Health care transformation through collaboration on open-source informatics projects: integrating a medical applications platform, research data repository, and patient summarization.
Health care transformation through collaboration on open-source informatics projects: integrating a medical applications platform, research data repository, and patient summarization.
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DOI：
10.2196/ijmr.2454
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发表时间：
2013-05-30
影响因子：
2
通讯作者：
Murphy SN
中科院分区：
文献类型：
--
作者：
Klann JG;McCoy AB;Wright A;Wattanasin N;Sittig DF;Murphy SN
战略健康 IT 高级研究项目 (SHARP) 计划旨在通过突破性研究克服医疗信息学领域众所周知的挑战。两个 SHARP 中心在方法论需求上达成了一致：(1) 国家认知信息学和决策中心 (NCCD) 的成员开发了知识库来支持以问题为导向的患者数据总结，以及 (2) 可替代医疗应用程序、可重复使用技术 (SMART)，这是一个可重复使用医疗应用程序的平台，可以在连接到各种电子健康记录 (EHR) 的参与平台上运行。结合这两个中心的工作将确保广泛传播患者数据综合视图的新方法。 Informatics for Integrating Biology and the Bedside (i2b2) 是一个由 NIH 资助的临床研究数据存储平台，在全球 100 多个站点使用。通过与支持 SMART 的 i2b2 共同发起的项目合作，我们可以自信地编写一款可以极其广泛使用的应用程序。我们的目标是使用可在任何 EHR 中运行的 NCCD 知识库，促进直观、面向问题的患者记录视图的开发。为此，我们在两个 SHARP 和 NIH 中心 i2b2 之间开展了合作。首先，我们实施了协作工具来连接三个机构的研究人员。接下来，我们使用 SMART 平台和先前验证的源自国家药物文件参考术语 (NDF-RT) 的 NCCD 问题药物链接知识库开发了一个患者摘要应用程序。最后，为了支持 SMART i2b2，我们实现了两个新的 Web 服务“单元”来公开 SMART 应用程序编程接口 (API)，并且我们对 i2b2 的 Web 界面进行了更改以托管 SMART 应用程序的“轮播”。我们在此 SMART-i2b2 容器中部署了基于 SMART、源自 NDF-RT 的患者汇总应用程序。它显示了以问题为导向的药物视图，并以线形图显示了实验室结果。此摘要应用程序可以在支持 SMART 或运行支持 SMART 的 i2b2 的任何 EHR 环境中运行。这个 i2b2“临床桥梁”展示了可重用应用程序开发的途径，不需要 EHR 供应商立即采用 SMART API。应用程序可以在 SMART 中开发，并由临床医生在 i2b2 存储库中运行，重复使用从 EHR 中提取的临床数据。这可能会通过支持 SMART 应用程序开发来鼓励 SMART 的采用，直到 EHR 采用该平台。它还允许在研究存储库中可用的数据类型的广泛聚合的推动下，推出各种新型临床 SMART 应用程序。该应用程序（包括其知识库）和 SMART-i2b2 是开源的，可以免费下载。
The Strategic Health IT Advanced Research Projects (SHARP) program seeks to conquer well-understood challenges in medical informatics through breakthrough research. Two SHARP centers have found alignment in their methodological needs: (1) members of the National Center for Cognitive Informatics and Decision-making (NCCD) have developed knowledge bases to support problem-oriented summarizations of patient data, and (2) Substitutable Medical Apps, Reusable Technologies (SMART), which is a platform for reusable medical apps that can run on participating platforms connected to various electronic health records (EHR). Combining the work of these two centers will ensure wide dissemination of new methods for synthesized views of patient data. Informatics for Integrating Biology and the Bedside (i2b2) is an NIH-funded clinical research data repository platform in use at over 100 sites worldwide. By also working with a co-occurring initiative to SMART-enabling i2b2, we can confidently write one app that can be used extremely broadly. Our goal was to facilitate development of intuitive, problem-oriented views of the patient record using NCCD knowledge bases that would run in any EHR. To do this, we developed a collaboration between the two SHARPs and an NIH center, i2b2. First, we implemented collaborative tools to connect researchers at three institutions. Next, we developed a patient summarization app using the SMART platform and a previously validated NCCD problem-medication linkage knowledge base derived from the National Drug File-Reference Terminology (NDF-RT). Finally, to SMART-enable i2b2, we implemented two new Web service “cells” that expose the SMART application programming interface (API), and we made changes to the Web interface of i2b2 to host a “carousel” of SMART apps. We deployed our SMART-based, NDF-RT-derived patient summarization app in this SMART-i2b2 container. It displays a problem-oriented view of medications and presents a line-graph display of laboratory results. This summarization app can be run in any EHR environment that either supports SMART or runs SMART-enabled i2b2. This i2b2 “clinical bridge” demonstrates a pathway for reusable app development that does not require EHR vendors to immediately adopt the SMART API. Apps can be developed in SMART and run by clinicians in the i2b2 repository, reusing clinical data extracted from EHRs. This may encourage the adoption of SMART by supporting SMART app development until EHRs adopt the platform. It also allows a new variety of clinical SMART apps, fueled by the broad aggregation of data types available in research repositories. The app (including its knowledge base) and SMART-i2b2 are open-source and freely available for download.