Smart Medical Information Technology for Healthcare (SMITH)

Abstract

Summary Introduction: This article is part of the Focus Theme of Methods of Information in Medicine on the German Medical Informatics Initiative. “Smart Medical Information Technology for Healthcare (SMITH)” is one of four consortia funded by the German Medical Informatics Initiative (MI-I) to create an alliance of universities, university hospitals, research institutions and IT companies. SMITH’s goals are to establish Data Integration Centers (DICs) at each SMITH partner hospital and to implement use cases which demonstrate the usefulness of the approach. Objectives: To give insight into architectural design issues underlying SMITH data integration and to introduce the use cases to be implemented. Governance and Policies: SMITH implements a federated approach as well for its governance structure as for its information system architecture. SMITH has designed a generic concept for its data integration centers. They share identical services and functionalities to take best advantage of the interoperability architectures and of the data use and access process planned. The DICs provide access to the local hospitals’ Electronic Medical Records (EMR). This is based on data trustee and privacy management services. DIC staff will curate and amend EMR data in the Health Data Storage. Methodology and Architectural Framework: To share medical and research data, SMITH’s information system is based on communication and storage standards. We use the Reference Model of the Open Archival Information System and will consistently implement profiles of Integrating the Health Care Enterprise (IHE) and Health Level Seven (HL7) standards. Standard terminologies will be applied. The SMITH Market Place will be used for devising agreements on data access and distribution. 3LGM 2 for enterprise architecture modeling supports a consistent development process. The DIC reference architecture determines the services, applications and the standards-based communication links needed for efficiently supporting the ingesting, data nourishing, trustee, privacy management and data transfer tasks of the SMITH DICs. The reference architecture is adopted at the local sites. Data sharing services and the market place enable interoperability. Use Cases: The methodological use case “Phenotype Pipeline” (PheP) constructs algorithms for annotations and analyses of patient-related phenotypes according to classification rules or statistical models based on structured data. Unstructured textual data will be subject to natural language processing to permit integration into the phenotyping algorithms. The clinical use case “Algorithmic Surveillance of ICU Patients” (ASIC) focusses on patients in Intensive Care Units (ICU) with the acute respiratory distress syndrome (ARDS). A model-based decision-support system will give advice for mechanical ventilation. The clinical use case HELP develops a “hospital-wide electronic medical record-based computerized decision support system to improve outcomes of patients with blood-stream infections” (HELP). ASIC and HELP ...

KETOS: Clinical decision support and machine learning as a service – A training and deployment platform based on Docker, OMOP-CDM, and FHIR Web Services

“…More recently, the German Medical Informatics Initiative (MI-I) [12] has begun funding multiple consortia to develop infrastructure for integrating clinical data from patient care with research data not only within a hospital, but also across hospitals and research institutions [13][14][15]. The fundamental component defined within the four funded MI-I consortia to tackle this challenge are data integration centers (DIC).…”

The French Health Data Hub and the German Medical Informatics Initiatives: Two National Projects to Promote Data Sharing in Healthcare

“…Concerning the German initiatives, the authors analyzed the five articles [17][18][19][20][21] published in the special issue of Methods of information in Medicine published in 2018. One of these articles provides a global view of the German MII project [17], whereas the other four describe the four consortia selected by the German Federal Ministry of Education and Research to build the system.…”

Hospital-wide ELectronic medical record evaluated computerised decision support system to improve outcomes of Patients with staphylococcal bloodstream infection (HELP): study protocol for a multicentre stepped-wedge cluster randomised trial

“…It aims at a more efficient allocation of infectious diseases specialists (IDS) without worsening patient-related outcomes such as mortality and relapse rates and also aims at improving adherence to best practice recommendations in treatment of blood stream infections. The HELP-CDSS operates on the structure of so-called ‘Data Integration Centers’ (DIC), which will be established at each study site by means of the ‘Smart Medical Information Technology for Healthcare’ (SMITH) consortium,10 which is one of four consortia funded by the ‘Medical Informatics Initiative’ of the German Federal Ministry of Education and Research. Two of the main goals of this initiative are to establish interoperability standards for medical data and to enable the integration of heterogeneous clinical routine data to make it available for clinical and scientific use in order to improve patient care.…”