■医院电子病历(EMR)系统越来越多地集成到患者数据管理中,特别是考虑到医疗补助和医疗保险服务中心最近发布的政策变化。除了数据管理,这些数据为一系列疾病的以患者为中心的结果研究提供了证据,包括癌症.将EMR患者数据与现有疾病登记处整合可增强所有必要组件,以确保最佳健康结果。
■为了确定提取的机制,链接,并使用佛罗里达癌症数据系统(FCDS)处理医院EMR数据;并评估现有注册治疗数据的完整性以及数据增强的潜力。
■佛罗里达卫生部之间的伙伴关系,FCDS,并建立了佛罗里达州的大型医院系统,以开发医院EMR提取和传输的方法。使用ICD-9-CM代码作为触发因素提取2007年至2010年之间的入院记录,并与乳腺癌浸润性癌症患者的癌症注册表相关联。
■总共11,506例独特患者与总共12,804例独特乳腺肿瘤相关。根据医院EMR对现有的注册治疗数据进行评估,总共有5%的注册记录具有更新的手术信息,1%的记录具有更新的辐射信息,7%的记录更新了化疗信息。化疗药物数据的可用性尤其影响了注册治疗信息的增强。
■医院EMR与癌症疾病登记处的联系是可行的,但由于缺乏数据收集标准而面临挑战,编码和传输,对现有数据的全面描述,以及排除某些医院数据集。FCDS标准治疗数据变量是高度稳健和完整的,但可以通过增加以患者为中心的结果研究中常用的详细化疗方案来增强。
UNASSIGNED: Hospital electronic medical record (EMR) systems are becoming increasingly integrated for management of patient data, especially given recent policy changes issued by the Centers for Medicaid and Medicare Services. In addition to data management, these data provide evidence for patient-centered outcomes research for a range of diseases, including cancer. Integrating EMR patient data with existing disease registries strengthens all essential components for assuring optimal health outcomes.
UNASSIGNED: To identify the mechanisms for extracting, linking, and processing hospital EMR data with the Florida Cancer Data System (FCDS); and to assess the completeness of existing registry treatment data as well as the potential for data enhancement.
UNASSIGNED: A partnership among the Florida Department of Health, FCDS, and a large Florida hospital system was established to develop methods for hospital EMR extraction and transmission. Records for admission years between 2007 and 2010 were extracted using ICD-9-CM codes as the trigger and were linked with the cancer registry for patients with invasive cancers of the breast.
UNASSIGNED: A total of 11,506 unique patients were linked with a total of 12,804 unique breast tumors. Evaluation of existing registry treatment data against the hospital EMR produced a total of 5% of registry records with updated surgery information, 1% of records with updated radiation information, and 7% of records updated with chemotherapy information. Enhancement of registry treatment information was particularly affected by the availability of chemotherapy medications data.
UNASSIGNED: Hospital EMR linkages to cancer disease registries is feasible but challenged by lack of standards for data collection, coding and transmission, comprehensive description of available data, and the exclusion of certain hospital datasets. The FCDS standard treatment data variables are highly robust and complete but can be enhanced by the addition of detailed chemotherapy regimens that are commonly used in patient centered outcomes research.