Julia Palm

About Julia Palm:
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LHA ID: 873TR7CDCQ-5

Location:  Germany

ORCID: https://orcid.org/0000-0003-1568-5893

Joined: 19th May 2021

Expertise: Not specified

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Related items

SMITH - Smart Medical Information Technology for Healthcare

Medical data routinely generated in everyday clinical practice is processed and made available to medical research in a standardized form. Patients benefit from reliable research results, more precise diagnoses and better treatments. In order to link data from care and research, the participating university hospitals in Aachen, Bonn, Essen, Halle, Hamburg, Jena and Leipzig have established sustainable Data Integration Centers. The network partners Ruhr University Bochum, the Düsseldorf University ...

Programme: MII - Medical Informatics Initiative

Public web page: https://www.smith.care/

Start date: 1st Jan 2018

POLAR - Polypharmacy, Drug Interactions, Risks

The aim of the project is to use methods and processes of the Medical Informatics Initiative (MII) to contribute to the detection of health risks in patients with polypharmacy. Polypharmacy occurs especially in elderly patients with multimorbidity. Polypharmacy associated with an increased risk for medication errors and drug-drug or drug-disease interactions, which either reduce or intensify the desired effect of individual active substances or lead to undesired adverse drug effects (ADE). In the ...

Programme: MII - Medical Informatics Initiative

Public web page: https://www.medizininformatik-initiative.de/en/POLAR

"fhircrackr": An R Package Unlocking Fast Healthcare Interoperability Resources for Statistical Analysis.
POLAR - Polypharmacy, Drug Interactions, Risks

Abstract (Expand)

BACKGROUND: The growing interest in the secondary use of electronic health record (EHR) data has increased the number of new data integration and data sharing infrastructures. The present work has been … developed in the context of the German Medical Informatics Initiative, where 29 university hospitals agreed to the usage of the Health Level Seven Fast Healthcare Interoperability Resources (FHIR) standard for their newly established data integration centers. This standard is optimized to describe and exchange medical data but less suitable for standard statistical analysis which mostly requires tabular data formats. OBJECTIVES: The objective of this work is to establish a tool that makes FHIR data accessible for standard statistical analysis by providing means to retrieve and transform data from a FHIR server. The tool should be implemented in a programming environment known to most data analysts and offer functions with variable degrees of flexibility and automation catering to users with different levels of FHIR expertise. METHODS: We propose the fhircrackr framework, which allows downloading and flattening FHIR resources for data analysis. The framework supports different download and authentication protocols and gives the user full control over the data that is extracted from the FHIR resources and transformed into tables. We implemented it using the programming language R [1] and published it under the GPL-3 open source license. RESULTS: The framework was successfully applied to both publicly available test data and real-world data from several ongoing studies. While the processing of larger real-world data sets puts a considerable burden on computation time and memory consumption, those challenges can be attenuated with a number of suitable measures like parallelization and temporary storage mechanisms. CONCLUSION: The fhircrackr R package provides an open source solution within an environment that is familiar to most data scientists and helps overcome the practical challenges that still hamper the usage of EHR data for research.

Authors: J. Palm, F. A. Meineke, J. Przybilla, T. Peschel

Date Published: 25th Jan 2023

Publication Type: Journal article

“fhircrackr”: An R package unlocking fast healthcare interoperability resources for statistical analysis
SMITH - Smart Medical Information Technology for Healthcare

Abstract (Expand)

BACKGROUND: The growing interest in the secondary use of electronic health record (EHR) data has increased the number of new data integration and data sharing infrastructures. The present work has been … developed in the context of the German Medical Informatics Initiative, where 29 university hospitals agreed to the usage of the Health Level Seven Fast Healthcare Interoperability Resources (FHIR) standard for their newly established data integration centers. This standard is optimized to describe and exchange medical data but less suitable for standard statistical analysis which mostly requires tabular data formats. OBJECTIVES: The objective of this work is to establish a tool that makes FHIR data accessible for standard statistical analysis by providing means to retrieve and transform data from a FHIR server. The tool should be implemented in a programming environment known to most data analysts and offer functions with variable degrees of flexibility and automation catering to users with different levels of FHIR expertise. METHODS: We propose the fhircrackr framework, which allows downloading and flattening FHIR resources for data analysis. The framework supports different download and authentication protocols and gives the user full control over the data that is extracted from the FHIR resources and transformed into tables. We implemented it using the programming language R [1] and published it under the GPL-3 open source license. RESULTS: The framework was successfully applied to both publicly available test data and real-world data from several ongoing studies. While the processing of larger real-world data sets puts a considerable burden on computation time and memory consumption, those challenges can be attenuated with a number of suitable measures like parallelization and temporary storage mechanisms. CONCLUSION: The fhircrackr R package provides an open source solution within an environment that is familiar to most data scientists and helps overcome the practical challenges that still hamper the usage of EHR data for research.

