The Research Of Stroke Data Modeling Based On OpenEHR

Stroke is a neurological deficit caused by vascular central nervous system damage,including cerebral infarction,intracranial hemorrhage and subarachnoid hemorrhage.Stroke has the characteristics of high morbidity,high mortality,high disability rate,high recurrence rate and high economic burden.The 2016 Global Burden of Disease report pointed out that stroke was already the second leading cause of death in the world,and stroke had been the first cause of death among residents in China in 2008.In recent years,due to the aging of the population and poor control of related risk factors,the number of stroke patients in China has continued to increase,and stroke has become a major public health problem in China.With the development of medical informatization,such as the popularization of electronic medical records,various medical institutions have accumulated massive and growing stroke data.Stroke data contains huge potential value,and effective use of these data plays an important role in improving the quality of stroke medical care,reducing medical expenses,and facilitating the progress and development of stroke prevention and treatment.However,the sources of stroke data are extensive and dispersed,such as different hospitals,communities,and medical examination institutions;The content of stroke data is complex and growing,including both general medical data and specialized disease medical data;The degree of standardization and structuring of stroke data is low,and the data structure is diverse,including structured,semi-structured and unstructured data.These greatly hinder the effective use of stroke data.The interoperability of medical information is able to facilitate the effective use of medical data,and the multi-level model of medical information has gradually become the main method to solve the semantic interoperability of medical information.How to use the muti-level model of medical information to solve the problem of semantic interoperability of stroke data has important theoretical significance and practical value.The openEHR specifications are medical information standards proposed by the openEHR Foundation.The medical information muti-level model and open collaborative modeling mechanism it provides are widely used in countries such as the United States,Australia,Japan,the United Kingdom,and Denmark,which are main international medical information model standards.However,there is no relatively mature stroke information model based on openEHR in the domestic and overseas.In response to the challenges above,this thesis does research on stroke data modeling based on openEHR,taking the National Health Commission’s Stroke Prevention Project screening data and medical records data as the research objects,and proposes a collaborative modeling method,and conducts a stroke screening data model and the specialized disease electronic medical record data model of stroke that provide medical information model standards for promoting the standardized collection,sharing and utilization of stroke data.The main content of this thesis is as follows:1.Analyze and summarize the current status of stroke data,and analyze the HL7V3,FHIR,CDE,OMOP CDM data model and openEHR multi-level model.On this basis,a collaborative modeling framework for stroke data based on openEHR is proposed.2.Propose a semantic interoperability-oriented stroke data collaborative modeling method,including 8 steps: establishment of a collaborative group,data requirements collection,domain concept refinement,archetypes and attributes mapping,archetypes construction,templates construction,models review and release.3.In response to the needs of the National Stroke Screening and Intervention Project,the method proposed in this thesis was used to carry out cross-regional and cross-domanial collaborative modeling,and a stroke screening data model containing117 domain concepts,40 archetypes and a stroke screening template were constructed.4.Based on the needs of specialized diseases electronic medical records for stroke,a cross-regional and multi-field collaborative modeling was carried out,and a data model for specialized disease electronic medical records for stroke and an admission note template were constructed,which included 51 domain concepts and 38 archetypes.5.The archetypes and templates constructed in this research have been applied to the National Stroke High-risk Population Screening and Intervention Information Platform and the Distributed Cerebrovascular Disease Specialized Disease Database Platform,and the feasibility and effectiveness of the methods and results of this thesis are verified through practice.