Adherence to Secondary Prevention Measures after Acute Myocardial Infarction and Its Impact on Patient Outcome-A Nationwide Perspective.

Secondary prevention is crucial for reducing morbidity and mortality in patients following acute myocardial infraction (MI). However, adherence to cardiac rehabilitation (CR) and pharmacotherapy remains suboptimal despite strong guideline recommendations. This study investigated the adherence to CR, dual antiplatelet therapy (DAPT), and statins following acute MI and evaluated their impact on patient outcomes from a nationwide perspective in Austria.

Converting Entity-Attribute-Value Data Sources to OMOP's CDM: Lessons Learned.

Clinical data repositories often use entity-attribute-value (EAV) data models. To be valuable for secondary use, these health data can be transformed to the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM). The present paper describes the lessons learned from such an endeavour based on the concept of registering transformation functions on source data elements.

Converting HL7 CDA Based Nationwide Austrian Medication Data to OMOP CDM.

Austria's national Electronic Health Record (EHR) system holds information on medication prescriptions and dispenses in highly structured HL7 Clinical Document Architecture (CDA) documents. Making these data accessible for research is desirable due to their volume and completeness. This work describes our approach of transforming the HL7 CDA data into Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM) and highlights a key challenge, namely mapping the Austrian drug terminology to OMOP standard concepts.

Transforming Documents of the Austrian Nationwide EHR System into the OMOP CDM.

The Austrian nationwide EHR system ELGA can contribute valuable data for research due to its high volume of data and broad population coverage. In order to be applicable in international research projects, transformation to a standardized, research-oriented data model such as the OMOP common data model is essential. In this paper we describe our experience with the corresponding transformation task.

Extending the Austrian National EHR System with Patient-Reported Outcome Data.

The Austrian national Electronic Health Record system ELGA is a population-based infrastructure for health data. However, to date, it does not include patient-reported outcomes. In this paper, we describe on-going work on extending ELGA with patient-reported outcome data.

Generation of FHIR-Based International Patient Summaries from ELGA Data.

Patient summaries grant healthcare providers a concise overview of a patient's status. This paper showcases to which degree International Patient Summaries (IPS) represented in HL7 FHIR format can be generated using data from the nationwide Austrian Electronic Health Record system ELGA. A solution is presented which enables the automated software-assembled generation of an IPS using the FHIR Mapping Language.

Semiautomatic Recruitment of Trial Patients Using ELGA Data: Conceptual Design and Implementation of an IT Tool.

Reuse of EHR data can substantially improve the recruitment process of clinical trials. As shown earlier, Shared EHR systems are particularly attractive data sources. The goal of this work was to conceptually design and implement a user-friendly tool for semiautomatic trial recruitment using ELGA data.

International Comparison of Six Basic eHealth Indicators Across 14 Countries: An eHealth Benchmarking Study.

Background: Many countries adopt eHealth applications to support patient-centered care. Through information exchange, these eHealth applications may overcome institutional data silos and support holistic and ubiquitous (regional or national) information logistics. Available eHealth indicators mostly describe usage and acceptance of eHealth in a country.

Reusing Data of an EU-Wide EHR System for Clinical Trials: A Capabilities Analysis.

Conduction of clinical trials may benefit from the reuse of EHR data. The upcoming EHR system eHDSI provides data exchange between European countries and thus represents an attractive data source for multinational trials. In this paper we analyze to what extent eHDSI could provide data relevant for trials with a focus on patient recruitment.

Telemonitoring readiness among Austrian diabetic patients: A cross-sectional validation study.

Digitalized healthcare services offer remote and cost-effective treatment of diabetes patients. Thus, the present online study analyzed the readiness to use telemonitoring among Austrian diabetes patients. We developed and validated a German version of the patient telehealth readiness assessment tool and performed quantitative context analysis of free-text comments on perceived barriers and benefits of telemonitoring.

Quantification of the resilience of primary care networks by stress testing the health care system.

There are practically no quantitative tools for understanding how much stress a health care system can absorb before it loses its ability to provide care. We propose to measure the resilience of health care systems with respect to changes in the density of primary care providers. We develop a computational model on a 1-to-1 scale for a countrywide primary care sector based on patient-sharing networks.

Expressing Patient Selection Criteria Based on HL7 V3 Templates Within the Open-Source Tool ART-DECOR.

Background: Reuse of EHR data for selecting patients who are eligible for clinical research can substantially improve the recruitment process. ART-DECOR is an open-source tool that is commonly used to design and publish HL7 V3 templates of national (e.g.

Patient-Sharing Relations in the Treatment of Diabetes and Their Implications for Health Information Exchange: Claims-Based Analysis.

Background: Health information exchange (HIE) among care providers who cooperate in the treatment of patients with diabetes mellitus (DM) has been rated as an important aspect of successful care. Patient-sharing relations among care providers permit inferences about corresponding information-sharing relations.

Objectives: This study aimed to obtain information for an effective HIE platform design to be used in DM care by analyzing patient-sharing relations among various types of care providers (ToCPs), such as hospitals, pharmacies, and different outpatient specialists, within a nationwide claims dataset of Austrian DM patients.

