Design And Implementation Of Open Clinical Quality Language

Clinical quality indicators,which are based on statistic,are very important parts of clinical quality measure.Traditionally,clinical quality indicators are presented in natural language.It leads to problems of ambiguity among orgnizations and obstructs the sharing and comparison of clinical quality information.Computer languages,such as Quality Data Model(QDM).Clinical Quality Language(CQL)can express clinical concepts and logical operations involved in the indicators without ambiguity,and can effectively address this issue.A standard and unified clinical information model is the key of computerized expression.OpenEHR is an open,easy-to-expand standardized clinical information model,but openEHR-based clinical quality indicator description language is yet missing.Therefore,the goal of this thesis is to design and implement an openEHR-based clinical quality indicator description language.The main work includes:1)The existing clinical quality indicator description languages such as QDM and CQL are reviewed,and their advantages and disadvantages are analyzed.The characteristics of openEHR information model are summarized,and the design of AQL and GDL for these characteristics is analyzed.2)The requirements for the expression of clinical quality indicators are analyzed.OCQL is designed referring to CQL,which includes five parts:data type,indicator metadata,term binding,data binding and conditional filtering.The general process of using OCQL to express clinical quality indicators is illustrated by a representative example.3)An interpreter for the OCQL is designed and implemented.After analyzing the existing programming language implementation techniques,a language lexical and syntax analyzer was generated by ANTLR4 tools.According to the predefined expression logic model,parse tree processing,data extraction processing,and expression execution were implemented.The assessment reveals that the interpreter can correctly interpret and execute indicators and its performance is acceptable.4)Based on the OCQL and its interpreter,an indicator-driven clinical quality measure system was designed and implemented,which allows users to dynamically add,edit,and deploy clinical quality indicators.Combineding CDR system that complies with the openEHR specification,indicators can be executed and displayed automatically.The assessment reveals that the system meets the requirements.