EHRs that is highly variable and customized for each provider organization (33).…”

Section: Ehrs Should Incorporate Ckd-related Data As Structured Data mentioning

confidence: 99%

CKD as a Model for Improving Chronic Disease Care through Electronic Health Records

Drawz

Archdeacon

McDonald

et al. 2015

Clinical Journal of the American Society of Nephrology

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Electronic health records have the potential to improve the care of patients with chronic medical conditions. CKD provides a unique opportunity to show this potential: the disease is common in the United States, there is significant room to improve CKD detection and management, CKD and its related conditions are defined primarily by objective laboratory data, CKD care requires collaboration by a diverse team of health care professionals, and improved access to CKD-related data would enable identification of a group of patients at high risk for multiple adverse outcomes. However, to realize the potential for improvement in CKD-related care, electronic health records will need to provide optimal functionality for providers and patients and interoperability across multiple health care settings. The goal of the National Kidney Disease Education Program Health Information Technology Working Group is to enable and support the widespread interoperability of data related to kidney health among health care software applications to optimize CKD detection and management. Over the course of the last 2 years, group members met to identify general strategies for using electronic health records to improve care for patients with CKD. This paper discusses these strategies and provides general goals for appropriate incorporation of CKD-related data into electronic health records and corresponding design features that may facilitate (1) optimal care of individual patients with CKD through improved access to clinical information and decision support, (2) clinical quality improvement through enhanced population management capabilities, (3) CKD surveillance to improve public health through wider availability of population-level CKD data, and (4) research to improve CKD management practices through efficiencies in study recruitment and data collection. Although these strategies may be most effectively applied in the setting of CKD, because it is primarily defined by laboratory abnormalities and therefore, an ideal computable electronic health record phenotype, they may also apply to other chronic diseases.

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Section: Ehrs Should Incorporate Ckd-related Data As Structured Data mentioning

confidence: 99%

CKD as a Model for Improving Chronic Disease Care through Electronic Health Records

Drawz

Archdeacon

McDonald

et al. 2015

Clinical Journal of the American Society of Nephrology

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“…Since this study was completed, additional examples of how standard terminologies can be used for nursing have been published and nursing informatics experts are working to increase nursing content and nursing value sets in standard terminologies 20, 21 22 . Therefore, it is important to discuss these study findings in the context of the current state of health IT and standard terminologies for nursing, with particular emphasis on LOINC and SNOMED CT.…”

Section: Discussionmentioning

confidence: 99%

“…SNOMED CT is also suggested to be used in tandem with LOINC for sharing data across systems using HL7 models, LOINC for assessment related data elements (questions) and SNOMED CT for the corresponding values (answers) 27 .…”

Section: Discussionmentioning

confidence: 99%

Mapping Perinatal Nursing Process Measurement Concepts to Standard Terminologies

Ivory

2016

CIN: Computers, Informatics, Nursing

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The use of standard terminologies is an essential component for employing data to inform practice and conduct research; perinatal nursing data standardization is needed. This study explored whether 76 distinct process elements important for perinatal nursing were present in four American Nurses Association (ANA)-recognized standard terminologies. The 76 process elements were taken from a valid paper-based perinatal nursing process measurement tool. Using terminology -supported browsers, the elements were manually mapped to the selected terminologies by the researcher. A five-member expert panel validated 100% of the mapping findings. The majority of the process elements (n=63, 83%) were present in SNOMED CT, (n=21, 28%) in LOINC, (n=26, 34%) in ICNP, and (n=11, 15%) in CCC. SNOMED CT and LOINC are terminologies currently recommended for use to facilitate interoperability in the capture of assessment and problem data in certified electronic medical records. Study results suggest that SNOMED CT and LOINC contain perinatal nursing process elements and are useful standard terminologies to support perinatal nursing practice in electronic health records. Terminology mapping is the first step toward incorporating traditional paper-based tools into electronic systems.

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“…Conversations between researchers and relevant computational and IT experts can help to align technologies to workflow needs and practices [25; 35]. Conversations with health science librarians, biomedical ontologists, and standards committees can do the same for information models [26]. …”

Section: Discussionmentioning

confidence: 99%

Research Infrastructure for Collaborative Team Science: Challenges in Technology-Supported Workflows in and Across Laboratories, Institutions, and Geographies

Mirel

Luo

Harris

2015

Seminars in Nephrology

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Harmonizing and extending standards from a domain-specific and bottom-up approach: an example from development through use in clinical applications

Cited by 33 publications

References 4 publications

CKD as a Model for Improving Chronic Disease Care through Electronic Health Records

CKD as a Model for Improving Chronic Disease Care through Electronic Health Records

Mapping Perinatal Nursing Process Measurement Concepts to Standard Terminologies

Research Infrastructure for Collaborative Team Science: Challenges in Technology-Supported Workflows in and Across Laboratories, Institutions, and Geographies

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