Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
권호 표지
DOI QR코드

DOI QR Code

Development and Application of Development Principles for Clinical Information Model

임상정보모델 개발원칙의 개발과 적용

  • 안선주 (EHR핵심공통기술연구개발사업단)
  • Received : 2010.07.15
  • Accepted : 2010.08.10
  • Published : 2010.08.31
Download PDF
⟨ Previous Next ⟩

Abstract

To be applicable under electronic health record system in order to ensure semantic interoperability of clinical information, the development principle for clinical information model to reflect objective and function is required. The aim of this study is to develop the development principles for clinical information model and evaluate the Clinical Contents Model. In order to develop the principle, from November 2008 to March 2009, the surveys about 1) definition, 2) function and 3) quality criteria were done, and 4) the components of advanced model were analyzed. The study was processed in 3 levels. Firstly in the development level, key words and key words-paragraph were driven from the references, and the principles were drawn based on the clinical or functional importance and frequency. In the application level, the 3 experts of clinical information model assessed 30 Clinical Contents Models by applying it. In the feedback level, the Clinical Contents Model in which errors were found was modified. As the results, 18 development principles were derived with 3 categories which were structure, process and contents. The Clinical Contents Models were assessed with the principles, and the 17 models were found that they did not follow it. During the feedback process, the necessity of the advanced education of the principle and the establishment of the regular quality improvement strategy to use it is raised. The proposed development principle supports the consistent model-development between clinical information model developers, and could be used as evaluation criteria.

임상정보모델이 전자건강기록시스템에서 활용되는 임상정보의 의미적 호환성을 보장하기 위해서는 그 목적과 기능이 반영된 개발원칙이 필요하다. 본 연구는 임상정보모델의 개발원칙을 개발하고, 이 원칙을 적용하여 임상정 보모델인 임상콘텐츠모형을 평가하기 위한 목적으로 수행되었다. 개발원칙의 정의를 위한 연구대상은 (1)정의 (2)기능 (3)품질 요건을 고찰하고, (4)선진 모델의 구성 요소와 같은 선행 연구였으며, 연구기간은 '08년 11월부터 '09년 3월까지였다. 본 연구는 3단계로 진행되었으며 개발단계에서는 선행 연구 문헌에서 주제어와 주제어구를 도출하고, 이의 임상적, 기능적 중요도와 빈도를 기준으로 개발원칙을 확정하였다. 적용단계에서 개발원칙을 이용하여 임상콘텐츠모형 30개를 임상정보모델 전문가 3인이 평가하였다. 환류단계에서 평가 대상 중 오류가 발견된 임상콘텐츠모형이 수정되었다. 연구 결과 구조, 과정, 내용의 3개 범주로 구성된 18개의 개발원칙이 도출되었다. 임상콘텐츠모형을 평가한 결과 개발원칙을 준수하지 않은 것은 총 17개였다. 환류 과정에서 개발원칙의 심화교육, 개발원칙을 이용한 정기적질 향상 전략이 수립의 필요성이 제기되었다. 본 개발원칙은 개발자에는 모델 개발 기준으로, 평가자에게는 모델의 질 평가기준으로도 활용될 수 있으며, 궁극적으로는 임상정보모델의 질 향상에 기여할 수 있을 것으로 기대한다.

Keywords

References

  1. JF Coyle, et al., "Standards for detailed clinical models as the basis for medical data exchange and decision support", Int J Med Inform, Vol. 69, No. 2-3, pp. 157-174, March, 2003. https://doi.org/10.1016/S1386-5056(02)00103-X
  2. ISO13606-2, "Health informatics-Electronic health information communication, Part 2 - Archetype interchange specification", 2008. available at www.iso.org
  3. Huff SM et al., "Integrating Detailed Clinical Models Into Application Development Tools", Stud Health Technol Inform. 2004;107(Pt 2):1058-62.
  4. Sebastian Garde et al., "Expressing clinical data sets with openEHR archetypes: A solid basis for ubiquitous computing", Int J Med Inform. Suppl 3:S334-41. Epub 2007 Mar 27. https://doi.org/10.1016/j.ijmedinf.2007.02.004
  5. 안선주 외, "표준용어기반의 임상정보모델개발", 대한의료정보학회 추계학술대회 연제집, 2008.
  6. SunJu Ahn et al., "CCM guideline and Development Principles", ASIA PACIFIC ASSOCIATION FOR MEDICAL MEDICAL INFORMATICS, Proceedings, 2009.
  7. http://www.clinicalcontentsmodel.org/
  8. Kalra et al,, Management and maintenance policies for EHR interoperability resources, Information Socitiey Technologies, pp. 136-144. 2008.
  9. Stanley Huff, "Ontologies, Vocabularies, and Data Models, in Robert A. Greenes et al, Clinical Decision Support", The Road Ahead, ELSEVIER, pp. 307-324, 2007.
  10. William Goossen, "Detailed Clinical Models : Report of a Workshop in Brisbane", 2007. available at http://www.global-e-health-standards.org/docs/Detailed% 20Clinical%20Models-Report%20of%20Workshop%20August%202007.pdf
  11. Rector AL, "The Interface between Information, Terminology, and Inference Models In: Patel V, et al., editors", MEDINFO 2001, Amsterdam, IOS Press, pp. 246-50, 2001.
  12. Sebastian Garde et al., "Archetype-based knowledge management for semantic interoperability of Electronic Health Record", IOS Press, available at 2009. http://person.hst.aau.dk/ska/MIE2009/papers/MIE2009p1007.pdf
  13. Beale T, "Archetypes: Constraint-based Domain Models for Future-proof Information Systems", OOPSLA 2002 workshop on behavioural semantics, 2002.
  14. Beale T, Heard. S, "Archetype Definition Language (ADL)", The openEHR Foundation, http://openehr.org, 2003.
  15. Stanley M Huff et al,. "An Event Model of Medical Information Representation", JAMIA, 2, pp. 116-134, 1995.
  16. David J. Steiner et al., "Medical Data Abstractionism: Fitting an EMR to Radically Evolving Medical Information Systems", Amsterdam, IOS Press, 2004. available at http://www.ncbi.nlm.nih.gov/pubmed/15360873
  17. Health Level Seven, "Version 3 Data Types", Health Level Seven, Inc., Ann Arbor, MI, http://www.hl7.org, 2002.
  18. www.clinicalelement.com
  19. www.openEHR.org
  20. Stanley Huff, Practical Modeling Issues Representing Coded and Structured Patient Data in EHR Systems, American Medical Information Association, Tutorial, 2007.

Cited by

  1. Development of Clinical Contents Model Markup Language for Electronic Health Records vol.18, pp.3, 2012, https://doi.org/10.4258/hir.2012.18.3.171