Project Number

# P21396

Title

Archetype based Electronic Health Record

(Archetypen-basierte Elektronische Gesundheitsakte)

Project Leader

AMMENWERTH Elske
 

Universities / Research Groups

Keywords

Electronic Health Record (EHR), Information overload, Information filtering, IHE-XDS, Archetype-based EHR, EN/ISO 13606

Abstract

Today’s health care professionals can access an ever increasing amount of patient-related information and clinical knowledge, one of the most-promising applications being the Electronic Health Record (EHR). While several clinical and economic benefits are expected by the EHR, it may also lead to information overload, as the relevant information item that an EHR user searches for may be hidden in vast amounts of information within the lifelong EHR. 

Therefore, we see an urgent need for supporting EHR users in selectively retrieving information that is relevant in their respective search context. Besides document meta-data, archetype-based dual-model EHR architectures propose a corresponding support, but it is unclear whether they fulfil this promise. Overall, it is unclear what the information needs of health care professionals are, and how to support them adequately by dual-model EHR architectures.

The objectives of this project are therefore
1.    to identify the information needs of health care professionals when accessing the EHR, considering the respective search context,
2.    to develop concepts to fulfil these information needs by combining document meta-data and dual-model EHR architectures,
3.    to evaluate the developed concepts in a trial implementation.

The project is innovative in the sense that information needs will be analysed (and not only information access patterns), and that we will propose concepts how to combine meta-data-based and archetype-based searching to optimize precision and recall of EHR queries. The concepts will be based on international standards such as IHE XDS to provide a future-proof, vendor independent solution. For the archetype-based search we will refer to the international EHR standard EN/ISO 13606 (http://www.en13606.org/).

As a proof-of-concept we will focus on information needs in the treatment of patients suffering from diabetes. This focus was chosen as diabetes represents a chronic disease in which much information from different sources accumulates within the EHR over time, thus making the identification of the relevant information a challenging task.

The information needs analysis will be based on interviews and observation of clinical EHR users and the analysis of clinical guidelines. The resulting information needs patterns will then form the basis for the concept of a generic document crawler that will support EHR users in finding information efficiently. The trial implementation of the document crawler will be evaluated by assessing precision and recall of information retrieval within the EHR, combined with user satisfaction surveys and usability evaluations.

The outcome of the project will be a better knowledge of information needs of clinical EHR users – the initial scope of diabetes treatment can easily be expanded in follow-up projects - and a concept and a trial implementation of efficient EHR information retrieval techniques. We expect that our results will also influence the further development of parts of international standards such as IHE XDS.