Integrating electronic health records in clinical decision support systems

Abstract

Electronic Health Records (EHR) are systematic collections of digital health information about individual patients or populations. They provide readily access to the complete medical history of the patient, which is useful for decision-making activities. In this paper we focus on a secondary benefit of EHR: the reuse of the implicit knowledge embedded in it to improve the knowledge on the mechanisms of a disease and/or the effectiveness of the treatments. In fact, all such patient data registries stored in EHR reflect implicitly different clinical decisions made by the clinical professionals that participated in the assistance of patients (e.g. criteria followed during decision making, patient parameters taken into account, effect of the treatments prescribed). This work proposes a methodology that allows the management of EHR not only as data containers and information repositories, but also as clinical knowledge repositories. Moreover, we propose an architecture for the extraction of the knowledge from EHR. Such knowledge can be fed into a Clinical Decision Support System (CDSS), in a way that could render benefits for the development of innovations from clinicians, health managers and medical researchers.