title: Maintaining the enterprisewide continuity and interoperability of patient allergy data.
abstract: OBJECTIVE
  The efforts, results, and challenges of a large tertiary care, academic health care system to standardize and integrate allergy information across clinical information systems are discussed.
  
  
  CONCLUSIONS
  The University of Michigan Health System and its Information Technology Strategic Advisory Committee recognized the necessity for storing and maintaining allergy information in a single repository; therefore, the clinical data repository (CDR) was named as the central database for coded allergens and reactions for the University of Michigan Hospitals and Health Care Centers (UMHHC) electronic medical record. The Enterprise Allergy Project (EAP) began in June 2005 with the formation of a steering committee that included representatives from clinical departments with order-entry systems. The initial phase of the EAP consisted of several components. One component was a one-time conversion of existing free-text allergy information into coded allergens and reactions. Before the implementation of the EAP, the order-entry system only supported the entry of uncoded allergen and reaction information. An initial process of allergy matching reduced the list of un-coded allergens from 272,519 to 29,500 by using terms that indicated no allergies were present and trimming and modifying free-text strings that closely matched or easily translated to a coded allergen counterpart. Another component of the EAP consisted of the interface and technical build to support allergy information processing between the CDR and University of Michigan (UM)-Carelink. One goal of the EAP was to transfer data bidirectionally, but that goal could not safely be accomplished.
  
  
  CONCLUSIONS
  Implementing a strategy for enterprise allergy integration at UMHHC has improved the quality of allergy information documented as measured by a significant decrease in the amount of uncoded allergens.
authors.affiliation: Department of Pharmacy Services, College of Pharmacy, University of Michigan, Ann Arbor, USA. chriszim@med.umich.edu
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Zimmerman
authors.forename: Bruce W
authors.initials: BW
authors.lastname: Chaffee
authors.forename: Josephine
authors.initials: J
authors.lastname: Lazarou
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Gingrich
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Russell
authors.forename: Marylou
authors.initials: M
authors.lastname: Galbraith
authors.forename: Nipa K
authors.initials: NK
authors.lastname: Khatlawala
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Laing
mesh_terms: D000046:Academic Medical Centers; D016907:Adverse Drug Reaction Reporting Systems; D016303:Clinical Pharmacy Information Systems; D019033:Delivery of Health Care, Integrated; D004342:Drug Hypersensitivity; D004360:Drug Therapy, Computer-Assisted; D006801:Humans; D008498:Medical Record Linkage; D016347:Medical Records Systems, Computerized; D008510:Medication Systems, Hospital; D008824:Michigan; D018511:Systems Integration