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CC BY-NC-ND 4.0 · Appl Clin Inform 2023; 14(02): 326-336
DOI: 10.1055/s-0043-1767681
Research Article

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

Maike H. J. Schepens
1   Cirka BV, Healthcare Strategy and Innovation, Zeist, The Netherlands
2   Department of Biomedical Data Sciences, LUMC, Leiden, The Netherlands
,
Annemarie C. Trompert
3   Dutch Institute for Clinical Auditing, Leiden, The Netherlands
,
Miranda L. van Hooff
4   Department of Orthopedics, Radboud UMC, Nijmegen, The Netherlands
5   Department of Orthopedics, Sint Maartenskliniek, Nijmegen, The Netherlands
,
Erik van der Velde
6   Dutch Association of Medical Specialists, Utrecht, The Netherlands
7   Zorgverbeteraars, Healthcare IT Consulting, Roden, The Netherlands
,
Marjon Kallewaard
6   Dutch Association of Medical Specialists, Utrecht, The Netherlands
,
Iris J. A. M. Verberk-Jonkers
6   Dutch Association of Medical Specialists, Utrecht, The Netherlands
8   Department of Nephrology, Maasstad Hospital, Rotterdam, The Netherlands
,
Huib A. Cense
9   Department of Surgery, Rode Kruis Hospital, Beverwijk, The Netherlands
10   Department of Health System Innovation. Faculty of Economics and Business, Groningen University. Groningen, The Netherlands
,
Diederik M. Somford
11   Department of Urology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
,
Sjoerd Repping
12   Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
,
Selma C. Tromp
6   Dutch Association of Medical Specialists, Utrecht, The Netherlands
13   Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
,
Michel W. J. M. Wouters
2   Department of Biomedical Data Sciences, LUMC, Leiden, The Netherlands
13   Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
14   Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
› Author Affiliations Funding The SKMS Program of the Dutch Association of Medical Specialists (Federatie Medisch Specialisten) funded the step-based approach executed with 31 NQRs.
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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.

Keywords

electronic health record - secondary use - data reuse - clinical information models - national quality registries - administrative burden - interoperability - FAIR

Authors' Contributions

M.S., A.T., and E.v.d.V. developed the study design and the mapping method. M.S. executed the analysis for this manuscript. M.v.H., M.W., and S.R. supervised the analyses for this manuscript. M.S., A.T., M.v.H., S.R., and M.W. contributed to the draft of the manuscript. All authors contributed to the manuscript review and editing.


Protection of Human and Animal Subjects

No human subjects were involved.


Supplementary Material



Publication History

Received: 14 October 2022

Accepted: 02 January 2023

Article published online:
03 May 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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