GARDE: a standards-based clinical decision support platform for identifying population health management cohorts

被引：14

作者：

Bradshaw, Richard L. ^{[1
,2
]}

Kawamoto, Kensaku ^{[1
,2
]}

Kaphingst, Kimberly A. ^{[3
,4
]}

Kohlmann, Wendy K. ^{[2
,3
,5
]}

Hess, Rachel ^{[2
,5
,6
]}

Flynn, Michael C. ^{[2
,6
,7
]}

Nanjo, Claude J. ^{[1
,2
]}

Warner, Phillip B. ^{[1
,2
]}

Shi, Jianlin ^{[1
]}

Morgan, Keaton ^{[1
,2
,8
]}

Kimball, Kadyn ^{[3
]}

Ranade-Kharkar, Pallavi ^{[1
,9
]}

Ginsburg, Ophira ^{[10
]}

Goodman, Melody ^{[11
]}

Chambers, Rachelle ^{[10
]}

Mann, Devin ^{[10
]}

Narus, Scott P. ^{[1
]}

Gonzalez, Javier ^{[10
]}

Loomis, Shane ^{[10
,12
]}

Chan, Priscilla ^{[10
]}

Monahan, Rachel ^{[10
]}

Borsato, Emerson P. ^{[1
]}

Shields, David E. ^{[1
,2
]}

Martin, Douglas K. ^{[1
,2
]}

Kessler, Cecilia M. ^{[2
,4
]}

Del Fiol, Guilherme ^{[1
]}

机构：

[1] Univ Utah, Dept Biomed Informat, 421 Wakara Way,Suite 140, Salt Lake City, UT 84108 USA

[2] Univ Utah Hlth, Salt Lake City, UT USA

[3] Univ Utah, Huntsman Canc Inst, Salt Lake City, UT 84108 USA

[4] Univ Utah, Dept Commun, Salt Lake City, UT 84108 USA

[5] Univ Utah, Dept Populat Hlth Sci, Salt Lake City, UT 84108 USA

[6] Univ Utah, Dept Internal Med, Salt Lake City, UT 84108 USA

[7] Univ Utah, Community Phys Grp, Salt Lake City, UT 84108 USA

[8] Univ Utah, Dept Surg, Salt Lake City, UT 84108 USA

[9] Intermt Healthcare, Salt Lake City, UT USA

[10] New York Univ Langone Hlth, New York, NY USA

[11] NYU, Sch Global & Publ Hlth, New York, NY USA

[12] Epic Syst Corp, Madison, WI USA

来源：

JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION | 2022年 / 29卷 / 05期

关键词：

clinical decision support system (D020000); population health management (D000076602); Health Level Seven (D057208); FHIR; CDS Hooks; FHIR; CARE;

D O I：

10.1093/jamia/ocac028

中图分类号：

TP [自动化技术、计算机技术];

学科分类号：

0812 ;

摘要：

Population health management (PHM) is an important approach to promote wellness and deliver health care to targeted individuals who meet criteria for preventive measures or treatment. A critical component for any PHM program is a data analytics platform that can target those eligible individuals. Objective The aim of this study was to design and implement a scalable standards-based clinical decision support (CDS) approach to identify patient cohorts for PHM and maximize opportunities for multi-site dissemination. Materials and Methods An architecture was established to support bidirectional data exchanges between heterogeneous electronic health record (EHR) data sources, PHM systems, and CDS components. HL7 Fast Healthcare Interoperability Resources and CDS Hooks were used to facilitate interoperability and dissemination. The approach was validated by deploying the platform at multiple sites to identify patients who meet the criteria for genetic evaluation of familial cancer. Results The Genetic Cancer Risk Detector (GARDE) platform was created and is comprised of four components: (1) an open-source CDS Hooks server for computing patient eligibility for PHM cohorts, (2) an open-source Population Coordinator that processes GARDE requests and communicates results to a PHM system, (3) an EHR Patient Data Repository, and (4) EHR PHM Tools to manage patients and perform outreach functions. Site-specific deployments were performed on onsite virtual machines and cloud-based Amazon Web Services. Discussion GARDE's component architecture establishes generalizable standards-based methods for computing PHM cohorts. Replicating deployments using one of the established deployment methods requires minimal local customization. Most of the deployment effort was related to obtaining site-specific information technology governance approvals.

引用

页码：928 / 936

页数：9

共 28 条

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