scholarly journals A Data-Driven Iterative Approach for Semi-automatically Assessing the Correctness of Medication Value Sets: A Proof of Concept Based on Opioids

2021 ◽  
Vol 60 (S 02) ◽  
pp. e111-e119
Author(s):  
Linyi Li ◽  
Adela Grando ◽  
Abeed Sarker
Keyword(s):  
Language Processing ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Automatic Data ◽  
Opioid Medication ◽  
Value Set ◽  
Domain Experts ◽  
Potential System ◽  
Value Sets ◽  
Trade Names

Abstract Background Value sets are lists of terms (e.g., opioid medication names) and their corresponding codes from standard clinical vocabularies (e.g., RxNorm) created with the intent of supporting health information exchange and research. Value sets are manually-created and often exhibit errors. Objectives The aim of the study is to develop a semi-automatic, data-centric natural language processing (NLP) method to assess medication-related value set correctness and evaluate it on a set of opioid medication value sets. Methods We developed an NLP algorithm that utilizes value sets containing mostly true positives and true negatives to learn lexical patterns associated with the true positives, and then employs these patterns to identify potential errors in unseen value sets. We evaluated the algorithm on a set of opioid medication value sets, using the recall, precision and F1-score metrics. We applied the trained model to assess the correctness of unseen opioid value sets based on recall. To replicate the application of the algorithm in real-world settings, a domain expert manually conducted error analysis to identify potential system and value set errors. Results Thirty-eight value sets were retrieved from the Value Set Authority Center, and six (two opioid, four non-opioid) were used to develop and evaluate the system. Average precision, recall, and F1-score were 0.932, 0.904, and 0.909, respectively on uncorrected value sets; and 0.958, 0.953, and 0.953, respectively after manual correction of the same value sets. On 20 unseen opioid value sets, the algorithm obtained average recall of 0.89. Error analyses revealed that the main sources of system misclassifications were differences in how opioids were coded in the value sets—while the training value sets had generic names mostly, some of the unseen value sets had new trade names and ingredients. Conclusion The proposed approach is data-centric, reusable, customizable, and not resource intensive. It may help domain experts to easily validate value sets.

Developing a K-CDA Implementation Guide for Applying Health Information Exchange Service in South Korea (Preprint)

2020 ◽  
Author(s):  
Sung Won Jung ◽  
Sungchul Bae ◽  
Donghyeong Seong ◽  
Byoung-Kee Yi
Keyword(s):  
Information Exchange ◽  
Health Information Exchange ◽  
Expert Committee ◽  
Healthcare Information ◽  
Entry Level ◽  
Template Library ◽  
Value Sets ◽  
Definition Of ◽  
Document Level ◽  
Section Level

BACKGROUND Through several years of the healthcare information exchange based on the HIE project, some problems were found in the CDA documents generated. OBJECTIVE To fix some problems, we developed the K-CDA Implementation Guide (K means S. Korea) that conforms to the HL7 CDA, and suits the domestic conditions regarding the healthcare information. METHODS We achieved by analyzing HIE guideline and the U.S. C-CDA, and comparing each item. The items that required further discussion were reviewed by the expert committee. Based on the reviews, the previously developed templates were revised. RESULTS A total of 35 CDA templates were developed: five document-level templates, fourteen section-level templates, and sixteen entry-level templates. The 28 value sets used in the templates have been improved and the OIDs for HIE have been redefined CONCLUSIONS The K-CDA IG allows management in the form of a template library based on the definition of the General K-Header and the structured templates. This enables the K-CDA IG to respond to the expansion of national HIE templates with flexibility. For the K-CDA IG, the CDA template in current use was incorporated to the greatest extent possible, to minimize the scope of modifications. It enables the national HIE and the HIE with countries abroad.

scholarly journals State of the Art in Clinical Informatics: Evidence and Examples

