Biomedical subjects

Knut Bernstein

Publications and source records attributed to Knut Bernstein.

9 recordsLinked to original sources

PubMed2006

A method for specification of structured clinical content in electronic health records.

The Copenhagen County is using clinical guidelines in the electronic health record development to provide documentation support, process support and decision support for the healthcare professionals. The electronic health record development is based on three main components: The first component is a national information model. The second component is a common classification system (SNOMED). The third key component is the so-called "clinical content". This paper describes the structured "clinical content", how it is linked to the clinical process, and how it is used to create clinical guidelines in the form of standard care plans. The Copenhagen County and MEDIQ has developed a methodology for identifying and specifying structured "clinical content" to be used in electronic health records. The method combines analyses of national clinical guidelines with local experience and practices and it heavily involves healthcare professionals. The method includes four main steps: Analyses of background material, analyses of clinical process-flow, mapping to standards (the national information model and the common classification system), and specification of the structured clinical content itself. Three secondary steps may be added to specify the clinical content in more detail: Workflow analyses, analyses of quality indicators, and decision analyses. This paper reports the experiences using the method and stresses the demand for a common exchange format and IT-tools for documenting clinical content in a formalised way.

Decision Support Systems, Clinical↗

PubMed2005

Development, implementation and diffusion of EHR systems in Denmark.

The Danish EHR-Observatory has monitored Danish EHR projects for several years with respect to a number of parameters such as diffusion, diffusion rate, barriers and limitations, and experience gained. The results of the 2002 monitoring reveal that investment in IT is relatively low and the diffusion rate is below the estimated level. The EHR projects gain a lot of valuable experience, but the coordination of evaluation results should be improved.

Denmark↗

PubMed2005

Modelling and implementing electronic health records in Denmark.

The Danish Health IT strategy [Danish Ministry of Interior and Health, National Strategy for IT in the Health Sector 2003-2007, Copenhagen, 2003 (in Danish). http://www.im.dk/publikationer/itstrategi/itstrategi.pdf. notes that integration between electronic health records (EHR) systems has a high priority. A prerequisite for real integration and semantic interoperability is agreement of the data content and the information models. The National Board of Health is working on a common model for EHR, and its adoption is now being promoted through pilot projects. At the same time, several development and implementation projects are taking place at a regional level. These EHRs are built on information models from different vendors and are based on different integration platforms. The Danish EHR observatory, which has been monitoring the development of EHRs in Denmark since 1998, has analysed the challenges of using different information models and integration platforms. This paper also maps the development in Denmark to the new paradigms in modelling techniques and integration technology.

Computer Simulation↗

PubMed2005

Quality labelling and certification of electronic health record systems.

The Danish Health IT strategy 2003-2007 demands implementation of Electronic Health Records (EHR) in all Hospitals based on common standards. The aim is to achieve integration and semantic interoperability between different EHR systems in order to support a better communication and coherence between the health care parties. The National Board of Health has developed a common model, which is a prerequisite for the development and implementation of interoperable EHR systems. The adoption of the common EHR model has been promoted and validated through a number of pilot projects in different Hospitals. The Danish EHR Observatory, which has been monitoring the development of EHR in Denmark since 1998, have developed a methodology for Quality labelling and certification of EHR systems. The methodology for certification of EHR systems has been used to validate EHR systems from different vendors to document to which extent the systems are based on the national requirements for EHR.

Certification↗

PubMed2003

Collaboration--a new IT-service in the next generation of regional health care networks.