Authors: Julia Palm, Frank A Meineke, Jens Przybilla, Thomas Peschel

Date Published: 2023

Publication Type: Journal article

POLAR – „POLypharmazie, Arzneimittelwechselwirkungen und Risiken“ – wie können Daten aus der stationären Krankenversorgung zur Beurteilung beitragen?
SMITH - Smart Medical Information Technology for Healthcare

Abstract (Expand)

Zusammenfassung Hintergrund Mit der zunehmenden Anzahl eingenommener Arzneimittel steigt die Prävalenz von Medikationsrisiken. Hierzu zählen beispielsweise Arzneimittelwechselwirkungen, welche erwünschte … und unerwünschte Wirkungen einzelner Arzneistoffe reduzieren aber auch verstärken können. Fragestellung Das Verbundvorhaben POLAR (POLypharmazie, Arzneimittelwechselwirkungen und Risiken) hat das Ziel, mit Methoden und Prozessen der Medizininformatikinitiative (MII) auf Basis von „Real World Data“ (stationärer Behandlungsdaten von Universitätskliniken) einen Beitrag zur Detektion von Medikationsrisiken bei Patient:innen mit Polymedikation zu leisten. Im Artikel werden die konkreten klinischen Probleme dargestellt und am konkreten Auswertebeispiel illustriert. Material und Methoden Konkrete pharmakologische Fragestellungen werden algorithmisch abgebildet und an 13 Datenintegrationszentren in verteilten Analysen ausgewertet. Eine wesentliche Voraussetzung für die Anwendung dieser Algorithmen ist die Kerndatensatzstruktur der MII, die auf internationale IT-, Interoperabilitäts- und Terminologiestandards setzt. Ergebnisse In POLAR konnte erstmals gezeigt werden, dass stationäre Behandlungsdaten standortübergreifend auf der Basis abgestimmter, interoperabler Datenaustauschformate datenschutzkonform für Forschungsfragen zu arzneimittelbezogenen Problemen nutzbar gemacht werden können. Schlussfolgerungen Als Zwischenstand in POLAR wird ein erstes vorläufiges Ergebnis einer Analyse gezeigt. Darüber hinaus werden allgemeinere technische, rechtliche, kommunikative Chancen und Herausforderungen dargestellt, wobei der Fokus auf dem Fall der Verwendung stationärer Behandlungsdaten als „Real World Data“ für die Forschung liegt.

Authors: André Scherag, Wahram Andrikyan, Tobias Dreischulte, Pauline Dürr, Martin F Fromm, Jan Gewehr, Ulrich Jaehde, Miriam Kesselmeier, Renke Maas, Petra A Thürmann, Frank Meineke, Daniel Neumann, Julia Palm, Thomas Peschel, Editha Räuscher, Susann Schulze, Torsten Thalheim, Thomas Wendt, Markus Loeffler, D Ammon, W Andrikyan, U Bartz, B Bergh, T Bertsche, O Beyan, S Biergans, H Binder, M Boeker, H Bogatsch, R Böhm, A Böhmer, J Brandes, C Bulin, D Caliskan, I Cascorbi, M Coenen, F Dietz, F Dörje, T Dreischulte, J Drepper, P Dürr, A Dürschmid, F Eckelt, R Eils, A Eisert, C Engel, F Erdfelder, K Farker, M Federbusch, S Franke, N Freier, T Frese, M Fromm, K Fünfgeld, T Ganslandt, J Gewehr, D Grigutsch, W Haefeli, U Hahn, A Härdtlein, R Harnisch, S Härterich, M Hartmann, R Häuslschmid, C Haverkamp, O Heinze, P Horki, M Hug, T Iskra, U Jaehde, S Jäger, P Jürs, C Jüttner, J Kaftan, T Kaiser, K Karsten Dafonte, M Kesselmeier, S Kiefer, S Klasing, O Kohlbacher, D Kraska, S Krause, S Kreutzke, R Krock, K Kuhn, S Lederer, M Lehne, M Löbe, M Loeffler, C Lohr, V Lowitsch, N Lüneburg, M Lüönd, I Lutz, R Maas, U Mansmann, K Marquardt, A Medek, F Meineke, A Merzweiler, A Michel-Backofen, Y Mou, B Mussawy, D Neumann, J Neumann, C Niklas, M Nüchter, K Oswald, J Palm, T Peschel, H Prokosch, J Przybilla, E Räuscher, L Redeker, Y Remane, A Riedel, M Rottenkolber, F Rottmann, F Salman, J Schepers, A Scherag, F Schmidt, S Schmiedl, K Schmitz, G Schneider, A Scholtz, S Schorn, B Schreiweis, S Schulze, A K Schuster, M Schwab, H Seidling, S Semler, K Senft, M Slupina, R Speer, S Stäubert, D Steinbach, C Stelzer, H Stenzhorn, M Strobel, T Thalheim, M Then, P Thürmann, D Tiller, P Tippmann, Y Ucer, S Unger, J Vogel, J Wagner, J Wehrle, D Weichart, L Weisbach, S Welten, T Wendt, R Wettstein, I Wittenberg, R Woltersdorf, M Yahiaoui-Doktor, S Zabka, S Zenker, S Zeynalova, L Zimmermann, D Zöller, für das POLAR-Projekt

