Skip to main content

Ontological Analysis of Meaningful Use of Healthcare Information Systems (MUHIS) Requirements and Practice

  • Conference paper
  • First Online:
Biomedical Engineering Systems and Technologies (BIOSTEC 2014)

Abstract

We present an ontology of meaningful use of healthcare information systems (MUHIS), and an analysis of its requirements and practices using the ontology. We map (a) the Stages 1 and 2 meaningful use requirements set by the Centers for Medicaid & Medicare Services (CMS) for Electronic Health Records (EHR), and (b) the current literature on meaningful use, to derive the ontological map of the two respectively. Both maps are fragmented and incomplete. We highlight the gaps (a) in the requirements, (b) in practices, and (c) between requirements and practices, and highlight the bright, light, blank, and blind spots in MUHIS. We discuss why these gaps should be (a) bridged if they are important, (b) ignored if they are unimportant, or (c) reconsidered if they have been overlooked. Thus ontological analysis can provide systemic feedback for continuous improvement of MUHIS though systematic changes in policies and practice.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Dermer, M., Morgan, M.: Certification of primary care electronic medical records: lessons learned from Canada. J. Healthc. Inf. Manage.: JHIM 24, 49–55 (2010)

    Google Scholar 

  2. Ke, W.C., Hsieh, Y.C., Chen, Y.C., Lin, E.T., Chiu, H.W.: Trend analysis and future development of Taiwan electronic medical records. Stud. Health Technol. Inf. 180, 1230–1232 (2012)

    Google Scholar 

  3. Kim, H., Kim, S.: Legislation direction for implementation of health information exchange in Korea. Asia-Pac. J. Public Health/Asia-Pacif. Acad. Consortium Public Health 24, 880–886 (2012)

    Article  Google Scholar 

  4. Varroud-Vial, M.: Improving diabetes management with electronic medical records. Diab. Metab. 37(suppl. 4), S48–S52 (2011)

    Article  Google Scholar 

  5. https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Meaningful_Use.html

  6. Churchman, C.W.: Wicked problems. Manage. Sci. 14, B-141 (1967)

    Article  Google Scholar 

  7. Ramaprasad, A.: Role of feedback in organizational-change - review and redefinition. Cybernetica 22, 105–113 (1979)

    Google Scholar 

  8. Ramaprasad, A.: On the Definition of Feedback. Behav. Sci. 28, 4–13 (1983)

    Article  Google Scholar 

  9. Ramaprasad, A.: Cognitive process as a basis for MIS and DSS design. Manage. Sci. 33, 139–148 (1987)

    Article  Google Scholar 

  10. Ramaprasad, A., Mitroff, I.I.: On formulating strategic problems. Acad. Manage. Rev. 9, 597–605 (1984)

    Google Scholar 

  11. Börner, K., Chen, C., Boyack, K.W.: Visualizing knowledge domains. Ann. Rev. Inf. Sci. Technol. 37, 179–255 (2003)

    Article  Google Scholar 

  12. Ramaprasad, A., Valenta, A.L., Brooks, I.: Clinical and translational science informatics: translating information to transform health care. In: Azevedo, L., Londral, A.R. (eds.) Proceedings of HEALTHINF 2009 – Second International Conference on Health Informatics, pp. 135–141. INSTICC Press, Porto (2009)

    Google Scholar 

  13. Zhang, J., Xie, J., Hou, W., Tu, X., Xu, J., Song, F., Wang, Z., Lu, Z.: Mapping the knowledge structure of research on patient adherence: knowledge domain visualization based co-word analysis and social network analysis. PLoS ONE 7, e34497 (2012)

    Article  Google Scholar 

  14. Scharnhorst, A.: Constructing knowledge landscapes within the framework of geometrically oriented evolutionary theories. In: Mathies, M., Malchow, H., Kriz, J. (eds.) Inegrative Systems Approaches to Natural Social Dynamics, pp. 505–515. Springer, Heidelberg (2001). http://www.virtualknowledgestudio.nl/staff/andrea-scharnhorst/documents/constructing-knowledge-landscapes.pdf

  15. Hoeffner, L., Smiraglia, R.: Visualizing domain coherence: social informatics as a case study. Adv. Classif. Res. Online 23, 49–51 (2013)

    Article  Google Scholar 

  16. Noar, S.M., Zimmerman, R.S.: Health Behavior Theory and cumulative knowledge regarding health behaviors: are we moving in the right direction? Health Educ. Res. 20, 275–290 (2005)

