Comments on: EHR Interoperability: The Structured Data Capture Initiative http://www.healthit.gov/buzz-blog/electronic-health-and-medical-records/ehr-interoperability-structured-data-capture-initiative/ The Latest on Health Information Technology from ONC Sun, 19 May 2013 19:05:15 +0000 hourly 1 http://wordpress.org/?v=3.5.1 By: Adrienne Tannenbaum http://www.healthit.gov/buzz-blog/electronic-health-and-medical-records/ehr-interoperability-structured-data-capture-initiative/#comment-325460 Adrienne Tannenbaum Mon, 18 Feb 2013 17:01:56 +0000 http://www.healthit.gov/buzz-blog/?p=4152#comment-325460 Thank you, thank you, thank you. I I am very excited that the US govt is now the place with the power to deploy standardization as a way of integrating data so that it can be “shared”, and the healthcare industry is the beneficiary that will be impacted almost immediately. I am looking forward to an organized approach that will begin here, but expand to other areas outside of healthcare.

Please see my linkedin profile. It points to many (what I consider to be) OLD publications which have been pointing out where “metadata” ties all of this together.

]]> By: Dr. Barry Robson http://www.healthit.gov/buzz-blog/electronic-health-and-medical-records/ehr-interoperability-structured-data-capture-initiative/#comment-320293 Dr. Barry Robson Wed, 06 Feb 2013 21:26:02 +0000 http://www.healthit.gov/buzz-blog/?p=4152#comment-320293 As an e-epidemiologist data mining medical records for epidemiological and EBM/CER metrics and probabilistic CDS rules, I’m dubious that a further structuralizing Event-Attribute-Value type of layer will allow us to tackle and respond fast to say 250 million EHRs, and changing constantly with the wanted data rather spread around the XML. That is certainly more of a problem if access, as it ideally ethically should do, captures some spirit of fine grained consent where the patient dictates by notification, observation by observation etc in the EHR, what can and can and cannot be available for access and to whom, with what resolution of value and timestamp, and what combinations. I retired moderately recently as CSO IBM Global Healthcare Pharmaceutical and Life Sciences, and whilst these views are certainly mine and not necessarily IBM’s, I don’t see much in my personal experience there, nor in my current job as an epidemiologist, to alleviate these concerns as the EHR stands at present. As an epidemiologist I would of course be very happy to be proven wrong.
My views on how to tackle this, and experiments with a pro-PCAST style of approach, can be seen in the following recording of the Johns Hopkins Grand Rounds Lecture that I gave on Feb 2 2013:-
http://webcast.jhu.edu/Mediasite/Play/80245ac77f9d4fe0a2a2bbf300caa8be1d

]]> By: Nick van Terheyden, MD http://www.healthit.gov/buzz-blog/electronic-health-and-medical-records/ehr-interoperability-structured-data-capture-initiative/#comment-317478 Nick van Terheyden, MD Fri, 01 Feb 2013 19:44:16 +0000 http://www.healthit.gov/buzz-blog/?p=4152#comment-317478 Interesting outline on structured data entry and capturing this using standard templates that are pre-populated – that’s dead on (how often does the family history change in a clinical note…?)
What I don’t see but believe will be central to capturing this information without burdening the physician with additional administrative tasks that detract from their focus on the patient is Natural Language Processing or as we call it Clinical Language Understanding (CLU)
We like narrative because it captures all the information and leaves nothing out – technology is able to convert this into structured data, today we can do some elements really well at an accuracy in excess of 90%. This could flow seamlessly into the S&I framework creating structured data for sharing that is tagged against the relevant controlled medical vocabulary. This data is readily available for registries, quality reporting etc, but more importantly it provides a level of granularity on clinical information that can be used for multiple other purposes especially verifying the delivery of high quality care.

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