Gokce B. Laleci

A survey and analysis of Electronic Healthcare Record standards

Medical information systems today store clinical information about patients in all kinds of proprietary formats. To address the resulting interoperability problems, several Electronic Healthcare Record standards that structure the clinical content for the purpose of exchange are currently under development. In this article, we present a survey of the most relevant Electronic Healthcare Record standards, examine the level of interoperability they provide, and assess their functionality in terms of content structure, access services, multimedia support, and security. We further investigate the complementarity of the standards and assess their market relevance.

Artemis: deploying semantically enriched web services in the healthcare domain

An essential element in defining the semantics of Web services is the domain knowledge. Medical informatics is one of the few domains to have considerable domain knowledge exposed through standards. These standards offer significant value in terms of expressing the semantics of Web services in the healthcare domain. In this paper, we describe the architecture of the Artemis project, which exploits ontologies based on the domain knowledge exposed by the healthcare information standards through standard bodies like HL7, CEN TC251, ISO TC215 and GEHR. We use these standards for two purposes: first to describe the Web service functionality semantics, that is, the meaning associated with what a Web service does and secondly to describe the meaning associated with the messages or documents exchanged through Web services. Artemis Web service architecture uses ontologies to describe semantics but it does not propose globally agreed ontologies; rather healthcare institutes reconcile their semantic differences through a mediator component. The mediator component uses ontologies based on prominent healthcare standards as references to facilitate semantic mediation among involved institutes. Mediators have a P2P communication architecture to provide scalability and to facilitate the discovery of other mediators.

Artemis message exchange framework: semantic interoperability of exchanged messages in the healthcare domain

One of the most challenging problems in the healthcare domain is providing interoperability among healthcare information systems. In order to address this problem, we propose the semantic mediation of exchanged messages. Given that most of the messages exchanged in the healthcare domain are in EDI (Electronic Data Interchange) or XML format, we describe how to transform these messages into OWL (Web Ontology Language) ontology instances. The OWL message instances are then mediated through an ontology mapping tool that we developed, namely, OWLmt. OWLmt uses OWL-QL engine which enables the mapping tool to reason over the source ontology instances while generating the target ontology instances according to the mapping patterns defined through a GUI.Through a prototype implementation, we demonstrate how to mediate between HL7 Version 2 and HL7 Version 3 messages. However, the framework proposed is generic enough to mediate between any incompatible healthcare standards that are currently in use.

Enriching ebXML registries with OWL ontologies for efficient service discovery

Web services, like their real life counterparts have several properties and thus truly useful semantic information can only be defined through standard ontology languages. Semantic Web is an important initiative in this respect. However, although service registries are the major mechanisms to discover services, the semantic support provided by service registries is completely detached from the semantic Web effort. In this paper, we address how ebXML registries can be enriched through OWL ontologies to describe Web service semantics. We describe how the various constructs of OWL can be mapped to ebXML classification hierarchies and show how the stored semantics can be queried through standardized queries by using the ebXML query facility. We also provide our observations on how ebXML registries can be extended to provide more efficient semantic support.

Semantically enriched web services for the travel industry

Today, the travel information services are dominantly provided by Global Distribution Systems (GDS). The Global Distribution Systems provide access to real time availability and price information for flights, hotels and car rental companies. However GDSs have legacy architectures with private networks, specialized hardware, limited speed and search capabilities. Furthermore, being legacy systems, it is very difficult to interoperate them with other systems and data sources. For these reasons, Web service technology is an ideal fit for travel information systems. However to be able to exploit Web services to their full potential, it is necessary to introduce semantics. Without describing the semantics of Web services we are looking for, it is difficult to find them in an automated way and if we cannot describe the service we have, the probability that people will find it in an automated way is low. Furthermore, to make the semantics machine processable and interoperable, we need to describe domain knowledge through standard ontology languages. In this paper, we describe how to deploy semantically enriched travel Web services and how to exploit semantics through Web service registries. We also address the need to use the semantics in discovering both Web services and Web service registries through peer-to-peer technology.

SAPHIRE: A Multi-Agent System for Remote Healthcare Monitoring through Computerized Clinical Guidelines

Due to increasing percentage of graying population and patients with chronic diseases, the world is facing serious problems for serving high quality healthcare services to citizens at a reasonable costs. In this paper, we are providing a Clininical Desicion Support system for remote monitoring of patients at their homes, and at the hospital to decrease the load of medical practitioners and also healthcare costs. As the expert knowledge required to build the clinical decision support system, Clinical Guidelines are exploited. Examining the reasons of failure for adoption of clinical guidelines by healthcare institutes, we have realized that necessary measures should be taken in order to establish a semantic interoperability environment to be able to communicate with various heterogenous clinical systems. In this paper these requirements are detailed and a semantic infrastructure to enable easy deployment and execution of clinical guidelines in heterogenous healthcare enviroments is presented. Due to the nature of the problem which necessitates having many autonomous entities dealing with heterogenous distributed resources, we have built the system as a Multi-Agent System. The architecture described in this paper is realized within the scope of IST-27074 SAPHIRE project.