2013 ◽  
Vol 22 (01) ◽  
pp. 13-19 ◽  
Author(s):  
A. B. McCoy ◽  
A. Wright ◽  
G. Eysenbach ◽  
B. A. Malin ◽  
E. S. Patterson ◽  
...  
Keyword(s):  
Health Information ◽  
Language Processing ◽  
Information Exchange ◽  
Health Informatics ◽  
Health Information Exchange ◽  
Clinical Decision ◽  
The United States ◽  
Clinical Informatics ◽  
Privacy And Security ◽  
Health Records

Summary Objective: The field of clinical informatics has expanded substantially in the six decades since its inception. Early research focused on simple demonstrations that health information technology (HIT) such as electronic health records (EHRs), computerized provider order entry (CPOE), and clinical decision support (CDS) systems were feasible and potentially beneficial in clinical practice. Methods: In this review, we present recent evidence on clinical informatics in the United States covering three themes: 1) clinical informatics systems and interventions for providers, including EHRs, CPOE, CDS, and health information exchange; 2) consumer health informatics systems, including personal health records and web-based and mobile HIT; and 3) methods and governance for clinical informatics, including EHR usability; data mining, text mining, natural language processing, privacy, and security. Results: Substantial progress has been made in demonstrating that various clinical informatics methodologies and applications improve the structure, process, and outcomes of various facets of the healthcare system. Conclusion: Over the coming years, much more will be expected from the field. As we move past the “early adopters” in Rogers' diffusion of innovations' curve through the “early majority” and into the “late majority,” there will be a crucial need for new research methodologies and clinical applications that have been rigorously demonstrated to work (i.e., to improve health outcomes) in multiple settings with different types of patients and clinicians.

An interoperable HL7 document standard to improve the quality of cancer care across multiple locations.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 12-12
Author(s):  
Jeremy Warner ◽  
Kevin S. Hughes ◽  
John C. Krauss ◽  
Suzanne Maddux ◽  
Peter Paul Yu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Data ◽  
Adjuvant Treatment ◽  
Cancer Care ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Work Group ◽  
Treatment Plan ◽  
Independent Consulting ◽  
Value Sets

12 Background: Cancer care is by nature interdisciplinary and increasingly depends on seamless electronic transmission of clinical data. Health information exchange and semantic understanding are critical for improved outcomes, personalized medicine, comparative effectiveness research, and cost control. While there is a growing focus on this, sharing patient information remains difficult due to a lack of standardization and general incompatibility between electronic health record products. There is a need for well-designed, oncology-specific interoperability standards. Thus ASCO is developing standards to improve the quality and insight of cancer care. Methods: ASCO volunteers formed a Standards Work Group (Standards WG) in 2012, and ASCO engaged an independent consulting firm to perform the technical work. The Standards WG first developed an interoperable standard with broad application that would also be a foundation for future standards work. They adapted ASCO’s Breast Cancer Adjuvant Treatment Plan and Summary (Breast TPS), which was originally developed as a paper-based form. This adaptation required extensive work involving input from medical and surgical oncologists, ASCO staff, and the consultants. This preparatory work was vital to define and disambiguate clinical concepts. Some value sets in the original Breast TPS were replaced with National Cancer Institute value sets. Multiple oncology and standards stakeholders reviewed the draft to ensure accurate representation of the data and harmonization with related standards. Results: The standard was developed using the Health Level Seven International (HL7) Clinical Document Architecture, a widely used XML-based markup standard with national and international recognition. The draft Breast Cancer Adjuvant Treatment Plan and Summary Standard was successfully balloted through HL7 in May 2013 and will subsequently be published for trial use in late 2013. Conclusions: The Breast Cancer Adjuvant Treatment Plan and Summary Standard will improve quality by allowing providers to efficiently transmit clinical data with semantic meaning to health professionals, patients, quality improvement initiatives, and registries.

scholarly journals Maturity assessment of Kenya’s health information system interoperability readiness

2021 ◽  
Vol 28 (1) ◽  
pp. e100241
Author(s):  
Job Nyangena ◽  
Rohini Rajgopal ◽  
Elizabeth Adhiambo Ombech ◽  
Enock Oloo ◽  
Humphrey Luchetu ◽  
...  
Keyword(s):  
Health Information ◽  
Information Exchange ◽  
Working Group ◽  
Data Exchange ◽  
Enterprise Architecture ◽  
Health Information Exchange ◽  
Digital Health ◽  
Health Information System ◽  
Maturity Level ◽  
Technical Standards