Date Published: 1st Sep 2022

Publication Type: Journal article

Integration of allergy documentation into an interoperable archiving and communication platform to improve patient care and clinical research at the Jena University Hospital
SMITH - Smart Medical Information Technology for Healthcare

Abstract (Expand)

As part of the digitalization strategy for medical documentation, we introduced a vendor-neutral archive (VNA) at the Jena University Hospital. The VNA provides data based on interoperable formats for … all clinical systems and for communication with other actors as well as for secondary data use. HL7 FHIR is used as a standard for structuring individual data. Using the example of allergy documentation, the paper describes objectives, work status, and experiences from several sub-projects currently being pursued in Jena to establish FHIR. Challenges in information modelling, semantic annotation, connection of clinical sub-systems and integration of FHIR resources in archiving structures and processes are discussed and the necessary cooperation for profiling technical standards is indicated.

Authors: Henner M. Kruse, Alexander Helhorn, Lo An Phan-Vogtmann, Julia Palm, Eric Thomas, Andreas Iffland, Andrew Heidel, Susanne Müller, Kutaiba Saleh, Karsten Krohn, Martin Specht, Michael Hartmann, Katrin Farker, Cord Spreckelsen, Andreas Henkel, Andre Scherag, Danny Ammon

Date Published: 26th Apr 2021

Publication Type: Journal article

Algorithmic surveillance of ICU patients with acute respiratory distress syndrome (ASIC): protocol for a multicentre stepped-wedge cluster randomised quality improvement strategy
SMITH - Smart Medical Information Technology for Healthcare

Abstract (Expand)

INTRODUCTION: The acute respiratory distress syndrome (ARDS) is a highly relevant entity in critical care with mortality rates of 40%. Despite extensive scientific efforts, outcome-relevant therapeutic … measures are still insufficiently practised at the bedside. Thus, there is a clear need to adhere to early diagnosis and sufficient therapy in ARDS, assuring lower mortality and multiple organ failure. METHODS AND ANALYSIS: In this quality improvement strategy (QIS), a decision support system as a mobile application (ASIC app), which uses available clinical real-time data, is implemented to support physicians in timely diagnosis and improvement of adherence to established guidelines in the treatment of ARDS. ASIC is conducted on 31 intensive care units (ICUs) at 8 German university hospitals. It is designed as a multicentre stepped-wedge cluster randomised QIS. ICUs are combined into 12 clusters which are randomised in 12 steps. After preparation (18 months) and a control phase of 8 months for all clusters, the first cluster enters a roll-in phase (3 months) that is followed by the actual QIS phase. The remaining clusters follow in month wise steps. The coprimary key performance indicators (KPIs) consist of the ARDS diagnostic rate and guideline adherence regarding lung-protective ventilation. Secondary KPIs include the prevalence of organ dysfunction within 28 days after diagnosis or ICU discharge, the treatment duration on ICU and the hospital mortality. Furthermore, the user acceptance and usability of new technologies in medicine are examined. To show improvements in healthcare of patients with ARDS, differences in primary and secondary KPIs between control phase and QIS will be tested. ETHICS AND DISSEMINATION: Ethical approval was obtained from the independent Ethics Committee (EC) at the RWTH Aachen Faculty of Medicine (local EC reference number: EK 102/19) and the respective data protection officer in March 2019. The results of the ASIC QIS will be presented at conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER: DRKS00014330.

