The Gap in Big Data: Getting to Wellbeing, Strengths, and a Whole-person Perspective

Abstract

Background:Electronic health records (EHRs) provide a clinical view of patient health. EHR data are becoming available in large data sets and enabling research that will transform the landscape of healthcare research. Methods are needed to incorporate wellbeing dimensions and strengths in large data sets. The purpose of this study was to examine the potential alignment of the Wellbeing Model with a clinical interface terminology standard, the Omaha System, for documenting wellbeing assessments.Objective:To map the Omaha System and Wellbeing Model for use in a clinical EHR wellbeing assessment and to evaluate the feasibility of describing strengths and needs of seniors generated through this assessment.Methods:The Wellbeing Model and Omaha System were mapped using concept mapping techniques. Based on this mapping, a wellbeing assessment was developed and implemented within a clinical EHR. Strengths indicators and signs/symptoms data for 5 seniors living in a residential community were abstracted from wellbeing assessments and analyzed using standard descriptive statistics and pattern visualization techniques.Results:Initial mapping agreement was 93.5%, with differences resolved by consensus. Wellbeing data analysis showed seniors had an average of 34.8 (range=22-49) strengths indicators for 22.8 concepts. They had an average of 6.4 (range=4-8) signs/symptoms for an average of 3.2 (range=2-5) concepts. The ratio of strengths indicators to signs/symptoms was 6:1 (range 2.8-9.6). Problem concepts with more signs/symptoms had fewer strengths.Conclusion:Together, the Wellbeing Model and the Omaha System have potential to enable a whole-person perspective and enhance the potential for a wellbeing perspective in big data research in healthcare.

Evaluation of the Omaha System Prototype Icons for Global Health Literacy

“…This finding aligned with the focus group participant observations regarding difficulty interpreting abstract icons. From a comprehensive, holistic perspective, much of health is intangible in a psychosocial or spiritual sense [17,23,24]. Thus, the dual challenges of visual representation of intangible concepts in a culturally universal way are clearly demonstrated in these findings with respect to health and health care.…”

“…It has been shown to be amenable to visual representation and useful for consumer communication [17,18,[23][24][25]. Icons representing the Omaha System concepts have been developed, embedded within digital platforms, and are available on-line [25].…”

“…Each problem concept is defined and has a unique list of signs/symptoms. It is intended for use by consumers and clinicians to describe strengths and needs relative to any of the 42 problem concepts [17,23,24]. Data generated by use of the Problem Classification Scheme can be used in community assessments to describe the strengths and needs of populations [17].…”

Interpretation of Ecological Theory for Physical Activity with the Omaha System

“…Likewise, the Omaha System is designed to address problems, including health‐related behaviors at the individual, family, and community levels. Additionally, the Omaha System has recently been used to classify and quantify client strengths (Monsen, Holland, Fung‐Houger, & Vanderboom, ; Monsen, Peters, Schlesner, Vanderboom, & Holland, ). Assessment and documentation are accomplished within the context of the practitioner‐client relationship (Martin, ).…”

“…For example, Monsen et al. (, ) reported the Omaha System can be used to capture client strengths related to problem concepts to support well‐being and self‐management. The Omaha System has been mapped to standardized instruments which can then be incorporated into the Rating Scale for Outcomes (Peters, ).…”