• MeSH
• Medical Informatics MeSH
• Hospital Information Systems MeSH
• Publication type
• Congress MeSH
• Collected Work MeSH

• Conspectus
• Lékařské vědy. Lékařství
• NML Fields
• lékařská informatika

• MeSH
• Medical Informatics MeSH
• Publication type
• Congress MeSH
• Collected Work MeSH

• Conspectus
• Lékařské vědy. Lékařství
• NML Fields
• lékařská informatika

Ciele: Výmena dát v prostredí českého zdravotníctva je väčšinou založená na národných štandardoch. Tento článok popisuje využitie medzinárodných štandardov a nomenklatúr na skonštruovanie pilotnej platformy sémantickej interoperability (PSI), ktorá by slúžila na výmenu informácií medzi systémami elektronických zdravotných záznamov (EZZ) v českom zdravotníctve. Táto práca bola zastrešená národným výskumným projektom programu „Informačná spoločnosť“. Metódy: Na začiatku projektu boli formulované požiadavky, ktoré by mala PSI splňovať. Bolo analyzovaných niekoľko komunikačných štandardov (openEHR, HL7 v3, DICOM) a HL7 v3 bol zvolený pre naše riešenie na výmenu medicínskych záznamov. Do pilotného prostredia boli zahrnuté dva systémy: WinMedicalc 2000 a EZZ ADAMEKj. Výsledky: Na popis informačného obsahu oboch systémov boli vytvorené Lokálne Informačné Modely (LIM) založené na HL7. Koncepty z našich pôvodných informačným modelov boli namapované na kódovacie systémy podporované HL7 (LOINC, SNOMED CT and ICD-10) a výmena dát pomocou správ HL7 v3 bola naimplementovaná a otestovaná pomocou dotazov na pacientove administratívne údaje. Ako brána medzi lokálnymi systémami EZZ (sEZZ) a infraštruktúrou založenou na správach HL7 slúžil nami vyvinutý konfigurovateľný HL7 broker. Záver: Celonárodná implementácia PSI v plnej veľkosti založená na HL7 v3 by zahrňovala prijatie a preklad príslušných medzinárodných kódovacích systémov a nomenklatúr, vytvorenie implementačných postupov uľahčujúcich migráciu od národných štandardov po tie medzinárodné. Naša pilotná štúdia ukázala, že náš prístup je uskutočniteľný, ale úplná integrácia systému českého zdravotníctva do európskeho kontextu e-zdravia bude vyžadovať ešte veľké úsilie.

Objectives: The data interchange in the Czech healthcare environment is mostly based on national standards. This paper describes a utilization of international standards and nomenclatures for building a pilot semantic interoperability platform (SIP) that would serve to exchange information among electronic health record systems (EHR-Ss) in Czech healthcare. The work was performed by the national research project of the „Information Society" program. Methods: At the beginning of the project a set of requirements the SIP should meet was formulated. Several communication standards (openEHR, HL7 v3, DICOM) were analyzed and HL7 v3 was selected to exchange health records in our solution. Two systems were included in our pilot environment: WinMedicalc 2000 and ADAMEKj EHR. Results: HL7-based local information models were created to describe the information content of both systems. The concepts from our original information models were mapped to coding systems supported by HL7 (LOINC, SNOMED CT and ICD-10) and the data exchange via HL7 v3 messages was implemented and tested by querying patient administration data. As a gateway between local EHR systems and the HL7 message-based infrastructure, a configurable HL7 Broker was developed. Conclusions: A nationwide implementation of a full-scale SIP based on HL7 v3 would include adopting and translating appropriate international coding systems and nomenclatures, and developing implementation guidelines facilitating the migration from national standards to international ones. Our pilot study showed that our approach is feasible but it would demand a huge effort to fully integrate the Czech healthcare system into the European e-health context.

• MeSH
• Medical Records Systems, Computerized standards   MeSH
• Financing, Organized MeSH
• Information Systems trends   utilization   MeSH
• Hospital Information Systems standards   utilization   MeSH
• Programming Languages MeSH
• Semantics MeSH
• Systems Integration MeSH
• Information Storage and Retrieval MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Czech Republic MeSH

• MeSH
• Morbidity MeSH
• Delivery of Health Care statistics & numerical data   MeSH
• National Health Programs MeSH
• Health Care Reform MeSH
• Health MeSH

• Conspectus
• Veřejné zdraví a hygiena
• NML Fields
• management, organizace a řízení zdravotnictví
• veřejné zdravotnictví
• ekonomie, ekonomika, ekonomika zdravotnictví
• statistika, zdravotnická statistika
• NML Publication type
• studie

• MeSH
• Electronic Data Processing * MeSH
• Electronic Health Records MeSH
• Medical Informatics Applications MeSH
• Health Information Systems MeSH
• Natural Language Processing * MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH

