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 ! " ! " 2

Informa(on)Models)and)Terminologies ICD Terminologies$/$Ontologies EHR$Informa,on$model They%provide%agreed%formal They%represent%what%is%known defini3ons%of%medical about%some%pa3ent concepts Overlapping,area THE$BOUNDARY$PROBLEM Medical$records$ contain Suspected%diagnosis cancer items%of%informa3on%that refer%to%his%clinical medica3on situa3on%(described%using Request administra3on medical%concepts) 3

!!!!!!!!!!!!!!!!!!! Framework Homogeneous+access+point +to+clinical+informa(on Descrip(on+logics formal+ontology encompassing+clinical+and informa(onal+en((es SEMANTIC INFRASTRUCTURE Seman(c+pa5erns+as +frame6like+user6friendly representa(on ! Non6interoperable,+possibly+isoseman(c+clinical+informa(on 4

Layer&1:&Iso,seman/c&informa/on Diagnosis ENTRY ENTRY Diagnosis Disease ELEMENT Disease ELEMENT Coded,Text , dysplasia|25723000| Coded,Text datatype datatype Location ELEMENT Stomach,dysplasia , |20915006| Coded,Text Stomach datatype |69695003| Structural,relaDonships ELEMENT Severity Diagnosis ENTRY Coded,Text severe,|24484000| datatype Disease ELEMENT , • Structural,relaDonships Coded,Text • Heterogeneous,context,requirements datatype • Heterogeneous,informaDon,detail Severe,stomach,dysplasia • IsoOsemanDc,models |308856004| 5 boundary,problem

!!!!!!!!!!!!!!!!!!! Framework Homogeneous+access+point +to+clinical+informa(on Descrip(on+logics formal+ontology ! encompassing+clinical+and informa(onal+en((es SEMANTIC INFRASTRUCTURE Seman(c+pa5erns+as +frame6like+user6friendly representa(on Non6interoperable,+possibly+isoseman(c+clinical+informa(on 6

Layer&3:Seman,c&Mediator Par%cular Top%level!Ontology BioTopLite Informa%on ! Process Material Object Object Plan Situa%on Qualifier Clinical Value Finding Request Body Informa%on record structure Severi%es A;ribute Disorder@of Finding Informa%on stomach Severe ! Context@Value Item ! Status Stomach Suspected Dysplasia Diagnosis Dysplasia Record Medical!Domain!Ontology Severe@Stomach Informa6on!en66y SNOMED!CT Dysplasia Ontology 7

Layer&3:&Seman,c&Mediator&(II) isAboutSitua*on,only Diagnosis Dysplasia Record ! isIncludedIn,some Stomach ! hasInforma*onA4ribute,some Severe hasInforma*onA4ribute,some Suspected isAboutSitua*on,only ! Stomach Diagnosis Detect7equivalences dysplasia Record Advanced7query7possibili;es: hasInforma*onA4ribute,some Records7about7diseases7located ! Severe in7the7stomach Suspected7diagnoses7of7stomach7diseases hasInforma*onA4ribute,some Suspected Records7about7severe7gastric7diseases isAboutSitua*on,only Severe7Stomach Diagnosis dysplasia Record ! hasInforma*onA4ribute,some Suspected 8

!!!!!!!!!!!!!!!!!!! Framework Homogeneous+access+point +to+clinical+informa(on Descrip(on+logics formal+ontology encompassing+clinical+and informa(onal+en((es SEMANTIC INFRASTRUCTURE Seman(c+pa5erns+as +frame6like+user6friendly ! representa(on Non6interoperable,+possibly+isoseman(c+clinical+informa(on 9

Layer&2:&Seman,c&Mapping ClinicalProcess OR CP_PT resultFromProcess+(1..*) InformationItem ! Information*Attribute InformationItem ! hasAttribute+(0..*) ClinicalSituation isAboutSituation+(1..*) InformationItem Composi)on Specializa)on example example DiagnosticProcess resultFromProcess+(1..1) DiagnosisRecord DiagnosisStatus DiagnosisRecord hasStatus+(1..1) ! DiagnosisRecord Severity hasSeverity+(0..1) ClinicalSituation DiagnosisRecord isAboutSituation+(1..*) 10

Layer&2:&Seman,c&Mapping&(II) hasParticipant+(0..*) MaterialObject ClinicalProcess occursAt+(0..1) TemporalRegion ClinicalProcess ! happensAt+(0..1) MaterialObject ClinicalProcess Instance(example DiagnosticProcess DiagnosisRecord resultFromProcess PatientX hasInformationSubject happensAt HospitalY occursAt 10/12/2013 ! DiagnosisRecord Suspected hasStatus DiagnosisRecord hasSeverity Severe Stomach;dysplasia DiagnosisRecord isAboutSituation 11

!!!!!!!!!!!!!!!!!!! Framework Homogeneous+access+point +to+clinical+informa(on ! Descrip(on+logics formal+ontology encompassing+clinical+and informa(onal+en((es SEMANTIC INFRASTRUCTURE Seman(c+pa5erns+as +frame6like+user6friendly representa(on Non6interoperable,+possibly+isoseman(c+clinical+informa(on 12

Layers'4)5:'Virtual'Homogeneous'data'/ Applica;on Suspected+diagnoses Records+about+severe stomach+diseases gastric+diseases A B Query'paBern Suspected diagnoses+of Records+about dysplasia Suspected hasStatus DiagnosisRecord suspected+stomach dysplasia Stomach-dysplasia DiagnosisRecord isAboutSituation % Severe hasSeverity DiagnosisRecord Applica;on Layer RULE%SET%A Query Severe%%|5..7| Virtual RULE%SET%B PaBerns Mild%|2…4| Homogeneous Severe%|9..10| % Data'Layer Mild%|6…8| % RDF'/'OWL'DL DL%reasoning 13

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 14 )

Thanks'for'your'a-en/on Contact: catalina.mar*nez@medunigraz.at Ques/ons 15