    Article  Google Scholar 

  17. Kazimierczak, K.A., Skea, Z.C., Dixon-Woods, M., Entwistle, V.A., Feldman-Stewart, D., N’Dow, J.M.O., MacLennan, S.J.: Provision of cancer information as a “support for navigating the knowledge landscape”: findings from a critical interpretive literature synthesis. Eur. J. Oncol. Nurs., 1–10 (2012)

    Google Scholar 

  18. Syed, K.A.A., Kröll, M., Sabol, V., Scharl, A., Gindl, S., Granitzer, M., Weichselbraun, A.: Dynamic topography information landscapes – an incremental approach to visual knowledge discovery. In: Cuzzocrea, A., Dayal, U. (eds.) DaWaK 2012. LNCS, vol. 7448, pp. 352–363. Springer, Heidelberg (2012)

    Chapter  Google Scholar 

  19. Brennan, L., Voros, J., Brady, E.: Paradigms at play and implications for validity in social marketing research. J. Soc. Mark. 1, 3 (2011)

    Google Scholar 

  20. Kotis, K., Vouros, G.: Human-centered ontology engineering: the HCOME methodology. Knowl. Inf. Syst. 10, 109–131 (2006)

    Article  Google Scholar 

  21. Horn, B.R., Lee, I.H.: Toward integrated interdisciplinary information and communication sciences: a general systems perspective. In: Proceedings of the Hawaii International Conference on System Sciences, vol. 244, pp. 244–255. IEEE (1989)

    Google Scholar 

  22. Fensel, D.: Ontologies: A Silver Bullet for Knowledge Management and Electronic Commerce. Springer, Heidelberg (2003)

    Google Scholar 

  23. Kriglstein, S., Wallner, G.: Human centered design in practice: a case study with the ontology visualization tool knoocks. In: Kraus, M., Mestetskiy, L., Richard, P., Braz, J., Csurka, G. (eds.) VISIGRAPP 2011. CCIS, vol. 274, pp. 123–141. Springer, Heidelberg (2013)

    Google Scholar 

  24. Gruber, T.R.: Ontology. In: Liu, L., Ozsu, M.T. (eds.) Encyclopedia of Database Systems. Springer, Heidelberg (2008)

    Google Scholar 

  25. Gruber, T.R.: Toward principles for the design of ontologies used for knowledge sharing. Int. J. Hum. Comput. Stud. 43, 907–928 (1995)

    Article  Google Scholar 

  26. Cimino, J.J.: In defense of the Desiderata. J. Biomed. Inf. 39, 299–306 (2006)

    Article  Google Scholar 

  27. Quine, W.V.O.: From a Logical Point of View. Harvard University Press, Boston (1961)

    Google Scholar 

  28. http://www.healthit.gov/providers-professionals

  29. Crosson, J.C., Schueth, A.J., Isaacson, N., Bell, D.S.: Early adopters of electronic prescribing struggle to make meaningful use of formulary checks and medication history documentation. J. Am. Board Fam. Med. 25, 24–32 (2012)

    Article  Google Scholar 

  30. Rahmner, P.B., Eiermann, B., Korkmaz, S., Gustafsson, L.L., Gruvén, M., Maxwell, S., Eichle, H.-G., Vég, A.: Physicians’ reported needs of drug information at point of care in Sweden. Br. J. Clin. Pharmacol. 73, 115–125 (2012)

    Article  Google Scholar 

  31. Spina, J.R., Glassman, P.A., Simon, B., Lanto, A., Lee, M., Cunningham, F., Good, C.B.: Potential safety gaps in order entry and automated drug alerts: a nationwide survey of VA physician self-reported practices with computerized order entry. Med. Care 49, 904–910 (2011)

    Article  Google Scholar 

  32. Classen, D.C., Phansalkar, S., Bates, D.W.: Critical drug-drug interactions for use in electronic health records systems with computerized physician order entry: review of leading approaches. J. Patient Saf. 7, 61–65 (2011)

    Article  Google Scholar 

  33. Smithburger, P.L., Buckley, M.S., Bejian, S., Burenheide, K., Kane-Gill, S.L.: A critical evaluation of clinical decision support for the detection of drug-drug interactions. Expert Opin. Drug Saf. 10, 871–882 (2011)

