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CC BY-NC-ND 4.0 · Methods Inf Med 2018; 57(S 01): e92-e105
DOI: 10.3414/ME18-02-0004
Focus Theme – Original Articles
Schattauer GmbH

Smart Medical Information Technology for Healthcare (SMITH)[*]

Data Integration based on Interoperability Standards
Alfred Winter
1   Leipzig University, Institute of Medical Informatics, Statistics and Epidemiology, Leipzig, Germany
,
Sebastian Stäubert
1   Leipzig University, Institute of Medical Informatics, Statistics and Epidemiology, Leipzig, Germany
,
Danny Ammon
2   University Medical Center Jena, Central Service Provider For Information Technology, Jena, Germany
,
Stephan Aiche
3   SAP SE, Potsdam, Germany
,
Oya Beyan
4   RWTH Aachen University, Chair of Computer Science 5, Aachen, Germany
,
Verena Bischoff
5   University of Leipzig Medical Center, Division Staff and Justice, Leipzig, Germany
,
Philipp Daumke
6   Averbis GmbH, Freiburg, Germany
,
Stefan Decker
4   RWTH Aachen University, Chair of Computer Science 5, Aachen, Germany
,
Gert Funkat
7   University of Leipzig Medical Center, Division Information Management, Leipzig, Germany
,
Jan E. Gewehr
8   University Medical Center Hamburg-Eppendorf, Business Division for Information Technology, Hamburg, Germany
,
Armin de Greiff
9   Essen University Hospital, Central Information Technology, Essen, Germany
,
Silke Haferkamp
10   RWTH Aachen University Hospital, Division Information Technology, Aachen, Germany
,
Udo Hahn
11   Friedrich-Schiller-Universität Jena, Language & Information Engineering Lab (JULIE Lab), Jena, Germany
,
Andreas Henkel
2   University Medical Center Jena, Central Service Provider For Information Technology, Jena, Germany
,
Toralf Kirsten
12   Leipzig University, LIFE Research Centre for Civilization Diseases, Leipzig, Germany
,
Thomas Klöss
13   Martin-Luther-Universität Halle-Wittenberg Medical Center, Medical Director, Halle, Germany
,
Jörg Lippert
14   Bayer AG, Wuppertal, Germany
,
Matthias Löbe
1   Leipzig University, Institute of Medical Informatics, Statistics and Epidemiology, Leipzig, Germany
,
Volker Lowitsch
10   RWTH Aachen University Hospital, Division Information Technology, Aachen, Germany
,
Oliver Maassen
15   RWTH Aachen University Hospital, Department of Intensive Care and Intermediate Care, Aachen, Germany
,
Jens Maschmann
16   University Medical Center Jena, Medical Director, Jena, Germany
,
Sven Meister
17   Fraunhofer Institute for Software and Systems Engineering, Dortmund, Germany
,
Rafael Mikolajczyk
18   Martin-Luther-Universität Halle-Wittenberg, Institute of Medical Epidemiology, Biometry and Informatics, Halle, Germany
,
Matthias Nüchter
12   Leipzig University, LIFE Research Centre for Civilization Diseases, Leipzig, Germany
,
Mathias W. Pletz
19   University Medical Center Jena, Institute of Infectious Diseases and Infection Control, Jena, Germany
,
Erhard Rahm
20   Leipzig University, Department of Computer Science – Database Group, Leipzig, Germany
,
Morris Riedel
21   Forschungszentrum Jülich, Jülich Supercomputing Centre, Jülich, Germany
,
Kutaiba Saleh
2   University Medical Center Jena, Central Service Provider For Information Technology, Jena, Germany
,
Andreas Schuppert
22   RWTH Aachen University, Institute for Computational Biomedicine II, Aachen, Germany
,
Stefan Smers
7   University of Leipzig Medical Center, Division Information Management, Leipzig, Germany
,
André Stollenwerk
23   RWTH Aachen University, Informatik 11 – Embedded Software, Aachen, Germany
,
Stefan Uhlig
24   RWTH Aachen University, Medical Faculty, Dean, Aachen, Germany
,
Thomas Wendt
25   University of Leipzig Medical Center, Data Integration Center, Leipzig, Germany
,
Sven Zenker
26   University of Bonn Medical Center, Department of Anesthesiology and Intensive Care Medicine, Bonn, Germany
,
Wolfgang Fleig   **
27   University of Leipzig Medical Center, Medical Director, Leipzig, Germany
,
Gernot Marx   **
15   RWTH Aachen University Hospital, Department of Intensive Care and Intermediate Care, Aachen, Germany
,
André Scherag   **
28   University Medical Center Jena, Center for Sepsis Control and Care, Jena, Germany
29   University Medical Center Jena, Institute of Medical Statistics, Computer and Data Sciences (IMSID), Jena, Germany
,
Markus Löffler   **
1   Leipzig University, Institute of Medical Informatics, Statistics and Epidemiology, Leipzig, Germany
› InstitutsangabenFunding: This work has been supported by German Federal Ministry of Education and Research (Grant No’s. 01ZZ1609A, 01ZZ1609B, 01ZZ1609C, 01ZZ1803A, 01ZZ1803B, 01ZZ1803C, 01ZZ1803D, 01ZZ1803E, 01ZZ1803F, 01ZZ1803G, 01ZZ1803H, 01ZZ1803I, 01ZZ1803J, 01ZZ1803K, 01ZZ1803L, 01ZZ1803M, 01ZZ1803N).
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Publikationsverlauf

