The Evolution of a Health Information Brokering Service in the Province of British Columbia
Notice bibliographique
Résumé
ElectronicHealthcare Vol.2 No.2>2003 The Provincial Health Services Authority (PHSA) is implementing a health information brokering service in the province of British Columbia. This brokering service (called the Clinical Broker) is based upon the experienced gained by the B.C. Cancer Agency (BCCA) in the creation of its Electronic Health Record (EHR) for cancer care. The brokering service will initially focus on an operational need for information exchange between healthcare providers. Over time, it will be extended to include more complex healthcare services, such as results query, appointment booking and clinical decision support. Given the results achieved at the BCCA, the brokering service is expected to more than pay for itself in operational savings. It will also result in improved care and reduced clinical risk by accelerating the delivery of clinical information. As a byproduct, a unique data resource for the development of a provincial EHR is being created at no additional cost. Extensive experience is also being gained on the development of interfaces to clinical information systems, clinical information workflow, and on the value of data standards for clinical information exchange. This paper will examine the circumstances leading to the development of the Clinical Broker, and the opportunities that it will create in British Columbia. The story begins at the BCCA. THE B.C. CANCER AGENCY AND THE CANCER AGENCY INFORMATION SYSTEM The BCCA operates a cancer care program for the population of British Columbia. The management of information on cancer patients begins with the B.C. Cancer Registry, where, by law, all patients with a positive pathology of cancer must be registered. Approximately 60% of these patients will eventually be referred to the BCCA for treatment. Within the BCCA, care is primarily delivered through four comprehensive cancer centres, where the patients are primarily seen as outpatients. Information on all cancer patients in the province is maintained in the Cancer Agency chart. As with other types of chronic disease, the chart is longitudinal rather than encounterbased. More than 60% of the pages in a cancer chart originate from outside the BCCA. Information is gathered and retained from diagnosis to death, and sometimes beyond, for research. The BCCA currently has more than 450,000 charts, of which more than 100,000 are active. These paper-based charts represent a very significant information management challenge. In the fall of 1992, the BCCA began planning to build a new cancer treatment facility in the Fraser Valley. The existing information systems were dated and not capable of expanding to include the new centre. The market was examined for vendor solutions, but none were found . Electronic Health Records
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,010 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,004 |
| Études des sciences et des technologies | 0,010 | 0,002 |
| Communication savante | 0,008 | 0,003 |
| Science ouverte | 0,002 | 0,003 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,010 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».