Methods Inf Med 2007; 46(05): 580-585
DOI: 10.1160/ME9060
Paper
Schattauer GmbH

Experiences with an Interoperable Data Acquisition Platform for Multi-centric Research Networks Based on HL7 CDA

A. Klein
1   Department of Medical Informatics, University of Erlangen-Nuremberg, Erlangen, Germany
,
H.-U. Prokosch
1   Department of Medical Informatics, University of Erlangen-Nuremberg, Erlangen, Germany
,
M. Müller
2   Department of Dermatology, University of Freiburg, Freiburg, Germany
,
T. Ganslandt
1   Department of Medical Informatics, University of Erlangen-Nuremberg, Erlangen, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
22 January 2018 (online)

Summary

Objectives: Today’s increasing specialization of medicine necessitates the integration oftelematic platforms for cross-institutional cooperation. In orderto leverage the strengths of each cooperating institution a centralized unified storage using shared electronic patient records (EPRs) as well as secured remote data entry capabilities for supporting collaborative clinical research and care is essential. The objective of this project was to develop and introduce into routine use such a shared remote data entry (RDE) platform for the German multicentric Epidermolysis Bullosa (EB) network.

Methods: An existing telematic application was extended by a remote data entry (RDE) module enabling thestorage of structured data and pedigrees. HL7 Clinical Document Architecture (CDA) was chosen as a suitable standardized storage format that provides flexibility and future interoperability. Flexible data entry forms adaptable to distinct medical domains were implemented using XML-based technologies.

Results: A flexible and comprehensive ePR/RDE platform was successfully implemented in the German EB network. A set of specific data entry forms was created to fully cover the network’s documentation needs. The platform has been in productive use since 2005.

Conclusions: Standardized documentation by using HL7 CDA to store the medical research data as an EPR can contribute to high interoperability and an easier integration of heterogeneous health care information systems. Existing XML technologies offer a high degree of flexibility and adaptability to distinct medical domains. The ongoing development of standards (e.g. HL7 CDA R2) and interfaces (CDA/CDISC bridge) could further improve semantic and syntactic interoperability.

