Integrating Continuous Glucose Monitor Data Directly into the Electronic Health Record: Proof of Concept
Integrating Continuous Glucose Monitor Data Directly into the Electronic Health Record: Proof of Concept
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DOI：
10.1089/dia.2019.0377
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发表时间：
2020-07-10
影响因子：
5.4
通讯作者：
Raymond, Jennifer
中科院分区：
文献类型：
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作者：
Espinoza, Juan;Shah, Payal;Raymond, Jennifer
背景：连续血糖监测(CGM)系统在糖尿病自我管理和临床就诊中的应用越来越广泛。然而，在访问期间获取CGM数据可能是具有挑战性的。诊所效率低下可能会限制可用于患者教育的时间，而无法将CGM数据集成到电子健康记录(EHR)系统可能会导致数据丢失。在这项研究中，我们描述了我们机构通过与CGM设备制造商的合作伙伴关系，而不是第三方数据聚合/数据可视化平台，将CGM数据直接集成到EHR中的方法。方法：我们采访了医院信息技术部、儿科内分泌科和一家CGM设备制造商的主要利益相关者。采用以人为中心的协作式设计方法来定义工作流程。健康水平7(HL7)标准被用来建立所有数据交换。结果：我们与各方合作，为账户连接和数据采集创建了一个简单的网络架构设计。对于这两个流程，系统都使用电子病历中提供的标准的计算机化医嘱输入界面。数据采集是实时进行的，定制的报告显示在EHR的结果部分。整个流程符合《健康保险可携带性与责任法案》(HIPAA)，并满足所有安全要求。结论：使用HL7标准建立可扩展的数据集成是可能的，并且允许在糖尿病供应商的现有工作流程内实时访问CGM数据，并且可以在患者在场或不在场的情况下进行。这可能会通过记录CGM数据捕获和审查来改善临床结果、提高效率和新的收入机会。
Background:Continuous glucose monitoring (CGM) systems are widely and increasingly used in diabetes self-management and in the context of clinic visits. However, access to CGM data during visits can be challenging. Clinic inefficiencies can restrict the time available for patient education, and the inability to integrate CGM data into electronic health record (EHR) systems can result in data being lost. In this study, we describe our institution's approach to integrating CGM data directly into the EHR through a partnership with a CGM device manufacturer and without a third-party data aggregation/data visualization platform. Methods:We interviewed key stakeholders with the hospital Information Technology Department, the Division of Pediatric Endocrinology, and a CGM device manufacturer. A collaborative, human-centered design approach was used to define the workflow. Health Level 7 (HL7) standards were used to build all data exchanges. Results:In collaboration with all parties, we created a simple network architecture design for both account linkage and data acquisition. The system uses the standard, computerized, physician order entry interface available in the EHR for both processes. Data acquisition occurs in real time, and customized reports are displayed within theresultssection of the EHR. The entire process is Health Insurance Portability and Accountability Act (HIPAA) compliant and meets all security requirements. Conclusions:Building scalable data integration using HL7 standards is possible and allows real-time access to CGM data within the diabetes provider's existing workflow and can occur with or without the patient present. This may lead to improved clinical outcomes, increased efficiency, and new revenue opportunities by documenting CGM data capture and review.