received: 05. März 2018

accepted: 07. Mai 2018

Publikationsdatum:
17. Juli 2018 (online)

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Summary

Introduction: This article is part of the Focus Theme of Methods of Information in Medicine on the German Medical Informatics Initiative. “Smart Medical Information Technology for Healthcare (SMITH)” is one of four consortia funded by the German Medical Informatics Initiative (MI-I) to create an alliance of universities, university hospitals, research institutions and IT companies. SMITH’s goals are to establish Data Integration Centers (DICs) at each SMITH partner hospital and to implement use cases which demonstrate the usefulness of the approach.

Objectives: To give insight into architectural design issues underlying SMITH data integration and to introduce the use cases to be implemented.

Governance and Policies: SMITH implements a federated approach as well for its governance structure as for its information system architecture. SMITH has designed a generic concept for its data integration centers. They share identical services and functionalities to take best advantage of the interoperability architectures and of the data use and access process planned. The DICs provide access to the local hospitals’ Electronic Medical Records (EMR). This is based on data trustee and privacy management services. DIC staff will curate and amend EMR data in the Health Data Storage.

Methodology and Architectural Framework: To share medical and research data, SMITH’s information system is based on communication and storage standards. We use the Reference Model of the Open Archival Information System and will consistently implement profiles of Integrating the Health Care Enterprise (IHE) and Health Level Seven (HL7) standards. Standard terminologies will be applied. The SMITH Market Place will be used for devising agreements on data access and distribution. 3LGM2 for enterprise architecture modeling supports a consistent development process.

The DIC reference architecture determines the services, applications and the standards-based communication links needed for efficiently supporting the ingesting, data nourishing, trustee, privacy management and data transfer tasks of the SMITH DICs. The reference architecture is adopted at the local sites. Data sharing services and the market place enable interoperability.

Use Cases: The methodological use case “Phenotype Pipeline” (PheP) constructs algorithms for annotations and analyses of patient-related phenotypes according to classification rules or statistical models based on structured data. Unstructured textual data will be subject to natural language processing to permit integration into the phenotyping algorithms. The clinical use case “Algorithmic Surveillance of ICU Patients” (ASIC) focusses on patients in Intensive Care Units (ICU) with the acute respiratory distress syndrome (ARDS). A model-based decision-support system will give advice for mechanical ventilation. The clinical use case HELP develops a “hospital-wide electronic medical record-based computerized decision support system to improve outcomes of patients with blood-stream infections” (HELP). ASIC and HELP use the PheP. The clinical benefit of the use cases ASIC and HELP will be demonstrated in a change of care clinical trial based on a step wedge design.

Discussion: SMITH’s strength is the modular, reusable IT architecture based on interoperability standards, the integration of the hospitals’ information management departments and the public-private partnership. The project aims at sustainability beyond the first 4-year funding period.

Keywords

Health information interoperability - inte grated advanced information management systems - systems integration - phenotyping - intensive care - antimicrobial stewardship

* Supplementary material published on our website https://doi.org/10.3414/ME18-02-0004


** Shared senior authorship