Circulation 36,825 • Volume 17, No. 2 • Summer 2002

Data Dictionary Task Force (DDTF) Launches Initiative

A task force comprised of anesthesiologists and anesthesia information management systems manufacturers are now working together on a project whose ultimate goal is to improve patient safety.

The Anesthesia Patient Safety Foundation (APSF) formally announced the launch of the Data Dictionary Task Force (DDTF), a collaboration with manufacturers of anesthesia information management systems, to define a common set of data elements required in an electronic anesthesia record. According to APSF President, Robert K. Stoelting, MD, “A common data set allows for the collection and comparison of large volumes of clinical data from multiple institutions for outcomes research and benchmarking.”

Supported by a seed grant from the APSF and contributions from each of the corporate participants, the DDTF will focus initially on leveraging existing standards and lexicons, as well as collecting and comparing data elements from installed clinical information systems to determine common terms.

“We welcome this community-wide effort that brings together the clinical expertise of the APSF, its expert clinician panel, and the visionary manufacturers of anesthesia information systems,” Dr. Stoelting said. “This important project would not be possible without the leadership and support of Deio, Inc., Draeger Medical, eko systems inc., GE Medical Systems, Philips Medical Systems, Picis, Inc., and Siemens Medical Solutions.”

The Data Dictionary Task Force functions under the leadership of Terri G. Monk, MD, Professor of Anesthesiology, University of Florida, and an experienced outcomes researcher with an interest in post-anesthesia cognitive function. “Paper-based medical records do not facilitate the reliable and efficient transfer of medical information between health care facilities and providers. Computer-based patient records provide better interfaces between clinical data and health care providers,” Dr. Monk said. “At present, there are a variety of computer-based anesthesia records in use, but they lack the ability to interface with each other or with a central clinical data repository. The retrieval of information from these systems is also limited by inconsistencies in the naming of problems, medications, and other data.”

The DDTF was formed to address two interrelated objectives: identification of the specific perioperative outcomes that should be investigated, and designation of the important questions in anesthesia that should be asked and answered through data collection and analysis to achieve the greatest immediate patient benefit. A data dictionary was deemed a prerequisite to collecting the data elements needed to answer these questions.

The Institute of Medicine’s groundbreaking report, “Crossing the Quality Chasm,” cited automated clinical information systems as having the potential to improve quality of care through the collection and evaluation of clinical data captured at the point of care. According to the report, “Automated clinical and administrative data also enable many types of health service research applications, such as assessment of clinical outcomes associated with alternative treatment options and care processes; identification of best practices; and evaluation of the effects of different methods of financing, organizing, and delivering services.” Lack of standards for the coding and exchange of information was noted as a significant barrier to technology adoption in clinical practice.

According to Dr. Iain Sanderson, Director of Anesthesia Informatics at Duke University Medical Center and the project’s Technical Director, the DDTF expects to have a preliminary reference data set available for review in October 2002 to coincide with the Annual Meeting of the American Society of Anesthesiologists. “The APSF’s DDTF is approaching the problem of sharing data from a different perspective, recognizing that the primary problem is the lack of a standard terminology. The technical arm of the DDTF has been given the task of creating a tool for organizing a Reference Set of terms for anesthesiology,” says Dr. Sanderson.

The Data Dictionary Task Force is one activity being conducted by the APSF in support of its October 2001 policy statement: “The APSF endorses and advocates the use of automated record keeping in the perioperative period and the subsequent retrieval and analysis of that data to improve patient safety.”