Abstract
In this chapter, we explore and consider many of the technical, data and knowledge issues that impact electronic health records. These issues include healthcare standards and semantic interoperability, security of applications and data, privacy of information, the ability to identify uniquely a participant across all healthcare domains, usability and context based information retrieval, and clinical decision support. These generally applicable informatics issues are then examined with a specific focus on the overall goal of integrating medical and dental health information. Thus, we also examine standards specific to dentistry, the data needs of dentists, and clinical dental decision support efforts.
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Notes
- 1.
The American Dental Association House of Delegates Resolution 92H-1996 states this vision of “seamless accessibility of health information throughout all aspects of health care, independent of profession, discipline or specialty, or care delivery environment.”
- 2.
Storing data in the long term.
- 3.
ASTM 2145–07 Standard Practice for Information Modeling. Available from www.ASTM.org.
- 4.
Louis H. Sullivan regarded excessively decorative elements as superfluous. Likewise in information modeling, excessive detail and ornamentation contribute little to understanding; rather these serve to complicate design, inhibit comprehension and ultimately defeat the purposes of information modeling. See http://www.famousquotesandauthors.com/authors/louis_h_sullivan_quotes.html and http://en.wikipedia.org/wiki/Louis_Sullivan.
- 5.
IDEF methodology described by the National Institute of Standards and Technology, Federal Information Processing Standards Publications 183 Integrated Definition for Function Modeling (IDEF0) and 184 Integrated Definition for Information Modeling (IDEF1X), 23 December 1993. IDEF0 aims at capturing “decisions,” “actions” and “activities” and IDEF1X has the goal of modeling data for using it as a resource. These use graphical representations as part of the modeling process.
- 6.
Bourke, M.K. Strategy and Architecture of Health care Information Systems. New York: Springer. 1994.
- 7.
United States Department of Defense, Military Health System (MHS) IDEF Process and Data Models used in the MHS Functional Area Model – Activity (FAM-A), and MHS Functional Area Model – Data (FAM-D), various dates.
- 8.
Available from the American Dental Association, Department of Standards Administration, 211 E. Chicago Ave., Chicago, IL 60611.
- 9.
This Diagnostic-Therapeutic Cycle is variously known by a variety of terms and is widely cited in the medicine texts used in first-year professional education; this is also noted in Van Bemmel, J., and M.A. Musen (Eds.). Handbook of Medical Informatics. 1st edition. Springer. 1997.
- 10.
IDEF0 Diagram from page 30 of the ANSI/ADA Specification 1039.
- 11.
Other conceptual models are centered on the provider, the procedure or the encounter.
- 12.
Except for the conditions listed above, antibiotic prophylaxis is no longer recommended for any other form of CHD.
- 13.
Prophylaxis is reasonable because endothelialization of prosthetic material occurs within 6 months after the procedure.
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Torres-Urquidy, M.H. et al. (2012). HIT Considerations: Informatics and Technology Needs and Considerations. In: Powell, V., Din, F., Acharya, A., Torres-Urquidy, M. (eds) Integration of Medical and Dental Care and Patient Data. Health Informatics, vol 3. Springer, London. https://doi.org/10.1007/978-1-4471-2185-5_2
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