# Aligning EMR Structure with Treatment Cycles: Enhancing Data Management and CDSS Functionality
## 4 Two Different Approaches Within EMRs for the Patient Treatment Process
### Treatment Cycle Approach Within EMRs  
The effective utilization of EMRs is pivotal in promoting physician engagement with these systems, as it provides significant incentives for adoption while enforcing penalties for non-compliance [53, 54]. However, to maximize the usability and clinical value of EMRs, it is essential to ensure that the data entered during the treatment process are structured in such a way that aligns with real-world medical workflows. Recognizing this necessity, we have introduced an innovative cycle-based approach that redefines how medical processes are documented and analyzed within EMRs. This proposed model systematically segments the entire treatment process into distinct cycles, allowing for a more structured and transparent representation of a patient's progression. By explicitly defining treatment stages and outcomes within the EMR, this approach enhances the ability of physicians and medical decision support systems to track treatment effectiveness, recognize iterative patterns, and optimize patient care strategies. Ultimately, the cycle-based framework bridges the gap between digitalized medical data and practical clinical needs, offering a more intuitive and analytically powerful solution for the management of treatment histories within EMRs.  
As illustrated in Figure 3, the proposed model establishes a structured sequence for data form arrangement, ensuring that, except for the initial form, each subsequent form has prerequisite entries before it can be accessed or completed. In this framework, the priority of data entry is a fundamental principle, with numbered data forms appearing sequentially based on their designated order of precedence. While each data form is associated with a specific department and utilized independently by its users, the model maintains interdependence and continuity, effectively linking them like a chain.  
This structured approach resolves the imbalance between the number of treatment cycles and the corresponding data forms used in the current system. By enforcing a logical sequence, the proposed model enhances data integrity and ensures a more coherent representation of the treatment process. To further illustrate the application of this method, Figure 3 presents a data field for intrauterine fetal demise (IUFD) as an example of a structured treatment cycle.  
In this model, each IUFD data field per referral is assigned a unique cycle number, distinguishing treatment cycles. For instance, IUFD data from 2020 are separable from IUFD data from 2022 through the cycle number. This patient underwent two treatment cycles, each with a different path and outcome. The cycle number field in medical reports helpsmedical teams to identify the corresponding treatment cycle for each data entry, allowing for a more precise evaluation of treatment progress and effectiveness. Additionally, this model provides flexibility in defining treatment cycles, enabling medical personnel to include multiple data forms as needed. The cycle structure and its components can be modified based on medical requirements, ensuring adaptability to different treatment scenarios. An empirical evaluation is conducted to validate this approach, comparing it with the conventional EMR design and demonstrating its advantages in structuring and analyzing medical data.