Mahdieh Montazeri, Reza Khajouei, Ali Afraz, Leila Ahmadian
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引用次数: 0
Abstract
Objective: Medication errors are the third leading cause of death. There are several methods to prevent prescription errors, one of which is to use a Computerized Physician Order Entry system (CPOE). In a CPOE system, necessary data needs to be collected so that making decisions about prescribing medications and treatment plans could be made. Although many CPOE systems have been developed worldwide, studies have yet to identify the necessary data and data elements of CPOE systems. This study aims to identify data elements of CPOE and standardize these data with Fast Healthcare Interoperability Resources (FHIR) to facilitate data sharing and integration with the electronic health record (EHR) system and reduce data diversity.
Methods: PubMed, Web of Science, Embase, and Scopus databases for studies up to October 2019 were searched. Two reviewers independently assessed original articles to determine eligibility for inclusion in this review. All articles describing data elements of a COPE system were included. Data elements were obtained from the included articles' text, tables, and figures.Classification of the extracted data elements and mapping them to FHIR was done to facilitate data sharing and integration with the electronic health record (EHR) system and reduce data diversity. The final data elements of CPOE were categorized into five main categories of FHIR (foundation, base, clinical, financial, and specialized) and 146 resources, where possible. One of the researchers did mapping and checked and verified by the second researcher. If a data element could not be mapped to any FHIR resources, this data element was considered an extension to the most relevant resource.
Results: We retrieved 5162 articles through database searches. After the full-text assessment, 21 articles were included. In total, 270 data elements were identified and mapped to the FHIR standard. These elements have been reported in 26 FHIR resources of 146 ones (18%). In total, 71 data elements were considered an extension.
Conclusions: The results of this study showed that the same data elements were not used in the CPOE systems, and the degree of homogeneity of these systems is limited. The mapping of extracted data with data elements used in the FHIR standard shows the extent to which these systems comply with existing standards. Considering the standards in these systems' design helps developers design more coherent systems that can share data with other systems.
目的:用药错误是导致死亡的第三大原因。预防处方错误有几种方法，其中之一是使用计算机化医嘱输入系统(CPOE)。在CPOE系统中，需要收集必要的数据，以便制定处方药物和治疗计划。虽然世界范围内已经开发了许多CPOE系统，但研究尚未确定CPOE系统所需的数据和数据要素。本研究旨在识别CPOE的数据元素，并利用快速医疗互操作性资源(FHIR)对这些数据进行标准化，以促进与电子健康记录(EHR)系统的数据共享和集成，减少数据多样性。方法:检索截至2019年10月的PubMed、Web of Science、Embase和Scopus数据库。两位审稿人独立评估原始文章以确定纳入本综述的资格。所有描述COPE系统数据元素的文章都包括在内。数据元素取自纳入文章的文本、表格和图表。对提取的数据元素进行分类并将其映射到FHIR，以促进与电子健康记录(EHR)系统的数据共享和集成，并减少数据多样性。在可能的情况下，将CPOE的最终数据元素分为FHIR的五大类(基础、基础、临床、财务和专业)和146种资源。其中一名研究人员绘制地图，并由另一名研究人员进行检查和验证。如果一个数据元素不能映射到任何FHIR资源，则该数据元素被认为是最相关资源的扩展。结果:我们通过数据库检索到5162篇文章。经全文评估，共纳入21篇文章。总共确定了270个数据元素并将其映射到FHIR标准。这些元素已在26个FHIR资源中的146个(18%)中报告。总共有71个数据元素被认为是扩展。结论:本研究结果表明，在CPOE系统中没有使用相同的数据元素，并且这些系统的同质程度有限。提取的数据与FHIR标准中使用的数据元素的映射显示了这些系统符合现有标准的程度。考虑这些系统设计中的标准可以帮助开发人员设计出更连贯的系统，可以与其他系统共享数据。
期刊介绍：
Informatics for Health & Social Care promotes evidence-based informatics as applied to the domain of health and social care. It showcases informatics research and practice within the many and diverse contexts of care; it takes personal information, both its direct and indirect use, as its central focus.
The scope of the Journal is broad, encompassing both the properties of care information and the life-cycle of associated information systems.
Consideration of the properties of care information will necessarily include the data itself, its representation, structure, and associated processes, as well as the context of its use, highlighting the related communication, computational, cognitive, social and ethical aspects.
Consideration of the life-cycle of care information systems includes full range from requirements, specifications, theoretical models and conceptual design through to sustainable implementations, and the valuation of impacts. Empirical evidence experiences related to implementation are particularly welcome.
Informatics in Health & Social Care seeks to consolidate and add to the core knowledge within the disciplines of Health and Social Care Informatics. The Journal therefore welcomes scientific papers, case studies and literature reviews. Examples of novel approaches are particularly welcome. Articles might, for example, show how care data is collected and transformed into useful and usable information, how informatics research is translated into practice, how specific results can be generalised, or perhaps provide case studies that facilitate learning from experience.
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