Julius – a template based supplementary electronic health record system

Dimension Wert
Abdeckungsgrad im Standardisierungsvorhaben
  • Standardisierung von Strukturen
  • Technische Standardisierung
  • Adressierte/Referenzierte Richtlinien und Verordnungen (sofern gegeben)
  • Europäische Richtlinien
  • FIM-Baustein
  • Formulare
  • Leistungsbeschreibungen
  • Prozesse
  • FIM-Baustein Formulare: Umfang Formularstandardisierung
    • einzelne Formularfelder
      • Standardisierung des Feldtyps
      • Standardisierung des Formularfeldinhalts
  • gesamte Formulare
  • Formularabschnitte
  • einzelne Formularfelder
  • Standardisierungstyp
  • Technischer Standard
  • Organisatorische Standards (bspw. redaktionelle Standards)
  • Standardisierungsverfahren/-organisation
    • multinationale Standardisierungs- bzw. Normungsverfahren
      • ISO Internationale Organisation für Normung
      • CEN Europäisches Komitee für Normung
  • Norm
  • Verbindlichkeit
  • Nutzung für bestimmte Anwendergruppe verpflichtend
  • Umsetzungsgrad: In Entwicklung seit01.01.2007

    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.