■语义互操作性促进了对电子健康记录(EHR)中记录的具有各种语义特征的健康数据的交换和访问。语义互操作性开发的主要目标需要患者数据的可用性,并在不丧失意义的情况下在不同的EHR中使用。国际上,当前的举措旨在加强EHR数据的语义开发,因此,患者数据的可用性。卫生信息系统之间的互操作性是欧洲卫生数据空间法规提案和世界卫生组织《2020-2025年全球数字卫生战略》的核心目标之一。
■为了实现集成的健康数据生态系统,利益相关者需要克服实现语义互操作性元素的挑战。为了研究语义互操作性发展的现有科学证据,我们定义了以下研究问题:构建集成在EHR中的语义互操作性的关键要素和方法是什么?推动发展的目标是什么?以及在这种发展之后可以感知到什么样的临床益处?
■我们的研究问题集中在语义互操作性的关键方面和方法以及在EHR背景下这些选择可能的临床和语义益处。因此,我们在PubMed中进行了系统的文献综述,根据以往的研究定义了我们的研究框架.
■我们的分析包括14项研究,其中数据模型,本体论,术语,分类,和标准被应用于建筑互操作性。所有文章都报道了所选方法增强语义互操作性的临床益处。我们确定了3个主要类别:增加临床医生的数据可用性(n=6,43%),提高护理质量(n=4,29%),并加强临床数据的使用和重复使用,用于不同的目的(n=4,29%)。关于语义发展目标,不同EHR之间的数据协调和语义互操作性发展是最大的类别(n=8,57%).通过标准化提高健康数据质量(n=5,36%)和开发基于可互操作数据的EHR集成工具(n=1,7%)是其他确定的类别。结果与需要从可通过各种EHR和数据库访问的异构医疗信息中构建可用和可计算的数据(例如,寄存器)。
■当走向临床数据的语义协调时,需要更多的经验和分析来评估所选择的解决方案如何适用于医疗数据的语义互操作性。而不是推广单一的方法,语义互操作性应该通过几个层次的语义需求来评估。双模型或多模型方法可能可用于解决开发过程中的不同语义互操作性问题。语义互操作性的目标将在分散和断开的临床护理环境中实现。因此,增强临床数据可用性的方法应该做好准备,思考出来,并有理由满足经济上可持续和长期的结果。
UNASSIGNED: Semantic interoperability facilitates the exchange of and access to health data that are being documented in electronic health records (EHRs) with various semantic features. The main goals of semantic interoperability development entail patient data availability and use in diverse EHRs without a loss of meaning. Internationally, current initiatives aim to enhance semantic development of EHR data and, consequently, the availability of patient data. Interoperability between health information systems is among the core goals of the European Health Data Space regulation proposal and the World Health Organization\'s Global Strategy on Digital Health 2020-2025.
UNASSIGNED: To achieve integrated health data ecosystems, stakeholders need to overcome challenges of implementing semantic interoperability elements. To research the available scientific evidence on semantic interoperability development, we defined the following research questions: What are the key elements of and approaches for building semantic interoperability integrated in EHRs? What kinds of goals are driving the development? and What kinds of clinical benefits are perceived following this development?
UNASSIGNED: Our research questions focused on key aspects and approaches for semantic interoperability and on possible clinical and semantic benefits of these choices in the context of EHRs. Therefore, we performed a systematic literature review in PubMed by defining our study framework based on previous research.
UNASSIGNED: Our analysis consisted of 14 studies where data models, ontologies, terminologies, classifications, and standards were applied for building interoperability. All articles reported clinical benefits of the selected approach to enhancing semantic interoperability. We identified 3 main categories: increasing the availability of data for clinicians (n=6, 43%), increasing the quality of care (n=4, 29%), and enhancing clinical data use and reuse for varied purposes (n=4, 29%). Regarding semantic development goals, data harmonization and developing semantic interoperability between different EHRs was the largest category (n=8, 57%). Enhancing health data quality through standardization (n=5, 36%) and developing EHR-integrated tools based on interoperable data (n=1, 7%) were the other identified categories. The results were closely coupled with the need to build usable and computable data out of heterogeneous medical information that is accessible through various EHRs and databases (eg, registers).
UNASSIGNED: When heading toward semantic harmonization of clinical data, more experiences and analyses are needed to assess how applicable the chosen solutions are for semantic interoperability of health care data. Instead of promoting a single approach, semantic interoperability should be assessed through several levels of semantic requirements A dual model or multimodel approach is possibly usable to address different semantic interoperability issues during development. The objectives of semantic interoperability are to be achieved in diffuse and disconnected clinical care environments. Therefore, approaches for enhancing clinical data availability should be well prepared, thought out, and justified to meet economically sustainable and long-term outcomes.