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Reviewing the integration of patient data: how systems are evolving in practice to meet patient needs.

Cruz-Correia RJ, Vieira-Marques PM, Ferreira AM, Almeida FC, Wyatt JC, Costa-Pereira AM - BMC Med Inform Decis Mak (2007)

Bottom Line: Regarding the type of medical data shared, 77% of projects integrated diagnosis and problems, 67% medical images and 65% lab results.More recently significantly more IS are extending to primary care and integrating referral letters.Many distinct technological solutions coexist to integrate patient data, using differing standards and data architectures which may difficult further interoperability.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Biostatistics and Medical Informatics, Faculty of Medicine of University of Porto, Porto, Portugal. rcorreia@med.up.pt

ABSTRACT

Background: The integration of Information Systems (IS) is essential to support shared care and to provide consistent care to individuals--patient-centred care. This paper identifies, appraises and summarises studies examining different approaches to integrate patient data from heterogeneous IS.

Methods: The literature was systematically reviewed between 1995-2005 to identify articles mentioning patient records, computers and data integration or sharing.

Results: Of 3124 articles, 84 were included describing 56 distinct projects. Most of the projects were on a regional scale. Integration was most commonly accomplished by messaging with pre-defined templates and middleware solutions. HL7 was the most widely used messaging standard. Direct database access and web services were the most common communication methods. The user interface for most systems was a Web browser. Regarding the type of medical data shared, 77% of projects integrated diagnosis and problems, 67% medical images and 65% lab results. More recently significantly more IS are extending to primary care and integrating referral letters.

Conclusion: It is clear that Information Systems are evolving to meet people's needs by implementing regional networks, allowing patient access and integration of ever more items of patient data. Many distinct technological solutions coexist to integrate patient data, using differing standards and data architectures which may difficult further interoperability.

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Diagram showing the methods used for study selection.
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Figure 1: Diagram showing the methods used for study selection.

Mentions: To maximize specificity, only selection by both reviewers was considered adequate. In cases of disagreement a third reviewer was called to decide. A total of 84 out of 923 articles were selected to be read entirely. These 84 articles were grouped into 69 distinct integration projects to avoid the distortion created by multiple papers describing the same project. All statistical analysis is based on projects and not on articles. Some of articles (n = 13) were descriptions of project plans or architecture models that were not already implemented on a real scenario nor even as a prototype. These projects were also excluded, leaving only 56 projects. Figure 1 is a flowchart illustrating the different stages of paper selection.


Reviewing the integration of patient data: how systems are evolving in practice to meet patient needs.

Cruz-Correia RJ, Vieira-Marques PM, Ferreira AM, Almeida FC, Wyatt JC, Costa-Pereira AM - BMC Med Inform Decis Mak (2007)

Diagram showing the methods used for study selection.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1919361&req=5

Figure 1: Diagram showing the methods used for study selection.
Mentions: To maximize specificity, only selection by both reviewers was considered adequate. In cases of disagreement a third reviewer was called to decide. A total of 84 out of 923 articles were selected to be read entirely. These 84 articles were grouped into 69 distinct integration projects to avoid the distortion created by multiple papers describing the same project. All statistical analysis is based on projects and not on articles. Some of articles (n = 13) were descriptions of project plans or architecture models that were not already implemented on a real scenario nor even as a prototype. These projects were also excluded, leaving only 56 projects. Figure 1 is a flowchart illustrating the different stages of paper selection.

Bottom Line: Regarding the type of medical data shared, 77% of projects integrated diagnosis and problems, 67% medical images and 65% lab results.More recently significantly more IS are extending to primary care and integrating referral letters.Many distinct technological solutions coexist to integrate patient data, using differing standards and data architectures which may difficult further interoperability.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Biostatistics and Medical Informatics, Faculty of Medicine of University of Porto, Porto, Portugal. rcorreia@med.up.pt

ABSTRACT

Background: The integration of Information Systems (IS) is essential to support shared care and to provide consistent care to individuals--patient-centred care. This paper identifies, appraises and summarises studies examining different approaches to integrate patient data from heterogeneous IS.

Methods: The literature was systematically reviewed between 1995-2005 to identify articles mentioning patient records, computers and data integration or sharing.

Results: Of 3124 articles, 84 were included describing 56 distinct projects. Most of the projects were on a regional scale. Integration was most commonly accomplished by messaging with pre-defined templates and middleware solutions. HL7 was the most widely used messaging standard. Direct database access and web services were the most common communication methods. The user interface for most systems was a Web browser. Regarding the type of medical data shared, 77% of projects integrated diagnosis and problems, 67% medical images and 65% lab results. More recently significantly more IS are extending to primary care and integrating referral letters.

Conclusion: It is clear that Information Systems are evolving to meet people's needs by implementing regional networks, allowing patient access and integration of ever more items of patient data. Many distinct technological solutions coexist to integrate patient data, using differing standards and data architectures which may difficult further interoperability.

Show MeSH