FAIRifying a Quality Registry Using OMOP CDM: Challenges and Solutions.

The need for health data to be internationally Findable, Accessible, Interoperable and Reusable (FAIR) and thereby support integrative analysis with other datasets has become crystal clear in the ongoing pandemic. The Dutch National Intensive Care Evaluation (NICE) quality registry adopted the Observational Medical Outcomes Partnership Common Database Model (OMOP CDM) to achieve a FAIR database. In the process of adopting the OMOP CDM, many modeling, technical, and communication challenges needed to be solved. Through communication with the OMOP CDM implementation community, previously done research and trial-and-error we found solutions that we believe can help other healthcare institutions, especially ICU quality registries, FAIRify their databases.

Intensive care admission of cancer patients: a comparative analysis.

The aim of this study was to obtain insight into which proportion of cancer patients is admitted to an Intensive Care Unit (ICU) and how their survival, demographic, and clinical characteristics relate to cancer patients not admitted to the ICU. Data from patients registered with cancer between 2006 and 2011 in four hospitals in the Netherlands were linked to the Dutch National Intensive Care Evaluation registry. About 36,860 patients with cancer were identified, of whom 2,374 (6.4%) were admitted to the ICU. Fifty-six percent of ICU admissions were after surgery, whereas 44% were for medical reasons. The risk for ICU admission was highest among cancer patients treated with surgery either alone or combined with chemotherapy and/or radiation therapy. Only 80 of 1,073 medical ICU admissions (3.3%) were for cancer-specific reasons. Although more women (54.0%) than men were registered with cancer, the proportion of male cancer patients admitted to an ICU was much higher (9.3 vs. 4.0%, P < 0.001). Five-year survival of cancer patients admitted to the ICU was substantial (41%) although median survival was much lower (1,104 days) than in patients not admitted to the ICU (median survival time not reached, P < 0.001). These results show that one out of 16 cancer patients was admitted to an ICU and that ICU support for this group should not be considered futile.

A web-based system to facilitate local, systematic quality improvement by multidisciplinary care teams: development and first experiences of CARDSS Online.

Continuous monitoring and systematic improvement of quality have become increasingly common in healthcare. To support multidisciplinary care teams in improving their clinical performance using feedback on quality indicators, we developed the CARDSS Online system. This system supports (i) monitoring of indicator-based performance, (ii) selecting aspects of care that need improvement, (iii) developing a quality improvement (QI) plan, and (iv) periodically adjusting the QI plan. During educational outreach visits, the system actively involves the team in the improvement effort, and guides them through the process of systematic QI without needing extensive knowledge of the underlying concepts. During the implementation of the system in the field of cardiac rehabilitation (CR) in the Netherlands, we have conducted the first outreach visits to four CR teams. During the visits, the teams formulated QI plans consisting of 4 to 7 improvement goals, each goal accompanied by 1 to 5 QI actions. Currently, we are evaluating the effect of CARDSS Online on the quality of CR in the Netherlands in a cluster randomized trial.