The realities of implementation of Clinical Context Object Workgroup (CCOW) standards for integration of vendor disparate clinical software in a large medical center

Berger, Robert; Baba, John

doi:10.1016/j.ijmedinf.2008.12.002

Cited by 6 publications

(3 citation statements)

References 3 publications

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“…Electronic chart review facilitated by the Chart Review module is performed through integration with a tool called Clinical Context Object Workgroup (CCOW) [12], which is available on Duke Medicine workstations. CCOW is typically used during patient care to allow clinicians to open different health IT applications in a way such that are synced to the same patient.…”

Section: Resultsmentioning

confidence: 99%

Modular design, application architecture, and usage of a self-service model for enterprise data delivery: The Duke Enterprise Data Unified Content Explorer (DEDUCE)

Horvath

Rusincovitch

Brinson

et al. 2014

Journal of Biomedical Informatics

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Purpose Data generated in the care of patients are widely used to support clinical research and quality improvement, which has hastened the development of self-service query tools. User interface design for such tools, execution of query activity, and underlying application architecture have not been widely reported, and existing tools reflect a wide heterogeneity of methods and technical frameworks. We describe the design, application architecture, and use of a self-service model for enterprise data delivery within Duke Medicine. Methods Our query platform, the Duke Enterprise Data Unified Content Explorer (DEDUCE), supports enhanced data exploration, cohort identification, and data extraction from our enterprise data warehouse (EDW) using a series of modular environments that interact with a central keystone module, Cohort Manager (CM). A data-driven application architecture is implemented through three components: an application data dictionary, the concept of “smart dimensions”, and dynamically-generated user interfaces. Results DEDUCE CM allows flexible hierarchies of EDW queries within a grid-like workspace. A cohort “join” functionality allows switching between filters based on criteria occurring within or across patient encounters. To date, 674 users have been trained and activated in DEDUCE, and logon activity shows a steady increase, with variability between months. A comparison of filter conditions and export criteria shows that these activities have different patterns of usage across subject areas. Conclusions Organizations with sophisticated EDWs may find that users benefit from development of advanced query functionality, complimentary to the user interfaces and infrastructure used in other well-published models. Driven by its EDW context, the DEDUCE application architecture was also designed to be responsive to source data and to allow modification through alterations in metadata rather than programming, allowing an agile response to source system changes.

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Section: Resultsmentioning

confidence: 99%

Modular design, application architecture, and usage of a self-service model for enterprise data delivery: The Duke Enterprise Data Unified Content Explorer (DEDUCE)

Horvath

Rusincovitch

Brinson

et al. 2014

Journal of Biomedical Informatics

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“…Thus, extensive local validation is needed prior to certifying any CCOW solution as being ready for clinical use. [24]…”

Section: Software Securitymentioning

confidence: 99%

Privacy and security of patient data in the pathology laboratory

Cucoranu

Parwani

West

et al. 2013

Journal of Pathology Informatics

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Data protection and security are critical components of routine pathology practice because laboratories are legally required to securely store and transmit electronic patient data. With increasing connectivity of information systems, laboratory work-stations, and instruments themselves to the Internet, the demand to continuously protect and secure laboratory information can become a daunting task. This review addresses informatics security issues in the pathology laboratory related to passwords, biometric devices, data encryption, internet security, virtual private networks, firewalls, anti-viral software, and emergency security situations, as well as the potential impact that newer technologies such as mobile devices have on the privacy and security of electronic protected health information (ePHI). In the United States, the Health Insurance Portability and Accountability Act (HIPAA) govern the privacy and protection of medical information and health records. The HIPAA security standards final rule mandate administrative, physical, and technical safeguards to ensure the confidentiality, integrity, and security of ePHI. Importantly, security failures often lead to privacy breaches, invoking the HIPAA privacy rule as well. Therefore, this review also highlights key aspects of HIPAA and its impact on the pathology laboratory in the United States.

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“…A system may thus be technically integrated (ie, have one underlying code aggregating multiple subsystems that function collectively as one coordinated system), but the end user may not be able to see this integration and benefit from it (eg, they may still need to switch between screens to get all information they need). Similarly, the end user presentation interface may seem integrated (eg, in clinical portals), but the systems may not allow data to be moved seamlessly between applications, and this can create safety risks (eg, relating to moving/transcribing information) 19 20…”

Section: Introductionmentioning

confidence: 99%

Safety risks associated with the lack of integration and interfacing of hospital health information technologies: a qualitative study of hospital electronic prescribing systems in England

et al. 2016

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Background Substantial sums of money are being invested worldwide in health information technology. Realising benefits and mitigating safety risks is however highly dependent on effective integration of information within systems and/or interfacing to allow information exchange across systems. As part of an English programme of research, we explored the social and technical challenges relating to integration and interfacing experienced by early adopter hospitals of standalone and hospital-wide multimodular integrated electronic prescribing (ePrescribing) systems. Methods We collected longitudinal qualitative data from six hospitals, which we conceptualised as case studies. We conducted 173 interviews with users, implementers and software suppliers (at up to three different times), 24 observations of system use and strategic meetings, 17 documents relating to implementation plans, and 2 whole-day expert round-table discussions. Data were thematically analysed initially within and then across cases, drawing on perspectives surrounding information infrastructures. Results We observed that integration and interfacing problems obstructed effective information transfer in both standalone and multimodular systems, resulting in threats to patient safety emerging from the lack of availability of timely information and duplicate data entry. Interfacing problems were immediately evident in some standalone systems where users had to cope with multiple log-ins, and this did not attenuate over time.

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The realities of implementation of Clinical Context Object Workgroup (CCOW) standards for integration of vendor disparate clinical software in a large medical center

Cited by 6 publications

References 3 publications

Modular design, application architecture, and usage of a self-service model for enterprise data delivery: The Duke Enterprise Data Unified Content Explorer (DEDUCE)

Modular design, application architecture, and usage of a self-service model for enterprise data delivery: The Duke Enterprise Data Unified Content Explorer (DEDUCE)

Privacy and security of patient data in the pathology laboratory

Safety risks associated with the lack of integration and interfacing of hospital health information technologies: a qualitative study of hospital electronic prescribing systems in England

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