半自动管道,加速多站点流程对齐和电子健康记录中的概念映射。

IF 4.6 2区 医学 Q1 COMPUTER SCIENCE, INFORMATION SYSTEMS
Hao Fan, Sarah C Rossetti, Jennifer Thate, Rosemary Mugoya, Albert M Lai, Po-Yin Yen
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引用次数: 0

摘要

目标:医疗保健机构定制电子健康记录(EHR)配置,以反映其独特的工作流程和患者护理优先事项。确保跨站点的EHR一致性有助于无缝的信息交换。我们开发了一个管道,用于在医疗保健组织之间对齐电子病历流程。该管道通过将流程图数据字段映射到临床护理分类(CCC)护理术语中的概念来增强。材料和方法:将2个研究点的流程模板和措施转化为模板-措施(T-M)对。它们通过精确的、词汇的或语义的匹配进行对齐。使用Jaccard相似度和模糊匹配方法评估词汇匹配。使用大型语言模型生成的T-M对嵌入和CCC概念之间的余弦相似度来确定语义对齐,并对CCC中排名前n的概念进行排序和推荐。概念映射的评估基于概念在CCC层次结构中的映射是否一致。结果:我们在两个研究地点的急诊科共对31 255对独特的T-M对进行了比对,重症监护病房对27 012对进行了比对。当仅限于排名最高的CCC概念(n = 1)时,我们实现了63%的流程图对齐率和53%的概念映射率。扩展到前3个概念(n = 3)将一致性提高到96.5%,概念映射提高到96%。讨论和结论:电子健康记录数据字段与概念映射的一致性提供了标准化医疗保健站点流程图中呈现的数据元素的机会。我们演示了利用半自动化管道简化EHR流程对齐并加速手动概念映射过程的可行性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Semi-automated pipeline to accelerate multi-site flowsheet alignment and concept mapping in electronic health records.

Objectives: Health-care institutions customize electronic health record (EHR) configurations to reflect their unique workflows and patient care priorities. Ensuring EHR alignment across sites facilitates seamless information exchange. We developed a pipeline for EHR flowsheet alignment between health-care organizations. The pipeline is augmented by mapping flowsheet data fields to concepts in the Clinical Care Classification (CCC) nursing terminology.

Materials and methods: Flowsheet templates and measures from 2 study sites were transformed into template-measure (T-M) pairs. They were aligned through exact, lexical, or semantic matching. Lexical matches were assessed using Jaccard similarity and fuzzy matching methods. Semantic alignment was determined using cosine similarity between large language model-generated embeddings of T-M pairs and CCC concepts to rank and recommend the top n concepts in CCC. Concept mappings were evaluated based on whether concepts were mapped consistently within the CCC hierarchy.

Results: We totally aligned 31 255 unique T-M pairs in acute care units and 27 012 T-M pairs in intensive care units from 2 study sites. When restricted to the top-ranked CCC concept (n = 1), we achieved a 63% flowsheet alignment rate with a 53% concept mapping rate. Expanding to the top 3 concepts (n = 3) improved alignment to 96.5% and concept mapping to 96%.

Discussion and conclusion: Electronic health record data field alignment with concept mapping offers opportunities to standardize data elements presented in flowsheets across health-care sites. We demonstrated the feasibility of leveraging a semi-automated pipeline to streamline the EHR flowsheet alignment and accelerate the manual concept mapping process.

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来源期刊
Journal of the American Medical Informatics Association
Journal of the American Medical Informatics Association 医学-计算机:跨学科应用
CiteScore
14.50
自引率
7.80%
发文量
230
审稿时长
3-8 weeks
期刊介绍: JAMIA is AMIA''s premier peer-reviewed journal for biomedical and health informatics. Covering the full spectrum of activities in the field, JAMIA includes informatics articles in the areas of clinical care, clinical research, translational science, implementation science, imaging, education, consumer health, public health, and policy. JAMIA''s articles describe innovative informatics research and systems that help to advance biomedical science and to promote health. Case reports, perspectives and reviews also help readers stay connected with the most important informatics developments in implementation, policy and education.
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