Metadata in Digital Preservation and Exchange of Electronic Healthcare Records.

Abstract: The Swedish National Archives are in charge of the management of Common Specifications (CS). CS are genericmetadata specifications that provides structure and markup when transferring digital information betweeninformation systems and to electronic archives. As of now there is no CS for electronic healthcare records (EHR).Organizations around Sweden have developed their own specifications for transferring healthcare information. Inaddition to that, there are comprehensive international EHR metadata standards established. The Swedish NationalArchives have commissioned a study of EHR metadata specifications and standards to aid in the development of theCS.A Delphi study was conducted, including respondents from major archiving organizations in Sweden, to identifynecessary metadata categories when exchanging EHRs. The data was analyzed considering the international EHRmetadata standards HL7 CDA2 and CEN/ISO EN13606, as well as digital preservation metadata categories. Theresults were a set of metadata categories necessary to include in a CS. In addition, a subset of suggested mandatorymetadata categories is proposed and a list of implications for practice. Clinical codes, auditing, and separatingmetadata related to different contexts are a sample size of the implications.The results were evaluated in an interview with the Swedish National Archives, as well as Sydarkivera. Three criteriafor evaluating the results were proposed, being that the results had to consider a common terminology as well as bebased on a metadata standard and Swedish metadata specifications for EHRs. The interview revealed that the resultssatisfied these criterions, except for requiring a study on one additional user environment of EHRs.