scholarly journals Towards Implementation of OMOP in a German University Hospital Consortium

2018 ◽  
Vol 09 (01) ◽  
pp. 054-061 ◽  
Author(s):  
C. Maier ◽  
L. Lang ◽  
H. Storf ◽  
P. Vormstein ◽  
R. Bieber ◽  
...  

Background In 2015, the German Federal Ministry of Education and Research initiated a large data integration and data sharing research initiative to improve the reuse of data from patient care and translational research. The Observational Medical Outcomes Partnership (OMOP) common data model and the Observational Health Data Sciences and Informatics (OHDSI) tools could be used as a core element in this initiative for harmonizing the terminologies used as well as facilitating the federation of research analyses across institutions. Objective To realize an OMOP/OHDSI-based pilot implementation within a consortium of eight German university hospitals, evaluate the applicability to support data harmonization and sharing among them, and identify potential enhancement requirements. Methods The vocabularies and terminological mapping required for importing the fact data were prepared, and the process for importing the data from the source files was designed. For eight German university hospitals, a virtual machine preconfigured with the OMOP database and the OHDSI tools as well as the jobs to import the data and conduct the analysis was provided. Last, a federated/distributed query to test the approach was executed. Results While the mapping of ICD-10 German Modification succeeded with a rate of 98.8% of all terms for diagnoses, the procedures could not be mapped and hence an extension to the OMOP standard terminologies had to be made.Overall, the data of 3 million inpatients with approximately 26 million conditions, 21 million procedures, and 23 million observations have been imported.A federated query to identify a cohort of colorectal cancer patients was successfully executed and yielded 16,701 patient cases visualized in a Sunburst plot. Conclusion OMOP/OHDSI is a viable open source solution for data integration in a German research consortium. Once the terminology problems can be solved, researchers can build on an active community for further development.

Author(s):  
Seon-Ju Kam ◽  
Young-Sun Yoo

Patients’ emotional responses to the hospital environment can be considered as important as medical technology and equipment. Therefore, this study investigated their experiences to determine whether the pattern using hospital identity (HI) elements, a widely used design method for patient clothing in university hospitals, can affect their emotional response and contribute to healing. It aimed to identify whether controlling the motif characteristics, arrangement, and spacing in this pattern design, and the direction between motifs, could be a method to design patient clothing for healing. To investigate patients’ emotional response and suggestions for patient clothing design, an interview-based qualitative approach was used. In-depth interviews were conducted with 12 patients discharged from Kyung Hee University Hospital Medical Center (KHUMC), Seoul. The interview questions consisted of two parts. One part featured questions about participants’ emotional responses to the medical environment and their latest patient clothing experience, and the other featured questions about their emotional response to, and suggestions for, the healing expression of pattern design using HI. The results confirmed that the motif characteristics, arrangement, and spacing, and the direction between motifs, influenced patients’ positive emotions and contributed to the healing effect. Therefore, when the HI elements of a medical institution are applied in the design of patient clothing with the characteristics of a healing design, patients perceive this as providing stability and comfort. The design of patient clothing becomes a medium that not only builds the brand image of medical institutions, but also enhances the quality of medical services centered on patient healing.


2021 ◽  
pp. 014556132098603
Author(s):  
Anni Koskinen ◽  
Marie Lundberg ◽  
Markus Lilja ◽  
Jyri Myller ◽  
Matti Penttilä ◽  
...  

Objectives: The aim of this controlled follow-up study was to compare the need for revision surgery, long-term efficacy, and satisfaction in chronic rhinosinusitis patients who had undergone maxillary sinus operation with either balloon sinuplasty or traditional endoscopic sinus surgery (ESS) technique. Methods: Thirty-nine ESS patients and 36 balloon patients of our previously described cohort, who had been primarily operated in 2008 to 2010, were contacted by phone. Symptoms, satisfaction, and need for revision surgery were asked. In addition, we collected data of patients who had undergone primary maxillary sinus balloon sinuplasty in the Helsinki University Hospital during the years 2005 to 2019. As a control group, we collected data of patients who had undergone primary maxillary sinus ESS at 3 Finnish University Hospitals, and 1 Central Hospital in years 2005, 2008, and 2011. Results: Altogether, 77 balloon patients and 82 ESS patients were included. The mean follow-up time was 5.3 years in balloon group and 9.8 years in ESS group. Revision surgery was performed on 17 balloon patients and 6 ESS patients. In the survival analysis, the balloon sinuplasty associated significantly with a higher risk of revision surgery compared to ESS. According to the phone interviews, 82% of ESS patients and 75% of balloon patients were very satisfied with the primary operation. Conclusion: Although the patient groups expressed equal satisfaction and change in symptoms after the operations, the need for revision surgery was higher after balloon sinuplasty than after ESS. This should be emphasized when counselling patients regarding surgical options.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ilaria Corazza ◽  
Kendall Jamieson Gilmore ◽  
Francesca Menegazzo ◽  
Valts Abols