BACKGROUND: Narrative medical reports do not use standardized terminology and often bring insufficient information for statistical processing and medical decision making. Objectives of the paper are to propose a method for measuring diversity in medical reports written in any language, to compare diversities in narrative and structured medical reports and to map attributes and terms to selected classification systems. METHODS: A new method based on a general concept of f-diversity is proposed for measuring diversity of medical reports in any language. The method is based on categorized attributes recorded in narrative or structured medical reports and on international classification systems. Values of categories are expressed by terms. Using SNOMED CT and ICD 10 we are mapping attributes and terms to predefined codes. We use f-diversities of Gini-Simpson and Number of Categories types to compare diversities of narrative and structured medical reports. The comparison is based on attributes selected from the Minimal Data Model for Cardiology (MDMC). RESULTS: We compared diversities of 110 Czech narrative medical reports and 1119 Czech structured medical reports. Selected categorized attributes of MDMC had mostly different numbers of categories and used different terms in narrative and structured reports. We found more than 60% of MDMC attributes in SNOMED CT. We showed that attributes in narrative medical reports had greater diversity than the same attributes in structured medical reports. Further, we replaced each value of category (term) used for attributes in narrative medical reports by the closest term and the category used in MDMC for structured medical reports. We found that relative Gini-Simpson diversities in structured medical reports were significantly smaller than those in narrative medical reports except the "Allergy" attribute. CONCLUSIONS: Terminology in narrative medical reports is not standardized. Therefore it is nearly impossible to map values of attributes (terms) to codes of known classification systems. A high diversity in narrative medical reports terminology leads to more difficult computer processing than in structured medical reports and some information may be lost during this process. Setting a standardized terminology would help healthcare providers to have complete and easily accessible information about patients that would result in better healthcare.

• MeSH
• Medical Records MeSH
• Clinical Coding methods   MeSH
• Humans MeSH
• Decision Support Techniques MeSH
• International Classification of Diseases MeSH
• Systematized Nomenclature of Medicine MeSH
• Terminology as Topic MeSH
• Narration MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Czech Republic MeSH

Brief summary of reasons for development of Hospital Information Systems (HIS) is described. We mention different concepts of HIS development. Primary negative attitude of physicians to the invasion of information technology to hospitals has been slowly changed. Extended teaching of fundamentals of computer science at medical universities is very important for a new generation of physicians. Modern methods of e‑learning allow using websites and medical atlases including presentations of surgical interventions in different branches of surgical medicine, physiotherapeutic methods, etc. Medical staff in hospitals may also profit from electronic tools used for education in medical informatics or for obligatory postgraduate courses. Software producing companies are obliged to teach potential users how to use implemented information systems effectively. E-learning is a good method how to teach new employees who need to start using the system. Telematics in health service and use of Internet data storages may be a trend in future development of information systems. Large amount of patient data in current databases is a big encouragement for expanded use of data mining and application of artificial intelligence methods in medical expert systems.

• Keywords
• coding systems in healthcare,
• MeSH
• Databases as Topic trends   MeSH
• Information Systems history   trends   MeSH
• Medical Informatics history   trends   MeSH
• Hospital Information Systems * history   trends   MeSH
• Computer-Assisted Instruction trends   MeSH
• Computing Methodologies MeSH
• Information Storage and Retrieval trends   MeSH
• Medical Informatics Applications * MeSH

INTRODUCTION: A growing body of research is examining how healthcare systems are responding to the increasing numbers of migrants and the resulting superdiversity of patients. The aim of this article is to identify and explain communication barriers in the provision of healthcare to Ukrainian war refugees in the Czech Republic from the perspectives of healthcare professionals and intercultural mediators. METHODS: The exploratory case study is based on a qualitative analysis of semi-structured interviews with frontline health professionals: 20 with doctors and 10 with nurses. The second source of data is two focus groups aimed at capturing communication problems from the perspective of intercultural mediators who accompany refugees to health facilities. The interview transcripts and FGs were analysed using six-stage thematic coding. RESULTS: The survey identified five main themes related to barriers to communication: (1) language barriers and interpreting, (2) cultural barriers, (3) differing expectations of health and the healthcare systems in the Czech Republic and Ukraine, (4) prejudices and negative attitudes and unethical behaviour towards refugees and migrants and (5) lack of awareness of patient rights. CONCLUSIONS: The arrival of large numbers of migrants has highlighted deficiencies in the system that may affect other vulnerable groups and the general population. These include the lack of general communication skills and legal awareness among many health professionals, which are barriers to the development of patient-centred care. The involvement of intercultural mediators fundamentally improves communication between health professionals and (not only) migrant patients. Nevertheless, it is necessary to legally anchor and define the position of intercultural mediators within the healthcare system. PATIENT OR PUBLIC CONTRIBUTION: Collaboration with intercultural mediators who interpreted the extensive experiences of Ukrainian refugee patients and also have personal experience as migrant or migrant-origin patients contributed to shaping research questions, facilitating study participation and enriching evidence interpretation. Researchers with multicultural backgrounds and experience with working with people from refugee backgrounds were involved in the study design and analysis.

