|
Robert H. Dolin answers a
few questions about this month's fast breaking paper in
the field of Social Sciences, general.
From
•>>December 2006
Field:
Social Sciences, general
Article Title: HL7 Clinical Document Architecture, Release 2
Authors: Dolin,
RH;Alschuler, L;Boyer, S;Beebe, C;Behlen, FM;Biron, PV;Shabo, A
Journal: J AMER MED INFORM ASSOC
Volume: 13
Issue: 1
Page: 30-39
Year: JAN-FEB 2006
* 411 N Lakeview Ave, Anaheim, CA 92807 USA.
* Kaiser Permanente, Pasadena, CA USA.
* Alschuler Associates LLC, E Thetford, VA USA.
* Mayo Clin, Rochester, MN USA.
* LAI Technol, Homewood, IL USA.
* IBM Haifa Res Lab, Haifa, Israel.
|
 Why
do you think your paper is highly cited?
Because it is addressing a large problem—that of
standardizing the contents of clinical notes.
|
“The HL7 Clinical Document Architecture defines a standard for the computer representation of clinical notes such as clinician progress notes, discharge summaries, consultations.”
|
|
The overriding driving force behind the development of the
HL7 Clinical Document Architecture (CDA) standard has been the
desire to further encode the narrative statements found in
clinical reports, and to do so in such a way as to enable
comparison of content from documents created on information
systems of widely varying characteristics.
Does
it describe a new discovery, methodology, or synthesis of
knowledge?
CDA builds upon years of international work in standards and
data representation. Inspiration and requirements used to guide
the process have come from implementation experience with the
first version of the standard; comparison with other models,
such as CEN ENV 13606, openEHR, and DICOM; national initiatives
for exchange of referral and medical summary documents; trade
show demonstrations; medical natural language processing models;
and more.
Could
you summarize the significance of your paper in layman’s terms?
The need for a clinical document standard stems from the
desire to unlock the considerable clinical content currently
stored in free-text clinical notes and to enable comparison of
content from documents created on information systems of widely
varying characteristics. Given the variability in clinical
notes, including structure, underlying information models,
degree of semantic encoding, use of standard healthcare
terminologies, and platform- and vendor-specific features, it is
currently difficult to store and exchange documents with
retention of standardized semantics over both time and distance.
The HL7 Clinical Document Architecture defines a standard for
the computer representation of clinical notes such as clinician
progress notes, discharge summaries and consultations. As we
standardize, we enable the computer to do more in terms of
alerts, reminders, and decision support.
For instance, in a recent demonstration, we created a CDA
document in one vendor’s electronic health record, and then
sent the note to another vendor where they were able to import
it. In the other vendor’s application, I tried to order
penicillin for the patient, but because the CDA document had
standardized the representation of allergy data, the application
was able to alert me that I was about to prescribe a medication
that the patient is allergic to.
How
did you become involved in this research, and were any problems
encountered along the way?
I've been interested in medical informatics and standards
since I built my first electronic health record some 15 years
ago. Consensus standards take a long time to develop. The best
standards are those that have been tested and reviewed by a wide
range of implementors.
Are there any social or political implications for your
research?
CDA is an international standard, and is already serving as
the foundation of national electronic health record strategies
in many countries.
Robert H. Dolin, M.D., F.A.C.P., F.A.C.M.I.
Kaiser Permanente
Department of Medicine
La Palma, CA, USA
|
ESI Special Topics,
December 2006
Citing URL - http://www.esi-topics.com/fbp/2006/december06-RobertHDolin.html
|
|