During the past 10-15 years, Regional Health Care Networks (RHCN) have been established in many regions throughout the world. RHCN build on well-known techniques, methodologies and appropriate standards. Most of the European Countries today have set up IT strategic plans that focus on the establishment of RHCN. The benefits of having access to all relevant information are tremendous and contribute to cost-effective and coherent health services. By the rapid spread and use of Internet, technology has made it possible to interconnect all kinds of applications. In 2000, the most experienced regions in Europe joined PICNIC, a European project to develop the Next Generation Regional Health Care Networks and to support their new ways of providing health and social care. The previous generation of Regional Health Care Networks supported the interconnection of applications by transfer of messages. Messaging is an effective means of integration for isolated high-specialised systems that only need to exchange data. This service will continue to be one of the most important services in the future health care networks. However, tighter coupling may be desirable in some instances to avoid replicating the same functionality in several applications. In other words, certain services can be common and used by a number of applications instead of building that service inside each application. These common services are called middleware services. In PICNIC (http://www.medcom.dk/picnic), a new middleware Collaboration IT service has been identified and developed. This service allows the end users to perform real-time clinical collaboration, with exchange of text, structured data, voice and images across the limits of a single region. A clinical collaboration is associated with the shared clinical context to provide a record of relevant clinical information and facilitates synchronous as well as asynchronous collaboration. This new IT service builds on the increasing popularity of instance messaging and presence systems that facilitate smooth transition between synchronous and asynchronous interaction. The new Collaboration IT service is expected to have a strong impact on the practice of health care in the next generation of Regional Health Care Networks.

Communication↗

PubMed2003

Modelling and implementing electronic health records in Denmark.

The Danish Health IT strategy [1] points out that integration between electronic health records (EHR) systems has a high priority. A prerequisite for real integration and semantic interoperability is agreement of the data content and the information models. The National Board of Health is working on a common model for EHR, but it is not yet fully developed. At the same time several development and implementation projects are taking place at a regional level. These EHRs are built on information models from different vendors and are based on different integration platforms. The Danish EHR observatory, which has been monitoring the development of EHRs in Denmark since 1998, have analysed the challenges of using different information models and integration platforms. This paper also reports new tendencies in modelling and integration platforms globally and how this is reflected in the National development.

Denmark↗

PubMed2003

Monitoring the development and diffusion of EHR systems in Denmark.

The Danish EHR Observatory has monitored Danish EHR projects for several years with respect to a number of parameters such as diffusion, diffusion rate, barriers and limitations, and experience gained. The results of the 2002 monitoring reveal that investment in IT is relatively low and the diffusion rate is below the estimated level. The EHR projects gain a lot of valuable experience, but the coordination of evaluation results should be improved.

Denmark↗

PubMed2002

A comparative study of EPR projects in Denmark.

The EPR-Observatory--a public funded project organization--has monitored Danish EPR-projects with respect to various parameters such as diffusion and diffusion rate, barriers and limitations, experience gained. Furthermore, the Observatory has aggregated and disseminated the results and has established a constructive dialogue between the Danish EPR projects. The Observatory has also focused in the later years on analysis of common frames of reference for EPR systems. The National Board of Health and some of the larger counties have developed such frames. First generation systems have been implemented in a few counties with moderate coverage, but a number of projects developing second generation systems are making progress, and the market situation is quickly maturing. There are still, however, major problems in the practical implementation of the systems.

Denmark↗

PubMed2002

Collaboration--a new IT-service in the next generation of regional health care networks.

During the past 10-15 years, Regional Health Care Networks have been established in many regions throughout the world. Regional Health Care Networks build on well-known techniques, methodologies and appropriate standards. Most of the European Countries have today set up IT strategic plans, with focus on establishment of Regional Health Care Networks. The benefits of having access to all relevant information are tremendous and provide a more cost-effective and coherent health service. By the rapid spread and use of Internet the technology have made it possible to interconnect all kinds of applications. The most experienced regions in Europe have joined a European project PICNIC to develop the Next Generation Regional Health Care Networks to support their new ways of providing health and social care. The previous generation of Regional Health Care Networks, developed in the past 10-15 years, supported the interconnection of applications by transfer of messages. This service will also continue to be one of the most important services in the future health care networks. Messaging is an effective means of integration of isolated high-specialised systems that only needs to exchange data. Tighter coupling may be desirable in some instances to avoid replicating the same functionality in several applications. In other words, certain services can be common and used by a number of applications instead of building that service inside each application. These common services are called middleware services. In PICNIC a new middleware Collaboration IT-service has been identified. This service allows the end users to perform real time clinical Collaboration, with exchange of text, structured data, voice and images.

Cooperative Behavior↗