Abstract Background Patient Reported Experience Measures (PREMs) are recognized as an important indicator of high quality care and person-centeredness. PREMs are increasingly adopted for paediatric care, but there is little published evidence on how to administer, collect, and report paediatric PREMs at scale. Methods This paper describes the development of a PREMs questionnaire and administration system for the Meyer Children’s University Hospital in Florence (Meyer) and the Children’s Clinical University Hospital in Riga (CCUH). The system continuously recruits participants into the electronic administration model, with surveys completed by caregivers or adolescents at their convenience, post-discharge. We analyse 1661 responses from Meyer and 6585 from CCUH, collected from 1st December 2018 to 21st January 2020. Quantitative and qualitative experience analyses are included, using Pearson chi-square tests, Fisher’s exact tests and narrative evidence from free text responses. Results The large populations reached in both countries suggest the continuous, digital collection of paediatric PREMs described is feasible for collecting paediatric PREMs at scale. Overall response rates were 59% in Meyer and 45% in CCUH. There was very low variation in mean scores between the hospitals, with greater clustering of Likert scores around the mean in CCUH and a wider spread in Meyer for a number of items. The significant majority of responses represent the carers’ point of view or the perspective of children and adolescents expressed through proxy reporting by carers. Conclusions Very similar reported scores may reflect broadly shared preferences among children, adolescents and carers in the two countries, and the ability of both hospitals in this study to meet their expectations. The model has several interesting features: inclusion of a narrative element; electronic administration and completion after discharge from hospital, with high completion rates and easy data management; access for staff and researchers through an online platform, with real time analysis and visualization; dual implementation in two sites in different settings, with comparison and shared learning. These bring new opportunities for the utilization of PREMs for more person-centered and better quality care, although further research is needed in order to access direct reporting by children and adolescents.


PEDIATRICS ◽  
1962 ◽  
Vol 29 (4) ◽  
pp. 678-679
Author(s):  
H. William Fink

I write with concern for the future of good community hospitals with qualified attending pediatricians and plenty of patient material but no residents. In the ever-increasing competition for residents, such hospitals are slowly being strangled by the more fortunate university hospitals with their access to medical students and interns. I fear that the ultimate consequences will be the downgrading of pediatric practice throughout the county in those areas where there is not a medical school.


2008 ◽  
Vol 2 (1) ◽  
pp. 52-56 ◽  
Author(s):  
Cássio Machado de Campos Bottino ◽  
Pedro Zucollo ◽  
Maria Del Pilar Quintero Moreno ◽  
Gislaine Gil ◽  
Carla Garcia Cid ◽  
...  

Abstract Memory clinics were established in the USA and European countries as services to attend patients who complain of cognitive deficits, referred by primary care doctors, specialists and other hospitals. Objective: We aimed to describe the clinical and cognitive profile of consecutively evaluated subjects during the initial three years of service of a memory clinic from a university hospital. Methods: Subjects were submitted to a clinical work-up for dementia, which included laboratory exams, cranial computerized tomography, cognitive tests, and a comprehensive neuropsychological battery. Diagnosis was made according to ICD-10 criteria. Results: We evaluated 104 subjects (67.3% females and 32.7% males), with mean age of 59.1 years, 88.8% aged 50 years or above. Mean schooling was 9.9 years. Patients were classified into 10 different primary diagnostic categories, namely Depression (26.9%), Alzheimer's disease (17.3%), Memory complaints without objective impairment (17.3%), Mild Cognitive Disorder - MCD (14.4%), and Anxiety (12.5%) the most frequent diagnosis. Comparing patients with dementia, MCD, Depression or Anxiety and Memory complainers, by age (below and above 60 years), dementia was more commonly diagnosed in older subjects, while a higher frequency of memory complainers was found in the younger group. Conclusions: This preliminary report from an outpatient group of referred patients with cognitive complaints showed a higher frequency of psychiatric disorders in this sample. The memory clinic approach should be considered as a model of service which can evaluate subjects with cognitive complaints effectively and improve the quality of care delivered to this patient group.


