当前位置: X-MOL 学术J. Am. Med. Inform. Assoc. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
A novel application of SMART on FHIR architecture for interoperable and scalable integration of patient-reported outcome data with electronic health records
Journal of the American Medical Informatics Association ( IF 4.7 ) Pub Date : 2021-07-19 , DOI: 10.1093/jamia/ocab110
Deliya B Wesley 1, 2 , Joseph Blumenthal 1, 3 , Shrenikkumar Shah 4 , Robin A Littlejohn 1, 3 , Zoe Pruitt 1, 3 , Ram Dixit 1, 3 , Chun-Ju Hsiao 5 , Christine Dymek 5 , Raj M Ratwani 1, 2, 3
Affiliation  

Abstract
Objective
Despite a proliferation of applications (apps) to conveniently collect patient-reported outcomes (PROs) from patients, PRO data are yet to be seamlessly integrated with electronic health records (EHRs) in a way that improves interoperability and scalability. We applied the newly created PRO standards from the Office of the National Coordinator for Health Information Technology to facilitate the collection and integration of standardized PRO data. A novel multitiered architecture was created to enable seamless integration of PRO data via Substitutable Medical Apps and Reusable Technologies on Fast Healthcare Interoperability Resources apps and scaled to different EHR platforms in multiple ambulatory settings.
Materials and Methods
We used a standards-based approach to deploy 2 apps that source and surface PRO data in real-time for provider use within the EHR and which rely on PRO assessments from an external center to streamline app and EHR integration.
Results
The apps were developed to enable patients to answer validated assessments (eg, a Patient-Reported Outcomes Measurement Information System including using a Computer Adaptive Test format). Both apps were developed to populate the EHR in real time using the Health Level Seven FHIR standard allowing providers to view patients’ data during the clinical encounter. The process of implementing this architecture with 2 different apps across 18 ambulatory care sites and 3 different EHR platforms is described.
Conclusion
Our approach and solution proved feasible, secure, and time- and resource-efficient. We offer actionable guidance for this technology to be scaled and adapted to promote adoption in diverse ambulatory care settings and across different EHRs.


中文翻译:

SMART 在 FHIR 架构上的一种新应用,用于将患者报告的结果数据与电子健康记录进行可互操作和可扩展的集成

摘要
客观的
尽管可以方便地从患者那里收集患者报告结果 (PRO) 的应用程序(应用程序)激增,但 PRO 数据尚未与电子健康记录 (EHR) 无缝集成,从而提高互操作性和可扩展性。我们应用了国家卫生信息技术协调员办公室新创建的 PRO 标准,以促进标准化 PRO 数据的收集和整合。创建了一种新颖的多层架构,以通过可替代医疗应用程序和快速医疗互操作资源应用程序上的可重用技术实现 PRO 数据的无缝集成,并在多个门诊环境中扩展到不同的 EHR 平台。
材料和方法
我们使用基于标准的方法来部署 2 个应用程序,这些应用程序实时获取和显示 PRO 数据以供 EHR 内的提供者使用,并依赖外部中心的 PRO 评估来简化应用程序和 EHR 集成。
结果
开发这些应用程序是为了让患者能够回答经过验证的评估(例如,患者报告的结果测量信息系统,包括使用计算机自适应测试格式)。这两款应用程序都是使用健康七级 FHIR 标准实时填充 EHR 的,允许提供者在临床就诊期间查看患者的数据。描述了使用跨 18 个门诊护理站点和 3 个不同 EHR 平台的 2 个不同应用程序实施此架构的过程。
结论
我们的方法和解决方案被证明是可行的、安全的、时间和资源高效的。我们为这项技术提供了可操作的指导,以使其在不同的门诊护理环境和不同的 EHR 中得到推广和调整。
更新日期:2021-09-20
down
wechat
bug