Andrew Goodchild

Properties of a federated epidemiology query system

PURPOSE The purpose of the study was to establish knowledge about how online access to epidemiological data from general practitioners (GPs) electronic health record (EHR) system should be provided. Before such systems are developed and deployed a decision about the appropriate system architecture must be made. Such a decision should ideally be based on knowledge about the properties of different system architectures. This choice is important because the system architecture may affect the willingness of GPs to participate in providing epidemiological data from their EHR system. METHOD Verifying the performance and properties of an architectural approach by implementing and deploying a system on a trans-institutional level and performing evaluations studies is a very resource demanding method to establish a foundation for the decision of appropriate system architecture. Instead, we have tried to create this foundation by constructing a prototype system, establish knowledge about the properties of the system using experiments, and finally compare the properties of the federated approach to the properties of the centralised approach. By using this methodological approach we provide the best available knowledge, on this stage, for the appropriate system architecture to use for providing access to epidemiological data from the local population. RESULTS Our experimental results show that it is possible to improve the timeliness and the temporal and spatial resolution of epidemiological data, compared to traditional centralised disease surveillance systems. Up-to-date epidemiological data from the local population may be provided directly from the source EHR system within 4s. The responsiveness of the system is minimally affected (0.1s) as the number of participating data providers grows from 1 to 49 data providers. The comparison of the federated approach to the centralised approach indicates that federated approaches avoid the privacy issues involved, as intended; it offers better scalability when computing speed is compared, and it provides better specificity because more data about the patient may be used. CONCLUSION The conclusion from our study is that the federated approach to providing epidemiological data about the local population has many benefits over the traditional centralised approach. A federated approach to an epidemiology system may raise the GPs awareness of local disease outbreak because it is possible to share information about incidence rates of communicable diseases and use of laboratory requests in a geographical area that predates laboratory-based disease surveillance. The effects of the federated approach could be improved data quality in the EHR systems and improved representativeness of the epidemiological data for the areas covered by such systems.

Designing guideline-based workflow-enabled electronic health records

With the rising prevalence of chronic illness, there is a growing pressure to develop systems that engender evidence-based care. The potential for workflow support to coordinate services and improve communication in the context of chronic disease management is intuitively appealing, but is still a challenging (and hence rarely seen) accomplishment in practice. We examine the problem of achieving a close relationship of electronic health record (EHR) content to other components of a clinical information system (guidelines, decision support and workflow), with particular emphasis on integrating the EHR with workflow. We use the openEHR architecture, which allows extension of a core reference model via archetypes, to refine the detailed information recording options for specific points in the workflow and to represent the chain of instructions that is the workflow itself. We illustrate the use of openEHR for tracking the relationship of a series of clinical services or events to a guideline-based workflow via a case study of an early supported discharge (ESD) program for post-stroke rehabilitation. This case study shows the contribution guideline content and its derived workflow can have on problem specific EHR structure and demonstrates the potential for a constructive interaction of workflow support and the EHR. We conclude with a discussion of the practical boundary of applicability of workflow approaches versus decision support system approaches in supporting guideline-based care.

An Overview of Catalog Design Problems in Resource Discovery.

Discusses some of the problems designers face in building catalogs in large networks and relates them back to the resource discovery problem. Currently many catalogs tend to be built in an ad hoc fashion ‐ which leads to a great variety in the quality of publicly accessible network catalogs. Furthermore, the research surrounding these catalogs tends to focus on narrow technical issues ‐ resulting in difficult‐to‐use catalogs. Addresses this problem by providing a usability framework based on the library science and human computer interaction literature, and demonstrates some of those principles via an example of a prototype. Results are interesting to resource discovery tool developers in that a framework for understanding the general resource discovery problem is provided and some techniques for dealing with those problems are presented.

An evaluation scheme for trader user interfaces

This paper provides a set of criteria to evaluate the usability of trader user interfaces with respect to resource discovery. The criteria were identified because trader user interface developers sometimes make unrealistic assumptions about the information seeking behavior of their users, leading to interfaces that are difficult to use for resource discovery. This paper uses some insights from the cognitive aspects of the information science field to justify the usability criteria. The results of this paper are general enough to aid the developer of a user interface to any resource discovery tool.