Healthcare Analytics: Electronic Medical Records

Healthcare Analytics: Electronic Medical RecordsTrần Thế Truyền & Shivapratap GopakumarCenter for Pattern Recognition and Data AnalyticsDeakin University, AustraliaEmail: truyen.tran@deakin.edu.auURL: truyen.vietlabs.comHUST, VN, Dec 2013What are EMRs ?Evolving concept:Starting from standardized patient records in the 1900s & 1910s (Mayo Clinic).HIS started in the 1960s.US: Aimed at full digitalization in 2014!Vietnam: Just started.Digital record: Systematic collection of health information about individual patients or populations.Accurately captures the state of the patient at all times.EMR, EHR & PHRElectronic Medical Record (EMR) – contains information from a single organizationElectronic Health Record (EHR) – records that span organizationsPersonal Health Record (PHR) – governments (companies like Google & Microsoft) trying to unify records for citizens.Five Main Functional ComponentsIntegrated view of patient dataClinical decision supportClinician order entryAccess to knowledge resourcesIntegrated communication and reporting support4Integrated view of patient dataRecord demographics, clinical events & episodes (Emergency Visits, Hospitalization, Medication, Risk Assessments, etc).Free text & codes (e.g., ICD-10 system)HL7 messaging standardMultimedia in nature5INTEGRATED DATA VIEW OF MULTIPLE HOSPITAL SYSTEMSMULTI DATA INPUT METHODSFLEXIBLE TO CREATE, EASY TO USESECURE AND ACCESSIBLE, ANYWHEREEMR Connects Services: System of SystemsExpertsMedical ReferencesHospitalPractice ManagementPharmacyRadiologyLaboratoryClinical Decision SupportSupport protocol/planning of treatment/discharge.Suggest course of actions:E.g., medication/dose/duration.Estimate risk & predict outcomes.Alert/reminder.Support (semi) automated diagnosis.7Clinician order entryTrack active orders.Make new orders.Provide warning for a new order.8Integrated communication and reporting supportDoctor-DoctorHospital-HospitalHospital-PatientHospital-GPs9 Other FunctionsMonitor hospital performanceProvide teaching resourcesDetermine charges (billing)Secondary (meaningful) uses10EMR: Different PerspectivesHospitalsData collection for patients +Secondary data (billing, audit etc.)Social SciencesData Mining and AnalysisResearch into socio-technical systemsPrediction of risk: Diseases ReadmissionsValidation, Security, Privacy and EthicsChecking for possible data errors (digits, spelling, range, magnitude of change).Controlled level of access.Secondary use needs ethic approval, depending on the risk levels.Who own the records?Deidentification for data sharing.12EMR in Vietnam Medisoft2003 is software designed by researchers from the MoH-VietnamHTMedsoft is a software designed by Medsoft-Vietnam Co. Ltd and QuestionsDoes EMR help improving quality of care?How much time should clinicians spend at EMR?What is error rate? In what section?14Role of EMR in Healthcare AnalyticsInformation at hand in a given case15Clinical knowledge and previous hypothesis for deciding best treatmentInferential GapMining high dimensional EMR data can help in bridging the Inferential gapChallenges in Mining EMR Data16EMR DataNameAgeAddressDiagnosis codesProceduresOperationsComorbiditiesStatic InformationTime Stamped EventsData is oftenNoisyTemporalIrregularHigh Dimensional