Can the Austrian Nation-Wide EHR System Support the Recruitment of Trial Patients?

Automatic comparison of routinely collected EHR data with trial eligibility criteria can speed up patient recruitment. The present work aims to analyze to what extent the Austrian nation-wide EHR system ELGA could support this task. Using the open source tool ART-DECOR we tried to map a reference list of 150 common eligibility criteria specified in the EHR4CR project to the HL7 CDA templates that describe the structure of ELGA document types.

Readiness to use telemonitoring in diabetes care: a cross-sectional study among Austrian practitioners.

Background: Telemonitoring services could dramatically improve the care of diabetes patients by enhancing their quality of life while decreasing healthcare expenditures. However, the potential for implementing innovative treatment options in the Austrian public and private health system is not known yet. Thus, we analyzed the readiness to use telemonitoring in diabetes care among Austrian practitioners.

Is Austria Ready for Telemonitoring? A Readiness Assessment Among Doctors and Patients in the Field of Diabetes.

Background: Telemonitoring offers new opportunities in the treatment of chronically ill patients and could help to improve their quality of life while reducing healthcare costs.

Objectives: The willingness to use telemonitoring is examined for both physicians and patients. From the perspective of the most important stakeholders, advantages and disadvantages as well as barriers for telemonitoring are analysed.

Mortality and continuity of care - Definitions matter! A cohort study in diabetics.

Objective: To demonstrate that when investigating the relevance of continuity of care for patient outcomes, different definitions can lead to contradicting results.

Methods: We used claims data from the regional public health insurer of Lower Austria covering the period from 2008 to 2011. The study sample included subjects with repeated dispensings of anti-diabetic drugs.

Disease Monitoring Related Adherence and Its Association with Mortality in Lower Austrian Diabetes Patients.

Background: Patient adherence is an important component of an efficient therapy. For diabetes patients it may contribute to controlled glucose values and reduction of adverse outcomes.

Objectives: We aim to examine a potential association of Lower Austrian diabetes patients' adherence concerning their disease monitoring and mortality.

A Web-Based Tool to Evaluate Data Quality of Reused Health Data Assets.

Background: Data from the health care domain is often reused to create and parameterize simulation models for example to support life science business in the evaluation of new products. Data quality assessments play an important part to help model users in interpreting simulation results by showing deficiencies in the raw data used in the model building and offers model builders a comparison of data quality amongst the used data assets.

Objectives: Assess data quality in raw data prior to creating simulation models and prepare results for model users.

Improving the informational continuity of care in diabetes mellitus treatment with a nationwide Shared EHR system: Estimates from Austrian claims data.

Purpose: Shared Electronic Health Record (EHR) systems, which provide a health information exchange (HIE) within a community of care, were found to be a key enabler of informational continuity of diabetes mellitus (DM) care. Quantitative analyses of the actual contribution of Shared EHR systems to informational continuity of care are rare. The goal of this study was to quantitatively analyze (i) the degree of fragmentation of DM care in Austria as an indicator for the need for HIE, and (ii) the quantity of information (i.

Secondary Use of Claims Data from the Austrian Health Insurance System with i2b2: A Pilot Study.

Background: In conformity with increasing international efforts to reuse routine health data for scientific purposes, the Main Association of Austrian Social Security Organisations provides pseudonymized claims data of the Austrian health care system for clinical research.

Objectives: We aimed to examine, whether an integration of the corresponding database into i2b2 would be possible and provide benefits.

Methods: We applied docker-based software containers and data transformations to set up the system.

Bridging the Gap between HL7 CDA and HL7 FHIR: A JSON Based Mapping.

The Austrian electronic health record (EHR) system ELGA went live in December 2016. It is a document oriented EHR system and is based on the HL7 Clinical Document Architecture (CDA). The HL7 Fast Healthcare Interoperability Resources (FHIR) is a relatively new standard that combines the advantages of HL7 messages and CDA Documents.

Plug-and-play Integration of dual-model based Knowledge Artefacts into an Open Source Ehr System.

In this paper we present our experiences with extending an existing approach for an archetype-compliant collection and export of data according to the openEHR specifications within the open source EHR system OpenMRS. It allows an automatic generation of forms from templates, which were introduced by openEHR as an extension of the dual-model approach. Data entered in these forms can be exported in form of standardized EHR extracts.

A nationwide computerized patient medication history: evaluation of the Austrian pilot project "e-Medikation".

Purpose: To manage medication treatment and to assure medication safety, health care professionals need a complete overview of all drugs that have been prescribed or are taken by a patient. In 2009, Austria launched the pilot project "e-Medikation" in three pilot regions. E-Medikation gives access to a patient's nationwide medication list and includes medication safety checks.

Generation of ELGA-compatible radiology reports from the Vienna Hospital Association's EHR system.

In the course of setting up the upcoming Austrian national shared EHR system ELGA, adaptors will have to be implemented for the local EHR systems of all participating healthcare providers. These adaptors must be able to transform EHR data from the internal format of the particular local EHR system to the specified format of the ELGA document types and vice versa. In the course of an ongoing diploma thesis we are currently developing a transformation application that shall allow the generation of ELGA-compatible radiology reports from the local EHR system of the Vienna Hospital Association.