Leveraging Clinical Data Treasures: Integration of an AI Platform into Clinical IT.

In recent years, there has been a rapid growth in the use of AI in the clinical domain. In order to keep pace with this development, a framework should be created in which clinical AI models can be easily trained, managed and applied. In our study, we propose a clinical AI platform that supports the development cycle and application of clinical AI models. We consider not only the development of an isolated clinical AI platform, but also its integration into clinical IT. This includes the consideration of so-called medical data integration centers. We evaluate our approach with the aid of a clinical AI use case to demonstrate the functionality of our clinical AI platform.

Challenges and Lessons Learned in Mapping HL7 v2 Data to openEHR: Insights from UKSH Medical Data Integration Center.

This paper explores the challenges and lessons learned during the mapping of HL7 v2 messages structured using custom schema to openEHR for the Medical Data Integration Center (MeDIC) of the University Hospital, Schleswig-Holstein (UKSH). Missing timestamps in observations, missing units of measurement, inconsistencies in decimal separators and unexpected datatypes were identified as critical inconsistencies in this process. These anomalies highlight the difficulty of automating the transformation of HL7 v2 data to any standard, particularly openEHR, using off-the-shelf tools. Addressing these anomalies is crucial for enhancing data interoperability, supporting evidence-based research, and optimizing clinical decision-making. Implementing proper data quality measures and governance will unlock the potential of integrated clinical data, empowering clinicians and researchers and fostering a robust healthcare ecosystem.

Integration of Oncological Data into openEHR: A Path Towards Improved Cancer Care and Research.

The integration of tumor-related diagnosis and therapy data is a key factor for cancer-related collaborative projects and research projects on-site. The Medical Data Integration Center (MeDIC) of the University Hospital Schleswig-Holstein, resulting from the Medical Informatics Initiative and Network University Medicine in Germany, has agreed on an openEHR-based data management based on a centralized repository with harmonized annotated data. Consequently, the oncological data should be integrated into the MeDIC to interconnect the information and thus gain added value. A uniform national data set for tumor-related reports is already defined for the cancer registries. Therefore, this work aims to transform the national oncological basis data set for tumor documentation (oBDS) so that it can be stored and utilized properly in the openEHR repository of the MeDIC. In a previous work openEHR templates representing the oncological basis data set were modeled. These templates were used to implement a processing pipeline including a metadata repository, which defines the mappings between the elements, a FHIR terminology service for annotation and validation, resulting in a tool to automatically build openEHR compositions from oBDS data. The prototype proved the feasibility of the referred mapping, integration into the MeDIC is straightforward and the architecture introduced is adaptable to future needs by design.

Advancing Healthcare Research Through Live-Data Integration: Implementing IEEE 11073 and FHIR in Clinical Environment.

The efficient direct integration of real-time medical device data is a promising approach to improve patient care enabling a direct and eminent intervention. This study presents a comprehensive approach for integrating real-time medical device data into clinical environments using the HL7® FHIR® standards and IEEE 11073 Service-Oriented Device Connectivity (SDC). The study proposes a conceptual framework and an opensource proof-of-concept implementation for real-time data integration within the Medical Data Integration Center (MeDIC) at UKSH. Key components include a selective recording mechanism to mitigate storage issues and ensure accurate data capture. Our robust network architecture utilizes Kafka brokers for seamless data transfer in isolated networks. The study demonstrates the selective capturing of real-time data within a clinical setting to enable medical device data for a down-stream processing and analysis.

Quality Assessment Framework of Clinical Routine Data for Secondary Use.

To systematically and comprehensively identify data issues in large clinical datasets, we adopted a harmonized data quality assessment framework with Python scripts before integrating the data into FHIR® for secondary use. We also added a preliminary step of categorizing data fields within the database scheme to facilitate the implementation of the data quality framework. As a result, we demonstrated the efficiency and comprehensiveness of detecting data issues using the framework. In future steps, we plan to continually utilize the framework to identify data issues and develop strategies for improving our data quality.

Implementation of an Atrioventricular Valve Intervention Registry: Comparative Study of REDCap vs. CDR-Based openEHR Registry.

This comparative study examines the transition from isolated registries to a consolidated data-centric approach at University Hospital Schleswig-Holstein, focusing on migrating the Atrioventricular Valve Intervention Registry (AVIR) from REDCap to a Medical Data Integration Center based openEHR registry. Through qualitative analysis, we identify key disparities and strategic decisions guiding this transition. While REDCap has historical utility, its limitations in automated data integration and traceability highlight the advantages of a data-centric approach, which include streamlined data (integration) management at a single-point-of-truth based on e.g., centralized consent management. Our findings lay the groundwork for the AVIR project and a proof-of-concept data-centric registry, reflecting a broader industry trend towards data-centric healthcare initiatives.

