Using Existing Clinical Information Models for Dutch Quality Registries to Reuse Data and Follow COUMT Paradigm

Applied Clinical Informatics, vol. 14, pp. 326–336

Abstract

BACKGROUND: Reuse of health care data for various purposes, such as the care process, for quality measurement, research, and finance, will become increasingly important in the future; therefore, "Collect Once Use Many Times" (COUMT). Clinical information models (CIMs) can be used for content standardization. Data collection for national quality registries (NQRs) often requires manual data entry or batch processing. Preferably, NQRs collect required data by extracting data recorded during the health care process and stored in the electronic health record. OBJECTIVES: The first objective of this study was to analyze the level of coverage of data elements in NQRs with developed Dutch CIMs (DCIMs). The second objective was to analyze the most predominant DCIMs, both in terms of the coverage of data elements as well as in their prevalence across existing NQRs. METHODS: For the first objective, a mapping method was used which consisted of six steps, ranging from a description of the clinical pathway to a detailed mapping of data elements. For the second objective, the total number of data elements that matched with a specific DCIM was counted and divided by the total number of evaluated data elements. RESULTS: An average of 83.0% (standard deviation: 11.8%) of data elements in studied NQRs could be mapped to existing DCIMs . In total, 5 out of 100 DCIMs were needed to map 48.6% of the data elements. CONCLUSION: This study substantiates the potential of using existing DCIMs for data collection in Dutch NQRs and gives direction to further implementation of DCIMs. The developed method is applicable to other domains. For NQRs, implementation should start with the five DCIMs that are most prevalently used in the NQRs. Furthermore, a national agreement on the leading principle of COUMT for the use and implementation for DCIMs and (inter)national code lists is needed.

Authors 11

1. Maike H. J. Schepens corresponding Aachen Department of Biomedical Data Sciences

   Leiden University Medical Center

   Affiliation as printed

   Cirka BV, Healthcare Strategy and Innovation, Zeist, The Netherlands

   Department of Biomedical Data Sciences, LUMC, Leiden, The Netherlands

2. Annemarie C. Trompert Aachen Dutch Institute for Clinical Auditing

   Dutch Institute for Clinical Auditing

   Affiliation as printed

   Dutch Institute for Clinical Auditing, Leiden, The Netherlands

3. Miranda L. van Hooff

   Radboud University Nijmegen · Radboud University Medical Center · Sint Maartenskliniek

   Affiliation as printed

   Department of Orthopedics, Radboud UMC, Nijmegen, The Netherlands

   Department of Orthopedics, Sint Maartenskliniek, Nijmegen, The Netherlands

4. Erik van der Velde
   Affiliation as printed

   Dutch Association of Medical Specialists, Utrecht, The Netherlands

   Zorgverbeteraars, Healthcare IT Consulting, Roden, The Netherlands

5. Marjon Kallewaard
   Affiliation as printed

   Dutch Association of Medical Specialists, Utrecht, The Netherlands

6. Iris J. A. M. Verberk-Jonkers

   Maasstad Ziekenhuis

   Affiliation as printed

   Department of Nephrology, Maasstad Hospital, Rotterdam, The Netherlands

   Dutch Association of Medical Specialists, Utrecht, The Netherlands

7. Huib A. Cense

   University of Groningen · Rode Kruis Ziekenhuis

   Affiliation as printed

   Department of Health System Innovation. Faculty of Economics and Business, Groningen University. Groningen, The Netherlands

   Department of Surgery, Rode Kruis Hospital, Beverwijk, The Netherlands

8. Diederik Meindert Somford

   Canisius-Wilhelmina Ziekenhuis

   Affiliation as printed

   Department of Urology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands

9. Sjoerd Repping

   Amsterdam University Medical Centers · University of Amsterdam

   Affiliation as printed

   Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands

10. Selma C. Tromp Aachen Department of Neurology, Leiden University Medical Center (LUMC)

    Leiden University Medical Center

    Affiliation as printed

    Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands

    Dutch Association of Medical Specialists, Utrecht, The Netherlands

11. Michel W.J.M. Wouters Aachen Department of Biomedical Data Sciences Department of Neurology, Leiden University Medical Center (LUMC)

    Leiden University Medical Center · The Netherlands Cancer Institute

    Affiliation as printed

    Department of Biomedical Data Sciences, LUMC, Leiden, The Netherlands

    Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands

    Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands