Development of an EHR System for Sharing - a Semantic Perspective , - PowerPoint PPT Presentation

For the latest, go to http://w3.ibm.com/ibm/presentations • ! IBM logo must not be moved, added to, or altered in any way China Research Laboratory , white Maximum length: 1 line Development of an EHR System for Sharing - a Semantic Perspective , black Recommended maximum Haifeng LIU, Xue Qiao HOU, Gang HU, Jing LI and Yu Qi DING For client presentations, 2009-08-31 client’ teal R045 | G182 | B179 go in this area I&K Department IBM China Research Lab. maximum length: 2 lines MIE2009 | Sarajevo, B&H

For the latest, go to http://w3.ibm.com/ibm/presentations • ! IBM logo must not be moved, added IBM China Research Laboratory , white to, or altered in any way Maximum length: 1 line Content • ! Background should blue R120 | G137 | B251 not be modified. Maximum length: 2 lines  ! Motivation  ! CDA-based Approach  ! System Architecture  ! Example demo  ! Conclusion , black teal R045 | G182 | B179 Recommended maximum 2

For the latest, go to http://w3.ibm.com/ibm/presentations • ! IBM logo must not be moved, added IBM China Research Laboratory , white to, or altered in any way Maximum length: 1 line Motivation and Goals • ! Background should blue R120 | G137 | B251 not be modified. Maximum length: 2 lines  ! Being able to perform semantic search is particularly crucial for clinical workers and researchers, as they often need to search for the descriptions of a specific clinical finding from a large volume of clinical documents while keywords search will often return incomplete search results or too many unrelated information. , black  ! The goal is to demonstrate the power of leveraging semantic technology to enable semantic search with an EHR system. teal R045 | G182 | B179 Recommended maximum 3

For the latest, go to http://w3.ibm.com/ibm/presentations • ! IBM logo must not be moved, added IBM China Research Laboratory , white to, or altered in any way Maximum length: 1 line Technical Approach: • ! Background should Modeling Medical Records for Interoperability blue R120 | G137 | B251 not be modified. What is “interoperability” � Maximum length: 2 lines , black teal R045 | G182 | B179 Recommended maximum 4

For the latest, go to http://w3.ibm.com/ibm/presentations • ! IBM logo must not be moved, added IBM China Research Laboratory , white to, or altered in any way Maximum length: 1 line HL7 CDA : Clinical Document Architecture • ! Background should blue R120 | G137 | B251 not be modified.  ! XML based architecture for clinical Maximum length: 2 lines document (Flexible and extensible) CDA Document  ! Incremental semantic interoperability Header  ! Level One  ! The unconstrained CDA specification. Body  ! Level Two  ! The CDA specification with section-level templates Section applied. , black  ! Level Three Narrative  ! The CDA specification with entry-level templates teal R045 | G182 | B179 applied.  ! Semantic annotation is key to enable interoperability Recommended maximum Clinical Statement and analytics code Incremental level of semantics � CDA code Entry CDA code Any to CDA Documents Schema Terminolog Formal Semantic Entry Transforma Exchange Structurali y Semantics Annotation � tion � ze CDA … Level One  �  � Entry Level Two  �  � * � Level  �  �  �  �  �  � Three 5

For the latest, go to http://w3.ibm.com/ibm/presentations • ! IBM logo must not be moved, added IBM China Research Laboratory , white to, or altered in any way Maximum length: 1 line • ! Background should blue R120 | G137 | B251 not be modified. Maximum length: 2 lines Semantic , black Annotation (CDA Anchor) teal R045 | G182 | B179 Recommended maximum 6

For the latest, go to http://w3.ibm.com/ibm/presentations • ! IBM logo must not be moved, added IBM China Research Laboratory , white to, or altered in any way HL7 CDA based EMR/EHR data model and application Maximum length: 1 line • ! Background should blue R120 | G137 | B251 not be modified. Maximum length: 2 lines Scenario: Patient Mr. Joe � (1) Mr. Joe fractured his left arm, and Semantic Interoperability go to see the Dr. George from Hospital A. (2) Dr. George gave Mr. Joe a treatment for two weeks. He wrote , black some medical records in the EMR Dr. George Header Dr. Smith system teal R045 | G182 | B179 Body (3) This EMR system can transfer the EHR/ HL7 CD HL7 CDA R2 A R2 Recommended maximum text into HL7 CDA format, and section EMR annotated by SNOMED CT. Text (4) Two weeks later, Mr. Joe was Entry introduced to Dr. Smith for more rehabilitation. Dr. Smith can read those EMR documents. Content profiles IBM Clinical Terminology Annotator 7

For the latest, go to http://w3.ibm.com/ibm/presentations • ! IBM logo must not be moved, added IBM China Research Laboratory , white to, or altered in any way Maximum length: 1 line System architecture • ! Background should blue R120 | G137 | B251 not be modified. Web user interface Maximum length: 2 lines Results Search request Document IDs Document IDs engine Semantic search CDA , black information request Document Search generator Level 3 RDF Indexer registry EHR teal R045 | G182 | B179 Recommended maximum triples RDF metadata Document triples triples RDF RDF CDA Publisher Reasoner documents CDA level 3 terminologies Clinical repository EHR 8

For the latest, go to http://w3.ibm.com/ibm/presentations • ! IBM logo must not be moved, added IBM China Research Laboratory , white to, or altered in any way Maximum length: 1 line CDA (L3) Generator � • ! Background should blue R120 | G137 | B251 not be modified. … … CDA instance CD A instance Maximum length: 2 lines <component> <section> <templateId root="1.3.6.1.4.1.19376.1.5.3.1.1.13.2.1" /> <id root="TEST" extension="2.16.840.1.113883.3.933"/> <code code=“10154-3” , displayName=‘History of present illness ’ , codeSystem="2.16.840.1.113883.6.1“ systemName="LOINC" /> <title> History of present illness </title> <text> 缘 患者近期情 绪 不 稳 ， 时 常 发 怒，于今年 2 月 1 日晚上 约 8 ： 00PM 与家人 发 生争 执 ，情 绪 激 动 ， 约 9 ： 15PM 家人 发现 患者昏坐于 椅 , 呼之不 应 , 当 时 无肢体抽搐、呕吐，遂呼 120 出 车 ，当 时查 患者呈 浅昏迷状 态 ，小便失禁， 测 血 压为 210/100mmHg ，予吸 氧 ，含服心 痛定、静滴硝酸甘油降 压 ，送我院急 诊 就 诊 , 急 查头颅 CT 口 头报 告： 左 侧 基底 节脑 出血，出血量 约 20ml 。急 诊 生化、血常 规 、凝血三 项 , black 正常。 脑 外科会 诊 指示 暂时 内科治 疗 。 经 予利喜定、醒 脑 静、清开 灵、七叶皂 甙钠 、甘露醇等 药 物治 疗 后，患者于今晨 约 7 ： 00AM 苏 醒，右 侧 肢体乏力，不能上抬，言 语 不清， 对 答欠合理， 为进 一步 治 疗 ，收入我区。 有高血 压 病史 4 年， 间 中服复方 罗 布麻片降 压 , 血 压 控制不 详 。 入院症 见 ：神志清， 烦 躁，反 应迟钝 ， 对 答欠合理， teal R045 | G182 | B179 面色偏 红 ，言 语 不清，右 侧 肢体乏力，伴 头 痛，停留尿管、胃管， 大便今日未解，口干。 无 头晕 、 恶 心欲呕、肢体抽搐、胸 闷 ，无 发 热 、咳嗽、咯痰。 </text> Recommended maximum </section> </component> � … … …… …… 9

For the latest, go to http://w3.ibm.com/ibm/presentations • ! IBM logo must not be moved, added IBM China Research Laboratory , white to, or altered in any way Maximum length: 1 line Core technique ： Localized terminology annotator • ! Background should blue R120 | G137 | B251 not be modified. Maximum length: 2 lines Terminology repository , black teal R045 | G182 | B179 Recommended maximum IBM terminology annotator Terminology Terminology Terminology Terminology 1 2 3 4 10