title: The Gap in Big Data: Getting to Wellbeing, Strengths, and a Whole-person Perspective.
abstract: BACKGROUND
  Electronic health records (EHRs) provide a clinical view of patient health. EHR data are becoming available in large data sets and enabling research that will transform the landscape of healthcare research. Methods are needed to incorporate wellbeing dimensions and strengths in large data sets. The purpose of this study was to examine the potential alignment of the Wellbeing Model with a clinical interface terminology standard, the Omaha System, for documenting wellbeing assessments.
  
  
  OBJECTIVE
  To map the Omaha System and Wellbeing Model for use in a clinical EHR wellbeing assessment and to evaluate the feasibility of describing strengths and needs of seniors generated through this assessment.
  
  
  METHODS
  The Wellbeing Model and Omaha System were mapped using concept mapping techniques. Based on this mapping, a wellbeing assessment was developed and implemented within a clinical EHR. Strengths indicators and signs/symptoms data for 5 seniors living in a residential community were abstracted from wellbeing assessments and analyzed using standard descriptive statistics and pattern visualization techniques.
  
  
  RESULTS
  Initial mapping agreement was 93.5%, with differences resolved by consensus. Wellbeing data analysis showed seniors had an average of 34.8 (range=22-49) strengths indicators for 22.8 concepts. They had an average of 6.4 (range=4-8) signs/symptoms for an average of 3.2 (range=2-5) concepts. The ratio of strengths indicators to signs/symptoms was 6:1 (range 2.8-9.6). Problem concepts with more signs/symptoms had fewer strengths.
  
  
  CONCLUSIONS
  Together, the Wellbeing Model and the Omaha System have potential to enable a whole-person perspective and enhance the potential for a wellbeing perspective in big data research in healthcare.
authors.affiliation: School of Nursing and Center for Spirituality and Healing; University of Minnesota, Minneapolis (Dr Monsen), United States.
authors.forename: Karen A
authors.initials: KA
authors.lastname: Monsen
authors.affiliation: The Waters Senior Living, Minnetonka, Minnesota (Ms Peters), United States.
authors.forename: Judith
authors.initials: J
authors.lastname: Peters
authors.affiliation: Edgewood College, Madison, Wisconsin (student; Ms Schlesner), United States.
authors.forename: Sara
authors.initials: S
authors.lastname: Schlesner
authors.affiliation: Mayo Clinic, Rochester, Minnesota (Dr Vanderboom), United States.
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Vanderboom
authors.affiliation: Mayo Clinic, Rochester, Minnesota (Dr Holland), United States.
authors.forename: Diane E
authors.initials: DE
authors.lastname: Holland
keywords: Electronic health records; Omaha System; Wellbeing Model; assessment