Integrating electronic healthcare records of armed forces personnel: Developing a framework for evaluating health outcomes in England, Scotland and Wales.
Integrating electronic healthcare records of armed forces personnel: Developing a framework for evaluating health outcomes in England, Scotland and Wales.
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DOI：
10.1016/j.ijmedinf.2018.02.012
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发表时间：
2018-05
影响因子：
4.9
通讯作者：
Goodwin L
中科院分区：
文献类型：
--
作者：
Leightley D;Chui Z;Jones M;Landau S;McCrone P;Hayes RD;Wessely S;Fear NT;Goodwin L
提出了一个整合英格兰、苏格兰和威尔士国家电子医疗记录数据集的框架。变量相似度用于开发一种模式，该模式允许跨国家的变量被链接和组合。综合评价表明，有可能实现跨国家的数据联动。创建电子医疗记录（ehr）是为了获取医疗服务的护理和联系摘要。电子病历为流行病学研究提供了一种分析医院入院情况的方法。在联合王国（联合王国），英格兰、苏格兰和威尔士保持单独的数据存储，由权力下放的政府专门管理和管理。这种独立性导致了协调方面的挑战，尤其是缺乏统一性，使得很难评估整个英国的护理、诊断和治疗。为了克服这种缺乏统一性的问题，重要的是制定方法来整合电子病历，以提供多国卫生数据集。开发和描述一种方法，根据可变共性将英格兰、苏格兰和威尔士武装部队人员的电子病历整合起来，以产生多国二级卫生保健数据集。一个武装部队队列被用来提取和整合三个电子病历数据集，使用共性作为连接点。这是通过评估和组合具有相同特征的变量来实现的。代表事故和急诊（A&E）、住院病人护理（APC）和门诊护理的电子病历被结合起来，创建了一个跨越三个国家的病人级别的历史。检查患者级别的电子病历，以确定入院差异、常见诊断和记录完整性。总共匹配了6336名武装部队人员，其中5460名人员进行了7510次急诊，9316次APC发作和45005次门诊预约。我们观察到APC的诊断完全完整，而门诊入院是稀疏编码的；88%的诊断被编码为“未知/未指明的发病原因”。此外，A&E记录偶尔被编码；我们找到了五种编码系统来识别入院原因。目前，电子病历的目的是监测治疗费用，实现行政监督，目前不适合流行病学研究。然而，可能只需要很小的改变，就可以利用应该是一种高成本效益的方式，为NHS的利益提供重要的研究。
A framework which integration national Electronic Healthcare Record datasets from England, Scotland and Wales is proposed. Variable similarity is used to develop a schema which allows for variables to be linked and combined across the nations. Evaluation of integration shows that it is possibly to perform data linkage across the nations. Electronic Healthcare Records (EHRs) are created to capture summaries of care and contact made to healthcare services. EHRs offer a means to analyse admissions to hospitals for epidemiological research. In the United Kingdom (UK), England, Scotland and Wales maintain separate data stores, which are administered and managed exclusively by devolved Government. This independence results in harmonisation challenges, not least lack of uniformity, making it difficult to evaluate care, diagnoses and treatment across the UK. To overcome this lack of uniformity, it is important to develop methods to integrate EHRs to provide a multi-nation dataset of health. To develop and describe a method which integrates the EHRs of Armed Forces personnel in England, Scotland and Wales based on variable commonality to produce a multi-nation dataset of secondary health care. An Armed Forces cohort was used to extract and integrate three EHR datasets, using commonality as the linkage point. This was achieved by evaluating and combining variables which shared the same characteristics. EHRs representing Accident and Emergency (A&E), Admitted Patient Care (APC) and Outpatient care were combined to create a patient-level history spanning three nations. Patient-level EHRs were examined to ascertain admission differences, common diagnoses and record completeness. A total of 6,336 Armed Forces personnel were matched, of which 5,460 personnel had 7,510 A&E visits, 9,316 APC episodes and 45,005 Outpatient appointments. We observed full completeness for diagnoses in APC, whereas Outpatient admissions were sparsely coded; with 88% of diagnoses coded as “Unknown/unspecified cause of morbidity”. In addition, A&E records were sporadically coded; we found five coding systems for identifying reason for admission. At present, EHRs are designed to monitor the cost of treatment, enable administrative oversight, and are not currently suited to epidemiological research. However, only small changes may be needed to take advantage of what should be a highly cost-effective means of delivering important research for the benefit of the NHS.
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影响因子：
2.9
作者：
Hagger-Johnson, Gareth;Harron, Katie;Parslow, Roger C.
通讯作者：
Parslow, Roger C.
影响因子：
3.5
作者：
Lyons RA;Jones KH;John G;Brooks CJ;Verplancke JP;Ford DV;Brown G;Leake K
通讯作者：
Leake K
影响因子：
8.8
作者：
Brewster, D. H.;Stockton, D. L.;Reekie, A.;Ashcroft, G. P.;Howie, C. R.;Porter, D. E.;Black, R. J.
通讯作者：
Black, R. J.
DOI：
10.1109/jbhi.2015.2450362
发表时间：
2015-07-01
影响因子：
7.7
作者：
Andreu-Perez, Javier;Poon, Carmen C. Y.;Yang, Guang-Zhong
通讯作者：
Yang, Guang-Zhong
DOI：
10.1016/j.ijmedinf.2013.01.002
发表时间：
2013-05-01
影响因子：
4.9
作者：
Greenhalgh, Trisha;Morris, Libby;Gunning, Katey
通讯作者：
Gunning, Katey