SAPHIRE: intelligent healthcare monitoring based on semantic interoperability platform: pilot applications

As a response to the challenge of providing high-quality healthcare services with reasonable costs while the elderly population and the associated chronic diseases increase, SAPHIRE architecture provides an intelligent healthcare monitoring architecture. The monitoring of patients is achieved through a clinical decision support system based on clinical guidelines. SAPHIRE provides the necessary interoperability layers to access the patients vital signs from wireless medical sensors and the electronic healthcare records of the patient in order to exploit them in the decision process seamlessly. This architecture is presented through two pilot applications: one for the bedside monitoring of cardiac patients at hospitals, and the other for homecare monitoring of the cardiac patients rehabilitated after a revascularisation therapy.

Exploiting ebXML registry semantic constructs for handling archetype metadata in healthcare informatics

Using archetypes is a promising approach in providing semantic interoperability among healthcare systems. To realise archetype based interoperability, the healthcare systems need to discover the existing archetypes, based on their semantics; annotate their archetypes with ontologies; compose templates from archetypes and retrieve corresponding data from the underlying medical information systems. In this paper, we describe how ebXML Registry semantic constructs can be used for annotating, storing, discovering and retrieving archetypes. For semantic annotation of archetypes, we present an example of an archetype metadata ontology and describe the techniques to access archetype semantics through ebXML query facilities. We present a GUI query facility and describe how the stored procedures, which we introduce, move the semantic support beyond what is currently available in ebXML registries. We also address how archetype data can be retrieved from clinical information systems by using ebXML web services. A comparison of web service technology with the ebXML messaging system is provided to justify the reasons for using web services.

Enhancing ebXML Registries to Make them OWL Aware

AbstractebXML is a standard from OASIS and UN/CEFACT which specifies an infrastructure to facilitate electronic business. In this paper, we address how ebXML registry semantics support can be further enhanced to make it OWL aware. OWL constructs are represented through ebXML registry information model constructs, and stored procedures are defined in the ebXML registry for processing the OWL semantics. These predefined stored queries provide the necessary means to exploit the enhanced semantics stored in the registry. In this way, an application program does not have to be aware of the details of how this semantics support is achieved in ebXML registry, and does not have to contain additional code to process this semantics.We believe that this approach is quite powerful to associate semantics with registry objects: it becomes possible to retrieve knowledge through queries, the enhancements to the registry are generic and also the registry specification is kept intact. The capabilities provided move the semantics support beyond what is currently available in ebXML registries and it does so by using a standard ontology language.To be able to demonstrate the benefits of the enhancements, we also show how the resulting semantics can be made use of in Web service discovery and composition.

Providing Semantic Interoperability Between Clinical Care and Clinical Research Domains

Improving the efficiency with which clinical research studies are conducted can lead to faster medication innovation and decreased time to market for new drugs. To increase this efficiency, the parties involved in a regulated clinical research study, namely, the sponsor, the clinical investigator and the regulatory body, each with their own software applications, need to exchange data seamlessly. However, currently, the clinical research and the clinical care domains are quite disconnected because each use different standards and terminology systems. In this paper, we describe an initial implementation of the Semantic Framework developed within the scope of SALUS project to achieve interoperability between the clinical research and the clinical care domains. In our Semantic Framework, the core ontology developed for semantic mediation is based on the shared conceptual model of both of these domains provided by the Biomedical Research Integrated Domain Group (BRIDG) initiative. The core ontology is then aligned with the extracted semantic models of the existing clinical care and research standards as well as with the ontological representations of the terminology systems to create a “model of meaning” for enabling semantic mediation. Although SALUS is a research and development effort rather than a product, the current SALUS knowledge base contains around 4.7 million triples representing BRIDG DAM, HL7 CDA model, Clinical Data Interchange Standards Consortium standards, and several terminology ontologies. In order to keep the reasoning process within acceptable limits without sacrificing the quality of mediation, we took an engineering approach by developing a number of heuristic mechanisms. The results indicate that it is possible to build a robust and scalable semantic framework with a solid theoretical foundation for achieving interoperability between the clinical research and clinical care domains.