Subscribe to RSS
DOI: 10.3414/ME17-01-0110
Development of an Open Metadata Schema for Clinical Pathway (openCP) in China
Funding This work was supported by the National Social Science Foundation of China [13BTQ012, 2013], and the National Natural Science Foundation of China [30972549, 2010].Publication History
received:
09 October 2017
accepted:
12 March 2018
Publication Date:
24 September 2018 (online)
Summary
Background: By the end of the first quarter of 2017, 1212 standard Clinical Pathways (CPs) had been developed and implemented in China since 2009, however, Chinese standard CPs are still paper-based CPs.
Objectives: To optimize the data structure and content of Chinese standard CPs based on Chinese health standards by two-level modeling approach and archetype method, and develop an Open Metadata Schema for Clinical Pathway (openCP) in China.
Methods: We chose 43 diseases covering 7 departments of internal medicine as samples and source materials including Respiratory, Gastroenterology, Neurology, Cardiology, Nephrology, Endocrinology, and Hematology, and we followed 4 steps to develop openCP: identify reference model of openCP; develop archetype models; standardize archetype terms and metadata; and evaluate its functionality.
Results: We have built hierarchical reference model and archetypes of openCP, created and standardized archetype terms and metadata, and evaluate the functionality of openCP. The qualitative comments from 5 doctors were inspiring.
Discussion and Conclusions: Medical staff may easily build localized CPs in openCP which can be integrated into EHR systems and shared among different hospitals and clinics.
-
References
- 1 Clinical Excellence Division of Queensland Government. Clinical Pathways [cited 2016 Aug 12]. Available from: https://www.health.qld.gov.au/improvement/pathways.
- 2 They’re back! Clinical pathways are in favor again. Hosp Case Manag 2015; 23 (02) 13-15.
- 3 The National Health and Family Planning Commission. Clinical Pathway Management and media communication meeting records [cited 2016 Aug 29]. Available from http://www.nhfpc.gov.cn/zhuz/xwfb/201708/a3ea7d5f6efa4a44bf338f1d55e60749.shtml.
- 4 Xu W, Wang ZY, Zhu YX, Wu C, Chen WW, Geng YB. Analysis and Evaluation of Clinical Pathways in China.. Stud Health Technol Inform 2013; 192: 919.
- 5 Okada O, Ohboshi N, Kuroda T, Nagase K, Yoshihara H. Electronic clinical path system based on semistructured data model using personal digital assistant for onsite access.. J Med Syst 2005; 29 (04) 379-89.
- 6 Wakamiya S, Yamauchi K. What are the standard functions of electronic clinical pathways?. Int J Med Inform 2009; 78 (08) 543-550.
- 7 Lenz R, Blaser R, Beyer M, Heger O, Biber C, Bäumlein M. et al. IT support for clinical pathways – lessons learned. Int J Med Inform 2007; 76 (Suppl. 03) S397-402.
- 8 Xu W, Guan ZY, Cao HX, Zhang HY, Lu M, Li TJ. Analysis and evaluation of the Electronic Health Record standard in China: a comparison with the American national standard ASTM E 1384.. Int J Med Inform 2011; 80 (08) 555-561.
- 9 Beale T, Heard S. openEHR Architecture: Architecture Overview. [cited 2017 Dec 5]. Available from: http://www.openehr.org/releases/1.0.2/architecture/overview.pdf
- 10 Beale T. Archetypes: Constraint-based Domain Models for Future-proof Information Systems [cited 2017 Dec 5]. Available from: http://www.openehr.org/files/resources/publications/archetypes/archetypes_beale_oopsla_2002.
- 11 Garcia D, Moro CM, Cintho LM. Bridging the Gap between Clinical Practice Guidelines and Archetype-Based Electronic Health Records: A Novel Model Proposal.. Stud Health Technol Inform 2015; 216: 952.
- 12 Lin CH, Lo YC, Hung PY, Liou DM. Building Chronic Kidney Disease Clinical Practice Guidelines Using the openEHR Guideline Definition Language.. Methods Inf Med 2016; 55 (06) 495-505.
- 13 Kohl CD, Garde S, Knaup P. Facilitating secondary use of medical data by using openEHR archetypes.. Stud Health Technol Inform 2010; 160 Pt 2 1117-1121.
- 14 Garde S, Knaup P, Hovenga E, Heard S. Towards semantic interoperability for electronic health records.. Methods Inf Med 2007; 46 (03) 332-343.
- 15 Xu W, Guan ZY, Sun JH, Wang ZY, Geng YB. Development of an open metadata schema for prospective clinical research (openPCR) in China.. Methods Inf Med 2014; 53 (01) 39-46.
- 16 Statistics Information Center of China’s ministry of health. China national health data dictionary and metadata management system (DRAFT) [cited 2017 Apr 20]. Available from: http://chisc.net/doc/view/6923.html.
- 17 The National Health and Family Planning Commission. Rules for data element standardization of health information (WS/T303–2009) [cited 2017 Jan 15]. Available from: http://www.nhfpc.gov.cn/zwgkzt/s9497/200909/42929.shtml.
- 18 State Administration of Traditional Chinese Medicine. Electronic Health Record (EHR) Architecture and Data Standard (trial version) [cited 2017 Apr 20]. Available from: http://www.moh.gov.cn/zwgkzt/ppxxhjs1/200912/45414.shtml.
- 19 ASTM E 1384: Standard Practice for Content and Structure of the Electronic Health Record (EHR). 2007
- 20 Currie L, Harvey G. Care pathways development and implementation.. Nurs Stand 1998; 12 (30) 35-38.
- 21 Wang HQ, Zhou TS, Zhang YF, Chen L, Li JS. Research and Development of Semantics-based Sharable Clinical Pathway Systems.. J Med Syst 2015; 39 (07) 73.
- 22 Hu Z, Li JS, Zhou TS, Yu HY, Suzuki M, Araki K. Ontology-based clinical pathways with semantic rules.. J Med Syst 2012; 36 (04) 2203-2212.
- 23 Hyde E, Murphy B. Computerized clinical pathways (care plans): piloting a strategy to enhance quality patient care.. Clin Nurse Spec 2012; 26 (05) 277-282.
- 24 Tschopp M, Despond M, Grauser D, Staub JC, Lovis C. Computer-based physician order entry: implementation of clinical pathways.. Stud Health Technol Inform 2009; 150: 673-677.
- 25 Sicotte C, Lapointe J, Clavel S, Fortin MA. Benefits of improving processes in cancer care with a care pathway-based electronic medical record.. Pract Radiat Oncol 2016; 6 (01) 26-33.
- 26 Zhang Y, Padman R, Patel NJ. Paving the COWpath: Learning and visualizing clinical pathways from electronic health record data.. Biomed Inform 2015; 58: 186-197.
- 27 Olive M, Lashwood A, Solomonides T. An approach to using care pathway records for research.. Stud Health Technol Inform 2010; 159: 283-288.
- 28 Ainsworth J, Buchan I. COCPIT: a tool for integrated care pathway variance analysis.. Stud Health Technol Inform 2012; 180: 995-999.
- 29 SNOMED CT The Global Language of Healthcare [cited 2017 Jan 15]. Available from: https://www.snomed.org/snomed-ct.
- 30 Zhang R, Liu JL, Huang Y, Wang MY, Shi QK, Chen J. et al. Enriching the international clinical nomenclature with Chinese daily used synonyms and concept recognition in physician notes.. BMC Med Inform Decis Mak 2017; 17 (01) 54.