Improving*EHR*Seman1c Interoperability ! - - PDF document

Improving*EHR*Seman1c Interoperability

!Future*Vision*and*Challenges>

Catalina'Mar*nez-Costa1,'Dipak'Kalra2'and'Stefan'Schulz1

1IMI,%Medical%University%of%Graz,%Austria 2CHIME,%University%College%London,%UK

EHR$Seman*c$Interoperability

• Seman&c(interoperability"requires"agreement"on

concept"meanings"and"labels"for"those"meanings

!

• Ontologies(and(terminologies(goal"is"to"enable"the

faithful"sharing"of"this"meaning"between"machines and"machines/people

!

"

!

"

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Informa(on)Models)and)Terminologies

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EHR$Informa,on$model Terminologies$/$Ontologies They%represent%what%is%known about%some%pa3ent They%provide%agreed%formal defini3ons%of%medical concepts Medical$records$contain items%of%informa3on%that refer%to%his%clinical situa3on%(described%using medical%concepts)

ICD

Overlapping,area THE$BOUNDARY$PROBLEM

medica3on administra3on Suspected%diagnosis cancer Request

!!!!!!!!!!!!!!!!!!!Framework

Descrip(on+logics formal+ontology encompassing+clinical+and informa(onal+en((es Seman(c+pa5erns+as +frame6like+user6friendly representa(on SEMANTIC INFRASTRUCTURE Homogeneous+access+point +to+clinical+informa(on Non6interoperable,+possibly+isoseman(c+clinical+informa(on

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!

Layer&1:&Iso,seman/c&informa/on

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ENTRY ELEMENT Coded,Text datatype

Disease Diagnosis

Stomach,dysplasia |20915006| ENTRY ELEMENT Coded,Text datatype

Disease Diagnosis

ELEMENT Coded,Text datatype

Location

dysplasia|25723000| Stomach |69695003| Structural,relaDonships ELEMENT Coded,Text datatype

Severity

severe,|24484000| ENTRY ELEMENT Coded,Text datatype

Disease Diagnosis

Severe,stomach,dysplasia |308856004|

• Structural,relaDonships
• Heterogeneous,context,requirements
• Heterogeneous,informaDon,detail
• IsoOsemanDc,models

boundary,problem , , ,

!!!!!!!!!!!!!!!!!!!Framework

Descrip(on+logics formal+ontology encompassing+clinical+and informa(onal+en((es Seman(c+pa5erns+as +frame6like+user6friendly representa(on SEMANTIC INFRASTRUCTURE Homogeneous+access+point +to+clinical+informa(on Non6interoperable,+possibly+isoseman(c+clinical+informa(on

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!

Layer&3:Seman,c&Mediator

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Par%cular Informa%on Object Material Object Plan Process Situa%on Request record Informa%on Item Informa%on A;ribute Status Diagnosis Record Clinical Finding Disorder@of stomach Suspected Stomach Dysplasia Qualifier Value Severi%es Severe Finding Context@Value

! ! ! Top%level!Ontology BioTopLite Informa6on!en66y Ontology Medical!Domain!Ontology SNOMED!CT

Body structure Dysplasia Severe@Stomach Dysplasia

Layer&3:&Seman,c&Mediator&(II)

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Diagnosis Record Suspected Dysplasia Severe isAboutSitua*on,only hasInforma*onA4ribute,some hasInforma*onA4ribute,some isIncludedIn,some Stomach

! !

Detect7equivalences Advanced7query7possibili;es: Records7about7diseases7located in7the7stomach Suspected7diagnoses7of7stomach7diseases Records7about7severe7gastric7diseases Diagnosis Record Suspected Stomach dysplasia Severe isAboutSitua*on,only hasInforma*onA4ribute,some hasInforma*onA4ribute,some

! !

Diagnosis Record Suspected Severe7Stomach dysplasia isAboutSitua*on,only hasInforma*onA4ribute,some

!

!!!!!!!!!!!!!!!!!!!Framework

Descrip(on+logics formal+ontology encompassing+clinical+and informa(onal+en((es Seman(c+pa5erns+as +frame6like+user6friendly representa(on SEMANTIC INFRASTRUCTURE Homogeneous+access+point +to+clinical+informa(on Non6interoperable,+possibly+isoseman(c+clinical+informa(on

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!

Layer&2:&Seman,c&Mapping

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Information*Attribute InformationItem hasAttribute+(0..*) isAboutSituation+(1..*) ClinicalSituation ClinicalProcess resultFromProcess+(1..*) InformationItem InformationItem DiagnosisStatus DiagnosisRecord hasStatus+(1..1) isAboutSituation+(1..*) ClinicalSituation DiagnosticProcess resultFromProcess+(1..1) DiagnosisRecord DiagnosisRecord ! ! Severity hasSeverity+(0..1) DiagnosisRecord Specializa)on example ! OR CP_PT Composi)on example

Layer&2:&Seman,c&Mapping&(II)

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hasParticipant+(0..*) MaterialObject ClinicalProcess

• ccursAt+(0..1)

happensAt+(0..1) TemporalRegion MaterialObject ClinicalProcess ClinicalProcess !

Suspected DiagnosisRecord hasStatus isAboutSituation Stomach;dysplasia DiagnosticProcess resultFromProcess DiagnosisRecord DiagnosisRecord Severe hasSeverity DiagnosisRecord hasInformationSubject PatientX happensAt HospitalY

• ccursAt

10/12/2013

!

Instance(example

!!!!!!!!!!!!!!!!!!!Framework

Descrip(on+logics formal+ontology encompassing+clinical+and informa(onal+en((es Seman(c+pa5erns+as +frame6like+user6friendly representa(on SEMANTIC INFRASTRUCTURE Homogeneous+access+point +to+clinical+informa(on Non6interoperable,+possibly+isoseman(c+clinical+informa(on

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!

Layers'4)5:'Virtual'Homogeneous'data'/ Applica;on

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RDF'/'OWL'DL

RULE%SET%A

Severe%%|5..7| Mild%|2…4| %

Suspected+diagnoses stomach+diseases

Suspected hasStatus isAboutSituation Stomach-dysplasia DiagnosisRecord DiagnosisRecord

% Query'paBern

Records+about+severe gastric+diseases

Query PaBerns

RULE%SET%B

Severe%|9..10| Mild%|6…8| % A B

hasSeverity Severe DiagnosisRecord

DL%reasoning

Suspected diagnoses+of dysplasia Records+about suspected+stomach dysplasia

Virtual Homogeneous Data'Layer Applica;on Layer

Conclusions)and)Outlook

• Seman'cHealthNet.proposes.an.intermediate

seman*c,layer.able.to.deal.with.the.present clinical.informa'on.heterogeneity

) )

• Logic;based.ontologies.allow.for.compu'ng

seman'c.equivalence.across.iso;seman'c models.and.advanced.clinical.informa'on exploita'on

) )

• Seman*c,pa3erns,offer.a.user;friendlier.way

to.work.with.the.ontologies

)

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Thanks'for'your'a-en/on

Contact: catalina.mar*nez@medunigraz.at

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Ques/ons