    Article  Google Scholar 

  34. Phansalkar, S., van der Sijs, H., Tucker, A.D., Desai, A.A., Bell, D.S., Teich, J.M., Middleton, B., Bates, D.W.: Drug–drug interactions that should be non-interruptive in order to reduce alert fatigue in electronic health records. J. Am. Med. Inf. Assoc. (2012)

    Google Scholar 

  35. Callen, J.L., Westbrook, J.I., Georgiou, A., Li, J.: Failure to follow-up test results for ambulatory patients: a systematic review. J. Gen. Intern. Med. 27, 1334–1348 (2011)

    Article  Google Scholar 

  36. Seidling, H.M., Phansalkar, S., Seger, D.L., Paterno, M.D., Shaykevich, S., Haefeli, W.E., Bates, D.W.: Factors influencing alert acceptance: a novel approach for predicting the success of clinical decision support. J. Am. Med. Inf. Assoc. 18, 479–484 (2011)

    Article  Google Scholar 

  37. Gaikwad, R., Sketris, I., Shepherd, M., Duffy, J.: Evaluation of accuracy of drug interaction alerts triggered by two electronic medical record systems in primary healthcare. Health Inf. J. 13, 163–177 (2007)

    Article  Google Scholar 

  38. Phansalkar, S., Desai, A.A., Bell, D., Yoshida, E., Doole, J., Czochanski, M., Middleton, B., Bates, D.W.: High-priority drug–drug interactions for use in electronic health records. J. Am. Med. Inf. Assoc. 19, 735–743 (2012)

    Article  Google Scholar 

  39. Takarabe, M., Shigemizu, D., Kotera, M., Goto, S., Kanehisa, M.: Network-based analysis and characterization of adverse drug-drug interactions. J. Chem. Inf. Model. 51, 2977–2985 (2011)

    Article  Google Scholar 

  40. Saverno, K.R., Hines, L.E., Warholak, T.L., Grizzle, A.J., Babits, L., Clark, C., Taylor, A.M., Malone, D.C.: Ability of pharmacy clinical decision-support software to alert users about clinically important drug–drug interactions. J. Am. Med. Inf. Assoc. 18, 32–37 (2011)

    Article  Google Scholar 

  41. Warholak, T.L., Hines, L.E., Saverno, K.R., Grizzle, A.J., Malone, D.C.: Assessment tool for pharmacy drug–drug interaction software. J. Am. Pharmacists Assoc. 51, 418–424 (2011)

    Article  Google Scholar 

  42. Hines, L.E., Malone, D.C., Murphy, J.E.: Recommendations for generating, evaluating, and implementing drug-drug interaction evidence. Pharmacother. J. Hum. Pharmacol. Drug Ther. 32, 304–313 (2012)

    Article  Google Scholar 

  43. Dhabali, A.A.H., Awang, R., Zyoud, S.H.: Clinically important drug–drug interactions in primary care. J. Clin. Pharm. Ther. 37, 426–430 (2012)

    Article  Google Scholar 

  44. Haueis, P., Greil, W., Huber, M., Grohmann, R., Kullak-Ublick, G.A., Russmann, S.: Evaluation of drug interactions in a large sample of psychiatric inpatients: a data interface for mass analysis with clinical decision support software. Clin. Pharmacol. Ther. 90, 588–596 (2011)

    Article  Google Scholar 

  45. Yu, D.T., Seger, D.L., Lasser, K.E., Karson, A.S., Fiskio, J.M., Seger, A.C., Bates, D.W.: Impact of implementing alerts about medication black-box warnings in electronic health records. Pharmacoepidemiol. Drug Saf. 20, 192–202 (2011)

    Article  Google Scholar 

  46. Ramaprasad, A., Syn, T.: Ontological meta-analysis and synthesis. In: Proceedings of the Nineteenth Americas Conference on Information Systems, Chicago, Illinois, 15–17 August 2013

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Arkalgud Ramaprasad .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this paper

Cite this paper

Ramaprasad, A., Syn, T., Thirumalai, M. (2015). Ontological Analysis of Meaningful Use of Healthcare Information Systems (MUHIS) Requirements and Practice. In: Plantier, G., Schultz, T., Fred, A., Gamboa, H. (eds) Biomedical Engineering Systems and Technologies. BIOSTEC 2014. Communications in Computer and Information Science, vol 511. Springer, Cham. https://doi.org/10.1007/978-3-319-26129-4_21

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-26129-4_21

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-26128-7

  • Online ISBN: 978-3-319-26129-4

  • eBook Packages: Computer ScienceComputer Science (R0)

Publish with us

Policies and ethics