BackgroundThe use of digital technology in healthcare promises to improve quality of care and reduce costs over time. This promise will be difficult to attain without interoperability: facilitating seamless health information exchange between the deployed digital health information systems (HIS).ObjectiveTo determine the maturity readiness of the interoperability capacity of Kenya’s HIS.MethodsWe used the HIS Interoperability Maturity Toolkit, developed by MEASURE Evaluation and the Health Data Collaborative’s Digital Health and Interoperability Working Group. The assessment was undertaken by eHealth stakeholder representatives primarily from the Ministry of Health’s Digital Health Technical Working Group. The toolkit focused on three major domains: leadership and governance, human resources and technology.ResultsMost domains are at the lowest two levels of maturity: nascent or emerging. At the nascent level, HIS activities happen by chance or represent isolated, ad hoc efforts. An emerging maturity level characterises a system with defined HIS processes and structures. However, such processes are not systematically documented and lack ongoing monitoring mechanisms.ConclusionNone of the domains had a maturity level greater than level 2 (emerging). The subdomains of governance structures for HIS, defined national enterprise architecture for HIS, defined technical standards for data exchange, nationwide communication network infrastructure, and capacity for operations and maintenance of hardware attained higher maturity levels. These findings are similar to those from interoperability maturity assessments done in Ghana and Uganda.

scholarly journals Despite Substantial Progress In EHR Adoption, Health Information Exchange And Patient Engagement Remain Low In Office Settings

2014 ◽  
Vol 33 (9) ◽  
pp. 1672-1679 ◽  
Author(s):  
Michael F. Furukawa ◽  
Jennifer King ◽  
Vaishali Patel ◽  
Chun-Ju Hsiao ◽  
Julia Adler-Milstein ◽  
...  
Keyword(s):  
Health Information ◽  
Patient Engagement ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Substantial Progress ◽  
Ehr Adoption

scholarly journals Valuation Survey of EQ-5D-Y Based on the International Common Protocol: Development of a Value Set in Japan

2021 ◽  
pp. 0272989X2110018
Author(s):  
Takeru Shiroiwa ◽  
Shunya Ikeda ◽  
Shinichi Noto ◽  
Takashi Fukuda ◽  
Elly Stolk
Keyword(s):  
Discrete Choice ◽  
Health Care Policy ◽  
Mixed Logit ◽  
Health State ◽  
Choice Data ◽  
Social Functions ◽  
Value Set ◽  
A Value ◽  
Value Sets ◽  
Utility Scale

Background EQ-5D-Y is a preference-based measure for children and adolescents (aged 8–15 y). This is the first study to develop an EQ-5D-Y value set for converting EQ-5D-Y responses to index values. Methods We recruited 1047 respondents (aged 20–79 y) from the general population, stratified by gender and age group, in 5 Japanese cities. All data were collected through face-to-face surveys. Respondents were asked to value EQ-5D-Y states for a hypothetical 10-y-old child from a proxy perspective using composite time tradeoff (cTTO) and a discrete choice experiment (DCE). The discrete choice data were analyzed using a mixed logit model. Latent DCE values were then converted to a 0 (death)/1 (full health) scale by mapping them to the cTTO values. Results The mean observed cTTO value of the worst health state [33333] was 0.20. Analysis of the DCE data showed that the coefficients of the domains related to mental functions (“Having pain or discomfort” and “Feeling worried, sad, or unhappy”) were larger than those for the domains related to physical and social functions. By converting latent DCE values to a utility scale, we constructed a value set for EQ-5D-Y. No inconsistencies were observed. The minimum predicted score was 0.288 [33333], and the second-best score was 0.957 [12111]. Conclusion A value set for EQ-5D-Y was successfully constructed. This is the first survey of an EQ-5D-Y value set. Interpreting the differences between EQ-5D-Y and EQ-5D-5L value sets is a future task with implications for health care policy.

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