Introduction of Enhancement Technologies into the Intensive Care Service,Royal Prince Alfred Hospital,Sydney

Abstract

In order to achieve the full potential of information technology in healthcare, information systems must have the ability to share and exchange data, which requires the support of standardised medical terminology, such as Systematised Nomenclature of Medicine – Clinical Terms (SNOMED-CT). The Royal Prince Alfred Intensive Care Service and the School of Information Technologies, University of Sydney have been collaborating for over two years, developing pioneering software initiatives for clinical information systems (CIS). More recently, the collaboration resulted in the development of two prototype systems. The Ward Round Information System (WRIS) has been designed to convert clinicians' clinical notes into the formal medical encoding ontology SNOMED-CT, thus enabling more consistent descriptions of patient conditions and allowing large-scale retrieval and analysis from the narrative part of the patient record. In addition, a Clinical Data Analytics Language (CDAL) system has also been developed and is designed to answer questions of the data stored in the CIS. It will assist clinicians in the management of vast amounts of complex information generated during an ICU admission and ultimately improve the quality and efficiency of care. CDAL provides clinicians with the ability to frame any question about their data in their database and get the answer almost immediately. Both systems went live in October 2007, and this report summarises the background, purpose, and progress thus far.

Keywords

Intensive Care Natural Language Processing Systematised Nomenclature of Medicine – Clinical Terms Clinical Terminologies Clinical Documentation Medical Records Clinical Information Systems

Get full access to this article

View all access options for this article.

References

Bates

Evans

Murff

Stetson

Pizziferri

Hripcsak

(2003). Detecting Adverse Events Using Information Technology. Journal of the American Medical Informatics Association 10(2):115–128. Available at: http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=150365&blobtype=pdf (accessed 03 January 2008).

Chen

Enberg

Klein

(2007). Julius – A Template Based Supplementary Electronic Health Records System. BMC Medical Informatics and Decision Making, 7(10): 1–11. Available at: http://www.biomedcentral.com/content/pdf/1472-6947-7-10.pdf (accessed 03 January 2008).

Cruz-Correia

Vieira-Marques

Ferreira

Almeida

Wyatt

Costa-Pereira

(2007) Reviewing the Integration of Patient Data: How Systems are Evolving in Practice to Meet Patient Needs. BMC Medical Informatics and Decision Making 7(14):1–11. Available at: http://www.biomedcentral.com/content/pdf/1472-6947-7-14.pdf (accessed 03 January 2008).

Detmer

(2003). Building the National Health Information Infrastructure for Personal Health, Health Care Services, Public Health and Research. BMC Medical Informatics and Decision Making 3(1): 1–12. Available at: http://www.biomedcentral.com/content/pdf/1472-6947-3-1.pdf (accessed 03 January 2008).

Elkin

Brown

Bauer

Husser

Carruth

Bergstrom

Wahner-Roedler

(2005). A Controlled Trial of Automated Classification of Negation from Clinical Notes. BMC Medical Informatics and Decision Making 5 (13):1–7. Available at: http://www.biomedcentral.com/content/pdf/1472-6947-5-13.pdf (accessed 03 January 2008).

Elkin

Brown

Husser

Bauer

Wahner-Roedler

Rosenbloom

Speroff

(2006). Evaluation of the Content Coverage of SNOMED-CT: Ability of SNOMED Clinical Terms to Represent Clinical Problem Lists. Mayo Clinic Proceedings 81(6):741–748. Available at: http://www.mayoclinicproceedings.com/pdf%2F8106%2F8106a1.pdf (accessed 03 January 2008).

Garde

Hovenga

Granz

Foozonkhah

Heard

(2007). Managing Archetypes for Sustainable and Semantically Interoperable Electronic Health Records. electronic Journal of Health Informatics 2(2):1–10. Available at: http://ejhi.net/ojs/index.php/ejhi/article/view/2%282%29%3Ae9/23 (accessed 03 January 2008).

Health Level 7 EHR Interoperability Work Group (2007). Coming to Terms: Scoping Interoperability for Healthcare. Available at: http://www.hln.com/assets/pdf/Coming-to-Terms-February-2007.pdf (accessed 03 January 2008).

Hrabak

Campbell

McClure

Weida

(2007). Creating Interoperable Guidelines: Requirements of Vocabulary Standards in Immunisation Decision Support. MEDInfo Proceedings Part 2 IOS Press: 930–934.

10.

International Health Terminology Standards Development Organisation (2007). History: SNOMED, International Health Terminology Standards Development Organisation website Available at: http://www.ihtsdo.org/about-us/history/snomed/ (accessed 03 January 2008).

11.

Kannry

Wright

Shifman

Silverstein

Miller

(1996). Portability Issues for a Structured Clinical Vocabulary: Mapping from Yale to the Columbia Medical Entities Dictionary. Journal of the American Medical Informatics Association 3(1):66–78. Available at: http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=116288&blobtype=pdf (accessed 03 January 2008).

12.

National E-Health Transition Authority (2007a). NEHTA SNOMED CT – July 2007 International Release: Release Notes. NEHTA, Sydney, Australia. Available at: http://www.nehta.gov.au/index.php?option=com_docman&task=cat_view&gid=-2&Itemid=139 (accessed 03 January 2008).

13.

National E-Health Transition Authority (2007b). Terminologies for the Australian Health Sector. NEHTA, Sydney, Australia. Available at: https://nehta.org.au/aht/ (accessed 03 January 2008).

14.

Patrick

Wang

Miller

O'Halloran

(2007). Automatic Mapping of ICPC-2 PLUS terms to the SNOMED-CT Terminology. electronic Journal of Health Informatics 2(2): 1–7. Available at: http://ejhi.net/ojs/index.php/ejhi/article/view/2%282%29%3Ae11/27 (accessed 03 January 2008).

15.

Sun

(2006). A System for Automated Lexical Mapping. Journal of the American Medical Informatics Association 13(3): 334–343. Available at: http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1513662&blobtype=pdf (accessed 03 January 2008).

16.

Wang

Patrick

Miller

O'Halloran

(2006). Linguistic Mapping of Terminologies to SNOMED-CT. Proceedings of the Semantic Mining Conference, Copenhagen, Denmark. Available at: http://www.hiww.org/smcs2006/proceedings/6WangSMCS2006final.pdf (accessed 03 January 2008).