Formalize clinical processes into electronic health information systems: Modelling a screening service for diabetic retinopathy

Aitor Eguzkiza; Jesús Daniel Trigo; Miguel Martínez-Espronceda; Luis Serrano; José Andonegui

doi:10.1016/j.jbi.2015.05.017

Formalize clinical processes into electronic health information systems: Modelling a screening service for diabetic retinopathy

J Biomed Inform. 2015 Aug:56:112-26. doi: 10.1016/j.jbi.2015.05.017. Epub 2015 Jun 3.

Authors

Aitor Eguzkiza¹, Jesús Daniel Trigo², Miguel Martínez-Espronceda³, Luis Serrano⁴, José Andonegui⁵

Affiliations

¹ Department of Electrical and Electronic Engineering, Public University of Navarra, Campus de Arrosadia, 31006 Pamplona, Spain. Electronic address: aitor.eguzkiza@unavarra.es.
² Department of Electrical and Electronic Engineering, Public University of Navarra, Campus de Arrosadia, 31006 Pamplona, Spain. Electronic address: jesusdaniel.trigo@unavarra.es.
³ Department of Electrical and Electronic Engineering, Public University of Navarra, Campus de Arrosadia, 31006 Pamplona, Spain. Electronic address: miguel.martinezdeespronceda@unavarra.es.
⁴ Department of Electrical and Electronic Engineering, Public University of Navarra, Campus de Arrosadia, 31006 Pamplona, Spain; Institute of Smart Cities - ISC, Public University of Navarra, Campus de Arrosadia, 31006 Pamplona, Spain. Electronic address: lserrano@unavarra.es.
⁵ Department of Ophthalmology, Complejo Hospitalario de Navarra, 31008 Pamplona, Spain. Electronic address: jose.andonegui.navarro@cfnavarra.es.

PMID: 26049092
DOI: 10.1016/j.jbi.2015.05.017

Abstract

Most healthcare services use information and communication technologies to reduce and redistribute the workload associated with follow-up of chronic conditions. However, the lack of normalization of the information handled in and exchanged between such services hinders the scalability and extendibility. The use of medical standards for modelling and exchanging information, especially dual-model based approaches, can enhance the features of screening services. Hence, the approach of this paper is twofold. First, this article presents a generic methodology to model patient-centered clinical processes. Second, a proof of concept of the proposed methodology was conducted within the diabetic retinopathy (DR) screening service of the Health Service of Navarre (Spain) in compliance with a specific dual-model norm (openEHR). As a result, a set of elements required for deploying a model-driven DR screening service has been established, namely: clinical concepts, archetypes, termsets, templates, guideline definition rules, and user interface definitions. This model fosters reusability, because those elements are available to be downloaded and integrated in any healthcare service, and interoperability, since from then on such services can share information seamlessly.

Keywords: Clinical knowledge modelling; Diabetic retinopathy; Dual-model layered architecture; Electronic health record; Ophthalmology; Semantic interoperability.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Algorithms
Diabetic Retinopathy / diagnosis*
Diagnosis, Computer-Assisted / methods
Electronic Health Records / standards*
Health Information Systems / standards*
Humans
Information Storage and Retrieval
Mass Screening / methods
Medical Informatics / methods*
Medical Informatics / standards*
Patient-Centered Care
Program Development
Retina / pathology
Spain
Systems Integration
User-Computer Interface