Author(s):  
Eugenia Rinaldi ◽  
Sylvia Thun

HiGHmed is a German Consortium where eight University Hospitals have agreed to the cross-institutional data exchange through novel medical informatics solutions. The HiGHmed Use Case Infection Control group has modelled a set of infection-related data in the openEHR format. In order to establish interoperability with the other German Consortia belonging to the same national initiative, we mapped the openEHR information to the Fast Healthcare Interoperability Resources (FHIR) format recommended within the initiative. FHIR enables fast exchange of data thanks to the discrete and independent data elements into which information is organized. Furthermore, to explore the possibility of maximizing analysis capabilities for our data set, we subsequently mapped the FHIR elements to the Observational Medical Outcomes Partnership Common Data Model (OMOP CDM). The OMOP data model is designed to support the conduct of research to identify and evaluate associations between interventions and outcomes caused by these interventions. Mapping across standard allows to exploit their peculiarities while establishing and/or maintaining interoperability. This article provides an overview of our experience in mapping infection control related data across three different standards openEHR, FHIR and OMOP CDM.


Author(s):  
Maryna Lienkova ◽  
Irina Bulakh

The article considers and analyzes the existing in the world, but new for Ukraine, type of healthcare institutions - a university hospital, which today is an example of one of the largest and best university hospitals in Germany - the Medical Center of the University of Aachen. The planning and functional structure of the university hospital and special design approaches that contributed to its design and development are analyzed. The purpose of the article is to illustrate an innovative approach for our state to the organization of medical institutions and to emphasize the importance of their implementation in the domestic healthcare system. The research methodology is based on the systematization and analysis of data from various information sources, as well as on the method of sociological survey (analysis of reviews). The article considers the features of the structure of the University Hospital Aachen, namely the multidisciplinary treatment, research and student training, which are combined in one institution. According to hospital patients, the only drawback of this structure is the frequent long wait for visitors. This is probably due to the significant daily flow of patients of varying complexity and, consequently, the shortcomings of the managerial approach. However, at the same time, the hospital has many advantages, which were highlighted in the article.  


2021 ◽  
Vol 9 (3) ◽  
pp. 213-218
Author(s):  
Patricio Garcia-Espinosa ◽  
Edgar Botello-Hernández ◽  
Gabriela Torres-Hernández ◽  
Clarissa Guerrero-Cavazos ◽  
Estefania Villareal-Garza ◽  
...  

Background: Arteriovenous Malformations (AVMs) are abnormalities in intracranial vessels between the arterial and venous systems. This study aimed to identify the predictors of mortality in patients that presented to our hospital with AVMs, ruptured or unruptured, and correlate them to those available in the literature. Methods: An analytical, observational, retrospective study was performed to review data of patients with cerebral AVMs in the University Hospital “Dr José Eleuterio González” from January 2016 to December 2020. Clinical files were reviewed based on AVMs diagnosis according to the  International Classification of Diseases 10th Revision, ICD-10. Variables were subjected to a univariate analysis and those found significant (p-value < 0.05) were subjected to a logistic regression. Results: A total of 80 patients were included in our study. Most of the participants were females (56.3%) and three were pregnant. The most common presenting symptom was holocranial headache (34 cases) occurring between the hours of 22:00 to 7:00. The most significant predictors of mortality were a total bleeding volume greater than 9.18 cm3 (p = 0.010), the presence of more than one symptom (p = 0.041), and a history of previous cerebral intraparenchymal hemorrhage (p = 0.014). Conclusion: Results demonstrated an important association between intracranial bleeding and mortality. Ultimately, more prospective studies are needed to determine predictor factors for mortality in AVMs patients.


2020 ◽  
Author(s):  
Julian Sass ◽  
Alexander Bartschke ◽  
Moritz Lehne ◽  
Andrea Essenwanger ◽  
Eugenia Rinaldi ◽  
...  

Background: The current COVID-19 pandemic has led to a surge of research activity. While this research provides important insights, the multitude of studies results in an increasing segmentation of information. To ensure comparability across projects and institutions, standard datasets are needed. Here, we introduce the "German Corona Consensus Dataset" (GECCO), a uniform dataset that uses international terminologies and health IT standards to improve interoperability of COVID-19 data. Methods: Based on previous work (e.g., the ISARIC-WHO COVID-19 case report form) and in coordination with experts from university hospitals, professional associations and research initiatives, data elements relevant for COVID-19 research were collected, prioritized and consolidated into a compact core dataset. The dataset was mapped to international terminologies, and the Fast Healthcare Interoperability Resources (FHIR) standard was used to define interoperable, machine-readable data formats. Results: A core dataset consisting of 81 data elements with 281 response options was defined, including information about, for example, demography, anamnesis, symptoms, therapy, medications or laboratory values of COVID-19 patients. Data elements and response options were mapped to SNOMED CT, LOINC, UCUM, ICD-10-GM and ATC, and FHIR profiles for interoperable data exchange were defined. Conclusion: GECCO provides a compact, interoperable dataset that can help to make COVID-19 research data more comparable across studies and institutions. The dataset will be further refined in the future by adding domain-specific extension modules for more specialized use cases.


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