Instance-level medical image classification for text-based retrieval in a medical data integration center.

A medical data integration center integrates a large volume of medical images from clinical departments, including X-rays, CT scans, and MRI scans. Ideally, all images should be indexed appropriately with standard clinical terms. However, some images have incorrect or missing annotations, which creates challenges in searching and integrating data centrally. To address this issue, accurate and meaningful descriptors are needed for indexing fields, enabling users to efficiently search for desired images and integrate them with international standards. This paper aims to provide concise annotation for missing or incorrectly indexed fields, incorporating essential instance-level information such as radiology modalities (e.g., X-rays), anatomical regions (e.g., chest), and body orientations (e.g., lateral) using a Deep Learning classification model - ResNet50. To demonstrate the capabilities of our algorithm in generating annotations for indexing fields, we conducted three experiments using two open-source datasets, the ROCO dataset, and the IRMA dataset, along with a custom dataset featuring SNOMED CT labels. While the outcomes of these experiments are satisfactory (Precision of >75%) for less critical tasks and serve as a valuable testing ground for image retrieval, they also underscore the need for further exploration of potential challenges. This essay elaborates on the identified issues and presents well-founded recommendations for refining and advancing our proposed approach.

[Data integration centers-from a concept in the Medical Informatics Initiative to its local implementation in the Network of University Medicine]. / Die Datenintegrationszentren ­ Von der Konzeption in der Medizininformatik-Initiative zur lokalen Umsetzung in einem Netzwerk Universitätsmedizin.

As part of the Medical Informatics Initiative (MII), data integration centers (DICs) have been established at 38 university and 3 non-university locations in Germany since 2018. At DICs, research and healthcare data are collected. The DICs represent an important pillar in research and healthcare. They establish the technical, organizational, and (ethical) data protection requirements to enable cross-site research with the available routine clinical data.This article presents the three main pillars of DICs: ethical-legal framework, organization, and technology. The organization of DICs and their organizational embedding and interaction are presented, as well as the technical infrastructure. The services that a DIC provides for its own location and for external researchers are explained, and the role of the DIC as an internal and external interface for strengthening cooperation and collaboration is outlined.Legal conformity, organization, and technology form the basis for the processes and structures of a DIC and are decisive for how it is integrated into the healthcare and research landscape of a location, but also for how it can react to national and European requirements and act and function as an interface to the outside world. In this context and with regard to national developments (e.g., introduction of the electronic patient file-ePA), but also international and European initiatives (e.g., European Health Data Space-EHDS), the DIC will play a central role in the future.

Structured Data Retrieval and Analysis of HL7 v2 Messages with Elasticsearch.

The era of the electronic health record (EHR) requires lots of semantic interoperability for data sharing and reusability. We select HL7 v2 messages as the most common structured data type in hospital information systems, to investigate the plausibility of using Elasticsearch (ES) as a healthcare search engine and data analytics tool. Due to the facts, Elasticsearch can be integrated as a powerful searchable database for practical healthcare applications, to analyze structured healthcare data from various locations. It allows easy and efficient searching for complex query tasks.

Large-Scale Standardized Image Integration for Secondary Use Research Projects.

Imaging techniques are a cornerstone of today's medicine and can be crucial for a successful therapy. But in addition, the generated imaging series are an important resource for new informatics' methods, especially in the field of artificial intelligence. This paper describes the success of integrating clinical routine imaging data into a standardized format for research purposes. Thus, we designed an integration flow and successfully implemented it in the local data integration center of University Hospital Schleswig-Holstein. The flow integrates imaging series and radiological reports from the primary system into an openEHR repository with enrichment by semantic codes for better findability and retrieval using HL7 FHIR. As a result, 6.6 million radiological studies with 29 million image series are now available for further medical (informatics) research.

An Image Retrieval Pipeline in a Medical Data Integration Center.

Medical images need annotations with high-level semantic descriptors, so that domain experts can search for the desired dataset among an enormous volume of visual media within a Medical Data Integration Center. This article introduces a processing pipeline for storing and annotating DICOM and PNG imaging data by applying Elasticsearch, S3 and Deep Learning technologies. The proposed method processes both DICOM and PNG images to generate annotations. These image annotations are indexed in Elasticsearch with the corresponding raw data paths, where they can be retrieved and analyzed.