Representing Knowledge Consistently Across Health Systems

Abstract

SummaryObjectives: Electronic health records (EHRs) have increasingly emerged as a powerful source of clinical data that can be leveraged for reuse in research and in modular health apps that integrate into diverse health information technologies. A key challenge to these use cases is representing the knowledge contained within data from different EHR systems in a uniform fashion. Method: We reviewed several recent studies covering the knowledge representation in the common data models for the Observational Medical Outcomes Partnership (OMOP) and its Observational Health Data Sciences and Informatics program, and the United States Patient Centered Outcomes Research Network (PCORNet). We also reviewed the Health Level 7 Fast Healthcare Interoperability Resource standard supporting app-like programs that can be used across multiple EHR and research systems. Results: There has been a recent growth in high-impact efforts to support quality-assured and standardized clinical data sharing across different institutions and EHR systems. We focused on three major efforts as part of a larger landscape moving towards shareable, transportable, and computable clinical data. Conclusion: The growth in approaches to developing common data models to support interoperable knowledge representation portends an increasing availability of high-quality clinical data in support of research. Building on these efforts will allow a future whereby significant portions of the populations in the world may be able to share their data for research.

Conceptual Design, Implementation, and Evaluation of Generic and Standard-Compliant Data Transfer into Electronic Health Records

“…Efficient development, reusability of data, and avoiding redundant input are positive aspects of this approach which allows for more rapid documentation. 11,12 The reusability of structured EHR data are required in clinical and translational research [13][14][15][16][17][18] and improves safety, quality, and efficiency in the health care sector. 19,20 Reusability of EHR data in research is currently limited due to a lack of standardization in EHR systems.…”

Translational Health Disparities Research in a Data-Rich World

“…42 To overcome the challenge of data fragmentation, networks like OHDSI and PCORnet are developing common data models to combine and compare EHRs across health service providers. 42,43 Another example, the Cancer Research Network (CRN), 44 combines clinical with tumor registry data to evaluate cancer outcomes. An advantage of EHR-linked networks is that they can include a broader range of diverse backgrounds (representing the demographics of those presenting to the hospital) and, thus, are sometimes more inclusive than other traditional research cohorts.…”

Lessons Learned in Creating Interoperable Fast Healthcare Interoperability Resources Profiles for Large-Scale Public Health Programs

“…FHIR is increasingly recognized as the preferred solution to enable application-based interoperable health information tools. 15,16 Objective ACOG's primary objective was to guide the development of the FHIR-based platform for OPA by engaging the HSPC terminology and modeling experts. HSPC is a providerdriven organization of leading health care organizations, information technology (IT) vendors, systems integrators, and venture firms dedicated to accelerating the delivery of a platform that supports innovative health care applications for the improvement of health and health care.…”