Utilisation d'une observation médicale informatisée à d'autres fins que les soins. Ingénierie des connaissances, évaluation des pratiques et recherche clinique

摘要

Electronic health records generate a large amount of data that can be used for non-clinical purposes. We propose two innovative ways of reusing these clinical data. An update of the computerized medical observation was performed after the analysis of its previous use during routine clinical practice. The deletion of rarely used items was discussed. Terminological analysis of guidelines and free-text answers from the clinical record identified clinically important concepts to be incorporated in the structured part of the record. The evaluation of practice individualization requires a representation of cases with a formal conceptual model. The construction of this ontology was based on the same terminological analysis as above. It underscored concepts pertaining to standardized management and others related to patient centered care. The data have also been reused to perform retrospective observational studies covering the main types of clinical or epidemiological research questions.