Abstracts

Electronic medical records for neurophysiology reports come in many forms. Many are sold with EEG equipment; others are customized by each epilepsy center or neurophysiology lab for prospective research projects. We report our experience with a multi-user, password protected customized relational database and discuss benefits and pitfalls encountered. In 1997 we developed a relational database using Microsoft Access for large multi-hospital epilepsy center and neurophysiology labs. Currently there are over 13,000 unique patients listed. The database was constructed to include demographic information, EEG report data to meet criteria specified by the American Clinical Neurophysiology Society guidelines, standardized classification of EEG abnormalities, classification of epileptic and nonepileptic events modified from the ILAE proposed classifications and other pertinent patient characteristics needed for epilepsy evaluations. The database can generate EEG reports, video-EEG reports and other neurophysiology reports such as the Wada test and evoked responses. Advantages of this database include easy report generation, compact data storage compared to text or word processing files, networked data availability for clinical management, ability to create queries for research and ease for database modification when needed for clinical care, research, or regulatory changes such as HIPAA.
Since the database stands independent of a specific neurophysiology equipment vendor, the use of multiple neurophysiology equipment vendors with their database incompatibilities is avoided and changing EEG equipment does not result in data retrieval inconvenience.
Problems encountered include obtaining network connectivity among affiliated institutions where different internet protocols exist, the desire of some hospitals to maintain separate databases, arrangements for database backups, training for database use vs. report retrieval, integration of reports into institutional electronic medical records that are insensitive to research requirements, and constantly evolving privacy rules and security for electronic records. For an academic epilepsy center using multiple equipment brands at multiple hospitals and neurophysiology laboratories, a customized neurophysiology database for EEG and other epilepsy program related data allows long term data collection and report retrieval that is more effective than databases supplied by equipment vendors. (Supported by Parkland Health and Hospital Systems, Children[apos]s Medical Center of Dallas, University of Texas Southwestern Medical Center.)