• MeSH
• Adult MeSH
• Communication MeSH
• Communication Barriers * MeSH
• Qualitative Research MeSH
• Middle Aged MeSH
• Humans MeSH
• Delivery of Health Care MeSH
• Attitude of Health Personnel MeSH
• Interviews as Topic MeSH
• Refugees * psychology   MeSH
• Health Personnel psychology   MeSH
• Focus Groups MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Czech Republic MeSH
• Ukraine MeSH

Cílem příspěvku je porovnat české lékařské zprávy psané volným textem a pomocí softwarové aplikace; analyzovat využitelnost mezinárodních klasifikačních systému v českém zdravotnickém prostředí. Analýza lékařských zpráv byla založena na atributech Minimálního datového modelu pro kardiologii (MDMK). Použili jsme lékařské zprávy psané volným textem a lékařské zprávy ze softwarové aplikace ADAMEK, kde jsou data ukládána strukturovaně. Pro naši práci jsme využili SNOMED CT a MKN-10. Zaměřili jsme se na jazyk česky psaných lékařských zpráv a na aplikaci výše zmíněných mezinárodních klasifikačních systémů v MDMK. Porovnali jsme, jak dobře jsou atributy MDMK zaznamenány v textových lékařských zprávách a v lékařských zprávách zaznamenávaných strukturovaně pomocí softwarové aplikace ADAMEK. Provedli jsme jazykovou analýzu českých textových lékařských zpráv. Dospěli jsme tedy k závěru, že zapisování lékařských zpráv formou volného textu je velice nehomogenní a není standardizováno. Standardizovaná terminologie by přinesla výhody lékařům, pacientům, administrátorům, softwarovým vývojářů a plátcům. Pomohla by poskytovatelům zdravotnické péče tím, že by poskytovala kompletní a snadno dostupné informace, které náleží k procesu zdravotnictví a to by vyústilo v lepší péči a pacienty. Použití mezinárodních klasifikačních systémů je nezbytným prvním krokem, který umožní interoperabilitu heterogenních elektronických zdravotních záznamů.

The objective of the paper is to compare Czech medical reports written in a free text and by means of a software application; to analyze the usability of international classification systems in the Czech healthcare environment. The analysis of medical reports was based on the attributes of the Minimal Data Model for Cardiology (MDMC). We have used medical reports written in a free text and medical reports from the ADAMEK software application where data are stored in a structured way. For our work SNOMED CT and ICD-10 have been used. We have focused on the language of Czech medical reports and the application of aforementioned international classification systems in MDMC. We have compared how well attributes of MDMC are recorded in textual medical reports and in medical reports recorded structurally by means of the ADAMEK software application. We have made the language analysis of the Czech textual medical reports. We compared how MDMC attributes are recorded in the ADAMEK application and in medical reports written in a free text. To conclude, using a free text in medical reports is very inhomogeneous and not standardized. The standardized terminology would bring benefits to physicians, patients, administrators, software developers and payers. It would help healthcare providers that it could provide complete and easily accessible information that belongs to the process of healthcare and it would result in better care of patients. The use of international classification systems is a necessary first step to enable interoperability of heterogeneous electronic health records.

• Keywords
• terminologie, synonyma, klasifikační systémy, tezaurus, nomenklatura, nomenklatura, elektronický zdravotní záznam, interoperabilita, sémantická interoperabilita,
• MeSH
• Atherosclerosis MeSH
• Medical Records Systems, Computerized utilization   MeSH
• Financing, Organized MeSH
• Cardiology MeSH
• Humans MeSH
• International Classification of Diseases utilization   MeSH
• Semantics MeSH
• Terminology as Topic MeSH
• Information Storage and Retrieval methods   utilization   MeSH
• Check Tag
• Humans MeSH
• Geographicals
• Czech Republic MeSH

Objectives: The purpose of this paper is to present and discuss the adoption and use of medical terminologies and coding systems in Italy, focusing on their management and integration for guaranteeing semantic interoperability among Electronic Health Records (EHRs). Semantic interoperability guarantees meaningful exchange of data between two or more healthcare information systems, ensuring that data content is not only understandable within its original context, but also in the destination one, and is capable of supporting health service management, clinical decision-making care collaboration, as well as public health reporting, and improving clinical research. Methods: The approach used for the coding systems management and integration in the Italian Fascicolo Sanitario Elettronico (FSE)a use case is presented according to the current Italian regulations on federated EHRs. Results: Results show the need to promote an advanced approach, in conformance to the literature best cases, which takes care about a better integration and maintenance of medical terminologies and coding systems through the use of standardized models of terminology services. Conclusion: The paper presents terminology interoperability issues arisen from the described approach and related requirements to propose a solution that could allow, through sophisticated terminology services framework, to achieve also in Italy semantic interoperability.

• MeSH
• Clinical Coding MeSH
• Logical Observation Identifiers Names and Codes MeSH
• Health Information Management * MeSH
• Vocabulary, Controlled * MeSH
• Health Information Exchange * MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Italy MeSH