An Evolving Ecosystem for Natural Language Processing in Department of Veterans Affairs.

Journal: Journal of medical systems
PMID:

Abstract

In an ideal clinical Natural Language Processing (NLP) ecosystem, researchers and developers would be able to collaborate with others, undertake validation of NLP systems, components, and related resources, and disseminate them. We captured requirements and formative evaluation data from the Veterans Affairs (VA) Clinical NLP Ecosystem stakeholders using semi-structured interviews and meeting discussions. We developed a coding rubric to code interviews. We assessed inter-coder reliability using percent agreement and the kappa statistic. We undertook 15 interviews and held two workshop discussions. The main areas of requirements related to; design and functionality, resources, and information. Stakeholders also confirmed the vision of the second generation of the Ecosystem and recommendations included; adding mechanisms to better understand terms, measuring collaboration to demonstrate value, and datasets/tools to navigate spelling errors with consumer language, among others. Stakeholders also recommended capability to: communicate with developers working on the next version of the VA electronic health record (VistA Evolution), provide a mechanism to automatically monitor download of tools and to automatically provide a summary of the downloads to Ecosystem contributors and funders. After three rounds of coding and discussion, we determined the percent agreement of two coders to be 97.2% and the kappa to be 0.7851. The vision of the VA Clinical NLP Ecosystem met stakeholder needs. Interviews and discussion provided key requirements that inform the design of the VA Clinical NLP Ecosystem.

Authors

  • Jennifer H Garvin
    IDEAS Center SLC VA Healthcare System, 500 Foothill Drive, Salt Lake City, UT, 84148, USA. jennifer.garvin@va.gov.
  • Megha Kalsy
    IDEAS Center SLC VA Healthcare System, 500 Foothill Drive, Salt Lake City, UT, 84148, USA.
  • Cynthia Brandt
    Yale Center for Medical Informatics, Yale University.
  • Stephen L Luther
    Center of Innovation on Disability and Rehabilitation Research, Department of Health Policy and Management, James A. Haley Veterans Hospital, and the University of South Florida College of Public Health, 8900 Grand Oak Circle, Tampa, FL, 33637, USA.
  • Guy Divita
    VA Salt Lake City Health Care System, Salt Lake City, Utah, USA.
  • Gregory Coronado
    IDEAS Center SLC VA Healthcare System, 500 Foothill Drive, Salt Lake City, UT, 84148, USA.
  • Doug Redd
    IDEAS Center, Veterans Administration, Salt Lake City Health Care System, Salt Lake City, UT, United States; Department of Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, UT, United States.
  • Carrie Christensen
    IDEAS Center SLC VA Healthcare System, 500 Foothill Drive, Salt Lake City, UT, 84148, USA.
  • Brent Hill
    IDEAS Center SLC VA Healthcare System, 500 Foothill Drive, Salt Lake City, UT, 84148, USA.
  • Natalie Kelly
    IDEAS Center SLC VA Healthcare System, 500 Foothill Drive, Salt Lake City, UT, 84148, USA.
  • Qing Zeng Treitler
    IDEAS Center SLC VA Healthcare System, 500 Foothill Drive, Salt Lake City, UT, 84148, USA.