Authors: Gernot Marx, Johannes Bickenbach, Sebastian Johannes Fritsch, Julian Benedict Kunze, Oliver Maassen, Saskia Deffge, Jennifer Kistermann, Silke Haferkamp, Irina Lutz, Nora Kristiana Voellm, Volker Lowitsch, Richard Polzin, Konstantin Sharafutdinov, Hannah Mayer, Lars Kuepfer, Rolf Burghaus, Walter Schmitt, Joerg Lippert, Morris Riedel, Chadi Barakat, André Stollenwerk, Simon Fonck, Christian Putensen, Sven Zenker, Felix Erdfelder, Daniel Grigutsch, Rainer Kram, Susanne Beyer, Knut Kampe, Jan Erik Gewehr, Friederike Salman, Patrick Juers, Stefan Kluge, Daniel Tiller, Emilia Wisotzki, Sebastian Gross, Lorenz Homeister, Frank Bloos, André Scherag, Danny Ammon, Susanne Mueller, Julia Palm, Philipp Simon, Nora Jahn, Markus Loeffler, Thomas Wendt, Tobias Schuerholz, Petra Groeber, Andreas Schuppert

Date Published: 1st Apr 2021

Publication Type: Journal article

Future medical artificial intelligence application requirements and expectations of physicians in German university hospitals: Web-based survey
SMITH - Smart Medical Information Technology for Healthcare

Abstract (Expand)

BACKGROUND: The increasing development of artificial intelligence (AI) systems in medicine driven by researchers and entrepreneurs goes along with enormous expectations for medical care advancement. … AI might change the clinical practice of physicians from almost all medical disciplines and in most areas of health care. While expectations for AI in medicine are high, practical implementations of AI for clinical practice are still scarce in Germany. Moreover, physicians’ requirements and expectations of AI in medicine and their opinion on the usage of anonymized patient data for clinical and biomedical research have not been investigated widely in German university hospitals. OBJECTIVE: This study aimed to evaluate physicians’ requirements and expectations of AI in medicine and their opinion on the secondary usage of patient data for (bio)medical research (eg, for the development of machine learning algorithms) in university hospitals in Germany. METHODS: A web-based survey was conducted addressing physicians of all medical disciplines in 8 German university hospitals. Answers were given using Likert scales and general demographic responses. Physicians were asked to participate locally via email in the respective hospitals. RESULTS: The online survey was completed by 303 physicians (female: 121/303, 39.9%; male: 173/303, 57.1%; no response: 9/303, 3.0%) from a wide range of medical disciplines and work experience levels. Most respondents either had a positive (130/303, 42.9%) or a very positive attitude (82/303, 27.1%) towards AI in medicine. There was a significant association between the personal rating of AI in medicine and the self-reported technical affinity level (H4=48.3, P<.001). A vast majority of physicians expected the future of medicine to be a mix of human and artificial intelligence (273/303, 90.1%) but also requested a scientific evaluation before the routine implementation of AI-based systems (276/303, 91.1%). Physicians were most optimistic that AI applications would identify drug interactions (280/303, 92.4%) to improve patient care substantially but were quite reserved regarding AI-supported diagnosis of psychiatric diseases (62/303, 20.5%). Of the respondents, 82.5% (250/303) agreed that there should be open access to anonymized patient databases for medical and biomedical research. CONCLUSIONS: Physicians in stationary patient care in German university hospitals show a generally positive attitude towards using most AI applications in medicine. Along with this optimism comes several expectations and hopes that AI will assist physicians in clinical decision making. Especially in fields of medicine where huge amounts of data are processed (eg, imaging procedures in radiology and pathology) or data are collected continuously (eg, cardiology and intensive care medicine), physicians’ expectations of AI to substantially improve future patient care are high. In the study, the greatest potential was seen in the application of AI for the identification of drug interactions, assumedly due to the rising complexity of drug administration to polymorbid, polypharmacy patients. However, for the practical usage of AI in health care, regulatory and organizational challenges still have to be mastered.

Authors: Oliver Maassen, Sebastian Fritsch, Julia Palm, Saskia Deffge, Julian Kunze, Gernot Marx, Morris Riedel, Andreas Schuppert, Johannes Bickenbach

Date Published: 1st Mar 2021

Publication Type: Journal article

MII - Medical Informatics Initiative

The medical informatics initiative was created to close the gap between research and healthcare. All of Germany’s university hospitals have joined forces with research institutions, businesses, health insurers, and patient advocacy groups to create a framework that harnesses research findings to the direct benefit of patients. The German Federal Ministry of Education and Research (BMBF) is investing around 160 million euros in the programme through 2021. The digitisation of medicine is creating ...

Projects: Methodical Use Case PheP, SMITH - Smart Medical Information Technology for Healthcare, POLAR - Polypharmacy, Drug Interactions, Risks

Web page: https://www.medizininformatik-initiative.de/en

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