ArticleJournal of the American Medical Informatics Association : JAMIA
Lessons learned in detailed clinical modeling at Intermountain Healthcare.
Article in Journal of the American Medical Informatics Association : JAMIA. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Clinical information modeling processes for semantic interoperability of electronic health records: systematic review and inductive analysis.Journal of the American Medical Informatics Association : JAMIA · 2015Pooled it
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- Lessons Learned in Creating Interoperable Fast Healthcare Interoperability Resources Profiles for Large-Scale Public Health Programs.Applied clinical informatics · 2019Article
- Evaluation of clinical information modeling tools.Journal of the American Medical Informatics Association : JAMIA · 2016Article
- An information model for computable cancer phenotypes.BMC medical informatics and decision making · 2016Article
- Clinical element models in the SHARPn consortium.Journal of the American Medical Informatics Association : JAMIA · 2016Article
- A Decade of Experience in Creating and Maintaining Data Elements for Structured Clinical Documentation in EHRs.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2016Article
- Profiling Fast Healthcare Interoperability Resources (FHIR) of Family Health History based on the Clinical Element Models.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2016Article
- Automatic Extraction and Post-coordination of Spatial Relations in Consumer Language.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2015Article
- Normalization and standardization of electronic health records for high-throughput phenotyping: the SHARPn consortium.Journal of the American Medical Informatics Association : JAMIA · 2013Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
BACKGROUND AND
objectiveIntermountain Healthcare has a long history of using coded terminology and detailed clinical models (DCMs) to govern storage of clinical data to facilitate decision support and semantic interoperability. The latest iteration of DCMs at Intermountain is called the clinical element model (CEM). We describe the lessons learned from our CEM efforts with regard to subjective decisions a modeler frequently needs to make in creating a CEM. We present insights and guidelines, but also describe situations in which use cases conflict with the guidelines. We propose strategies that can help reconcile the conflicts. The hope is that these lessons will be helpful to others who are developing and maintaining DCMs in order to promote sharing and interoperability.
methodsWe have used the Clinical Element Modeling Language (CEML) to author approximately 5000 CEMs.
resultsBased on our experience, we have formulated guidelines to lead our modelers through the subjective decisions they need to make when authoring models. Reported here are guidelines regarding precoordination/postcoordination, dividing content between the model and the terminology, modeling logical attributes, and creating iso-semantic models. We place our lessons in context, exploring the potential benefits of an implementation layer, an iso-semantic modeling framework, and ontologic technologies.
conclusionsWe assert that detailed clinical models can advance interoperability and sharing, and that our guidelines, an implementation layer, and an iso-semantic framework will support our progress toward that goal.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.