An openEHR based approach to improve the semantic interoperability of clinical data registry

摘要

Clinical data registry is designed to collect and manage information about the practices and outcomes of a patient population for improving the quality and safety of care and facilitating novel researches. Semantic interoperability is a challenge when integrating the data from more than one clinical data registry. The openEHR approach can represent the information and knowledge semantics by multi-level modeling, and it advocates the use of collaborative modeling to facilitate reusing existing archetypes with consistent semantics so as to be a potential solution to improve the semantic interoperability. This paper proposed an openEHR based approach to improve the semantic interoperability of clinical data registry. The approach consists of five steps: clinical data registry meta-information collection, data element definition, archetype modeling, template editing, and implementation. Through collaborative modeling and maximum reusing of existing archetype at the archetype modeling step, the approach can improve semantic interoperability. To verify the feasibility of the approach, this paper conducted a case study of building a Coronary Computed Tomography Angiography (CCTA) registry that can interoperate with an existing Electronic Health Record (EHR) system. The CCTA registry includes 183 data elements, which involves 20 archetypes. A total number of 45 CCTA data elements and EHR data elements have semantic overlap. Among them, 38 (84%) CCTA data elements can be found in the 10 reused EHR archetypes. These corresponding clinical data can be collected from the EHR system directly without transformation. The other 7 (16%) CCTA data elements correspond to one coarse-grained EHR data elements, and these clinical data can be collected with mapping rules. The results show that the approach can improve semantic interoperability of clinical data registry. Using an openEHR based approach to develop clinical data registry can improve the semantic interoperability. Meanwhile, some challenges for broader semantic interoperability are identified, including domain experts’ involvement, archetype sharing and reusing, and archetype semantic mapping. Collaborative modeling, easy-to-use tools, and semantic relationship establishment are potential solutions for these challenges. This study provides some experience and insight about clinical modeling and clinical data registry development.