Gustavo Marísio Bacelar-Silva

Relevant Lifelong Nutrition Information for the Prevention and Treatment of Childhood Obesity - Design and Creation of New openEHR Archetype Set

Introduction: The worldwide prevalence of obesity had a drastic increase in childhood/ adolescents. In 2014, it was estimated that 41 million children in all world, under the age of 5 were overweight or obese. Despite all the efforts, the number of overweight and obese children/adolescents is rising in almost all countries. Meanwhile, some points impaired the healthcare professionals to follow obesity guideline clinical practice (CPG). Information systems have an important role to play in the maintaining of this reality. Aim: To propose a set of archetypes for the integration of CPG recommendations for treatment and prevention of obesity in children and adolescents in an openEHR based Electronic Health Record (EHR). Methods: We assessed obesity guidelines as National Heart, Lung and Blood Institute (NHLBI), American Academic of Paediatrics (AAP), Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), World Health Organization (WHO) and Dietary Reference Intake (DRI) and selected the most representative variables in nutrition parameters (anthropometry, body composition, nutrients intake, etc.) in order to create/ find archetypes in Clinical Knowledge Manager (CKM) repository, and, finally, compose a template in openEHR. Results: 38 variables were identified in guidelines. However, only 22 archetypes were necessary to represent all of them. Of these 22 archetypes, 8 are already available in CKM, while 14 clinical statements had no archetype representation and they had to be created. Conclusion: Based on the created archetypes, an openEHR template can be created for the representation of clinical statements regarding the most important clinical guidelines in obesity. This template can be used by nutritionists and others health professionals to manage data relevant to obesity care.

Creating openEHR content to different moments of care: Obstetrics emergency scenario

Introduction: If health information systems used a common reference model to store patient data it would ease health data exchange and achievement of semantic interoperability. Aim: To describe the process and the issues related to developing openEHR content to be used during different moments in the Obstetrics scenario, namely to retrieve patients data. Methods: It was conducted a search on two major repositories - openEHR and National E-Health Transition Authority (NEHTA) - for archetypes to represent clinical concepts defined in a previous study (Obstetrics Scenario). The better-suited archetypes were chosen to design the templates. Results: 22 clinical concepts were identified and 21 of them could be covered by the archetypes. It was necessary 28 archetypes (23 openEHR / 5 NEHTA) to represent them (13 openEHR / 8 NEHTA). Discussion and Conclusion: This paper demonstrates that it was possible to create an openEHR template to describe the information needs during different moments of an Obstetrics scenario. A possible application is to use them to retrieve patients data from external systems.

Comparing security and privacy issues of EHR: Portugal, the Netherlands and the United Kingdom

Health information technologies are becoming more common in the health care practice and electronic health records are considered a keystone. However, there is also an increasing concern of keeping secure the patients data and assure privacy. The aim of this paper was to perceive and illustrate by what means Portugal, the Netherlands and the United Kingdom intend to keep their electronic health information secure and assure patient privacy. Based in official documents collected in the health departments websites of the three selected countries, it was used an analysis model framework previously published that includes 14 topic areas of health records security policies. Analyzing 14 official documents of the subject countries, it was possible to design an illustrative table of the 14 topic areas regarding security and privacy issues. This table allows comparing the different security measures adopted by the three countries to keep the patient privacy, such as a network security and access control to system resources. Given the analysis of the official documents of the three countries, it was verified that none of them has a very thorough approach of how electronic health records should be implemented with regard to privacy and security.

Nutrigenomic Information in the openEHR Data Set

BACKGROUND The traditional concept of personalized nutrition is based on adapting diets according to individual needs and preferences. Discussions about personalized nutrition have been on since the Human Genome Project, which has sequenced the human genome. Thenceforth, topics such as nutrigenomics have been assessed to help in better understanding the genetic variation influence on the dietary response and association between nutrients and gene expression. Hence, some challenges impaired the understanding about the nowadays important clinical data and about clinical data assumed to be important in the future. OBJECTIVE Finding the main clinical statements in the personalized nutrition field (nutrigenomics) to create the future-proof health information system to the openEHR server based on archetypes, as well as a specific nutrigenomic template. METHODS A systematic literature search was conducted in electronic databases such as PubMed. The aim of this systemic review was to list the chief clinical statements and create archetype and templates for openEHR modeling tools, namely, Ocean Archetype Editor and Ocean Template Design. RESULTS The literature search led to 51 articles; however, just 26 articles were analyzed after all the herein adopted inclusion criteria were assessed. Of these total, 117 clinical statements were identified, as well as 27 archetype-friendly concepts. Our group modeled four new archetypes (waist-to-height ratio, genetic test results, genetic summary, and diet plan) and finally created the specific nutrigenomic template for nutrition care. CONCLUSION The archetypes and the specific openEHR template developed in this study gave dieticians and other health professionals an important tool to their nutrigenomic clinical practices, besides a set of nutrigenomic data to clinical research.