Julius – a template based supplementary electronic health record system
Dimension | Wert |
---|---|
Abdeckungsgrad im Standardisierungsvorhaben | |
Adressierte/Referenzierte Richtlinien und Verordnungen (sofern gegeben) | |
FIM-Baustein | |
FIM-Baustein Formulare: Umfang Formularstandardisierung |
|
Standardisierungstyp | |
Standardisierungsverfahren/-organisation |
|
Status | |
Verbindlichkeit | |
Umsetzungsgrad: In Entwicklung seit | 01.01.2007 |
Background: EHR systems are widely used in hospitals and primary care centres but it is usually
difficult to share information and to collect patient data for clinical research. This is partly due to
the different proprietary information models and inconsistent data quality. Our objective was to
provide a more flexible solution enabling the clinicians to define which data to be recorded and
shared for both routine documentation and clinical studies. The data should be possible to reuse
through a common set of variable definitions providing a consistent nomenclature and validation of
data. Another objective was that the templates used for the data entry and presentation should be
possible to use in combination with the existing EHR systems.
Methods: We have designed and developed a template based system (called Julius) that was
integrated with existing EHR systems. The system is driven by the medical domain knowledge
defined by clinicians in the form of templates and variable definitions stored in a common data
repository. The system architecture consists of three layers. The presentation layer is purely webbased,
which facilitates integration with existing EHR products. The domain layer consists of the
template design system, a variable/clinical concept definition system, the transformation and
validation logic all implemented in Java. The data source layer utilizes an object relational mapping
tool and a relational database.
Results: The Julius system has been implemented, tested and deployed to three health care units
in Stockholm, Sweden. The initial responses from the pilot users were positive. The template
system facilitates patient data collection in many ways. The experience of using the template system
suggests that enabling the clinicians to be in control of the system, is a good way to add
supplementary functionality to the present EHR systems.
Conclusion: The approach of the template system in combination with various local EHR systems
can facilitate the sharing and reuse of validated clinical information from different health care units.
However, future system developments for these purposes should consider using the openEHR/
CEN models with shareable archetypes.