 
  • References

  • 1 Knaup P, Garde S, Merzweiler A, Graf N, Schilling F, Weber R, Haux R. Towards shared patient records: an architecture for using routine data for nationwide research. Int J Med Inform 2006; 75 3-4 191-200.
  • 2 Poulymenopoulou M, Vassilacopoulos G. An electronic patient record implementation using clinical document architecture. Stud Health Technol Inform 2004; 103: 50-57.
  • 3 Prokosch HU, Ganslandt T, Dumitru RC, Ueckert F. Telemedicine and Collaborative Health Information Systems. it – Information Technology 2006; 48: 12-23.
  • 4 van der Haak M, Mludek V, Wolff AC, Buelze-bruck H, Oetzel D, Zierhut D, Drings P, Wannenmacher M, Haux R. Networking in shared care – first steps towards a shared electronic patient record for cancer patients. Methods Inf Med 2002; 41: 419-425.
  • 5 Clark AM, Findlay IN. Attaining adequate consent for the use of electronic patient records: an opt-out strategy to reconcile individuals’ rights and public benefit. Public Health 2005; 119: 1003-1010.
  • 6 van der Haak M, Wolff AC, Brandner R, Drings P, Wannenmacher M, Wetter T. Data security and protection in cross-institutional electronic patient records. Int J Med Inform 2003; 70: 117-130.
  • 7 Safran C, Goldberg H. Electronic patient records and the impact of the Internet. Int J Med Inform 2000; 60: 77-83.
  • 8 Kuhn KA, Giuse DA. From hospital information systems to health information systems. Problems, challenges, perspectives. Methods Inf Med 2001; 40: 275-287.
  • 9 Schabetsberger T, Ammenwerth E, Andreatta S, Gratl G, Haux R, Lechleitner G, Schindelwig K, Stark C, Vogl R, Wilhelmy I, Wozak F. From a paper-based transmission of discharge summaries to electronic communication in health care regions. Int J Med Inform 2006; 75: 209-215.
  • 10 Ganslandt T, Ruderich F, Prokosch HU. Building a Communications Infrastructure for a Multi-Centric Research Network. J Qual Life Res. 2004; 2 (01) 125-127.
  • 11 Graf N, Paulussen M, Huf T, Ganslandt T, Stahl J, Jurgens H. Telemedicine in pediatric oncology. Klin Padiatr 2002; 214 (01) 8-13.
  • 12 Brinkmann L, Klein A, Ganslandt T, Uckert F. Implementing a data safety and protection concept for a web-based exchange of variable medical image data. Int Congr Ser 2005; 1281: 191-195.
  • 13 Lachmund P, Nebel I, Führer D, Paschke R. The pedigree tool: web-based visualization of a family tree. Hum Mutat 2004; 23: 103-105.
  • 14 Brandt CA, Sun K, Charpentier P, Nadkarni PM. Integration of Web-based and PC-based clinical research databases. Methods Inf Med 2004; 43: 287-295.
  • 15 Brandt CA, Gadagkar R, Rodriguez C, Nadkarni PM. Managing complex change in clinical study metadata. J Am Med Inform Assoc 2004; 11: 80-391.
  • 16 Reng CM, Debold P, Specker C, Pommerening K. Generische Lösungen zum Datenschutz für die Forschungsnetze in der Medizin – Schriftenreihe der Telematikplattform für Medizinische Forschungsnetze.. Berlin: Medizinisch Wissenschaftliche Verlagsgesellschaft; 2006
  • 17 Nadkarni PM, Brandt CM, Marenco L. WebEAV: automatic metadata-driven generation of web interfaces to entity-attribute-value databases. J Am Med In form Assoc 2000; 7: 343-356.
  • 18 Beck P, Truskaller T, Rakovac I, Cadonna B, Pieber TR. On-the-fly form generation and online metadata conf iguration -aclinical data management Web infrastructure in Java. Stud Health Technol Inform 2006; 124: 271-276.
  • 19 Nadkarni PM, Brandt CA. The common data elements for cancer research: remarks on functions and structure. Methods Inf Med 2006; 45: 594-601.
  • 20 Brandt CA, Argraves S, Money R, Ananth G, Trocky NM, Nadkarni PM. Informatics tools to improve clinical research study implementation. Contemp Clin Trials 2006; 27: 112-122.
  • 21 Dolin R, Alschuler L, Beebe C, Biron P, Boyer SL, Essin D, Kimber E, Lincoln T, Mattison J. The HL7 Clinical Document Architecture. J Am Med In form Assoc 2001; 8: 552-569.
  • 22 Muller ML, Uckert F, Burkle T, Prokosch HU. Cross-institutional data exchange using the clinical document architecture (CDA). Int J Med Inform 2005; 74 2-4 245-256.
  • 23 Iberson-Hurst D. The CDISC Operational Data Model: Ready to Roll? Applied Clinical Trials. 2004: 25-28.
  • 24 Rassinoux A, Lovis C, Baud R, Geissbuhler A. XML as standard for communicating in a document-based electronic patient record: a 3 years experiment. Int J Med Inform 2003; 70: 109-115.
  • 25 Gerdsen F, Müller S, Jablonski S, Prokosch HU. Standardized exchange of clinical documents – towards a shared care paradigm in glaucoma treatment. Methods Inf Med 2006; 45: 359-366.
  • 26 Bludau HB, Wolff A, Hochlehnert AJ. Presenting XML-based medical discharge letters according to CDA. Methods Inf Med 2003; 42: 552-556.
  • 27 Heitmann KU, Schweiger R, Dudeck J. Discharge and referral data exchange using global standards – the SCIPHOX project in Germany. Int J Med Inform 2003; 70: 195-203.
  • 28 BRIDG Project. www.bridgproject.org. Last accessed: 2007-01-23.
  • 29 Hollerbach A, Brandner R, Bess A, Schmücker P, Bergh B. Electronically Signed Documents in Health Care. Methods Inf Med 2005; 44 (04) 520-527.
  • 30 Wuebbelt P, Fernandez G, Heymer J. Clinical trial management and remote data entry on the Internet based on XML case report forms. Stud Health Technol Inform 2000; 77: 333-337.
  • 31 van der Linden H, Grimson J, Tange H, Talmon J, Hasman A. Archetypes: the PropeR way. Medinfo 2004; 11 (Pt 2): 1110-1114.