Extraction of standardized archetyped data from Electronic Health Record systems based on the Entity-Attribute-Value Model

OBJECTIVE The ISO/EN 13606 Electronic Health Record architecture standard permits semantically interoperable exchange of Electronic Health Record data by using archetypes to define the structure and semantics of Electronic Health Record contents. Practical implementations of the ISO/EN 13606 standard have been scarcely reported on, and none of the publications describes in detail an efficient technique of archetype-compliant data extraction from an Electronic Health Record system. We address this research issue in the present report, and focus on a specific class of largely research-oriented Electronic Health Record systems which are internally based on the Entity-Attribute-Value Model. METHOD We propose an approach for extracting data described by archetypes from an Entity-Attribute-Value based Electronic Health Record system in an ISO/EN 13606-conformant manner. The approach is based on mapping from the structure of exported source documents to the archetype. It is implemented via standard XML technologies. RESULTS We tested our approach on an Electronic Health Record system employed for clinical research at the Medical University of Vienna. Using test data defined by three different archetypes, source documents were successfully extracted as archetype-conformant ISO/EN 13606 Electronic Health Record extracts. CONCLUSIONS Electronic Health Record data may be effectively extracted from Entity-Attribute-Value based Electronic Health Record systems using the suggested approach. As a prerequisite for applying our approach, the internal data model of the Electronic Health Record system and the archetype must overlap in a way that a semantic mapping between them is possible. The system must further provide an XML interface which permits the export of the source documents in conventional format. The export must include data and metadata that are mandatorily postulated by the archetype and the ISO/EN 13606 Reference Model.