Hilary Paniagua

Electronic Health Records (EHRs) Standards and the Semantic Edge: A Case Study of Visualising Clinical Information from EHRs

Exchanging medical documents over healthcare networks is becoming a reality. This increases the need to effectively manage the growing amount of information for a single patient. Therefore, there is a current need to visualise Electronic Health Records (EHRs) in a way that assist physicians with clinical tasks and medical decision-making. The new methods to visualise clinical information from EHRs should take into account time and be intuitive for clinicians. This paper uses Semantic Web technologies and HL7 Clinical Document Architecture (CDA) to provide well-defined interfaces that help clinicians to visualize the medical procedures performed and how clinical findings have changed over the time for a patient. To validate the proposal, the research has focused on diagnosis and clinical management of Glaucoma (Worldwide, it is the second leading cause of blindness) and the evaluation performed has involved health professionals who are not familiarized with Semantic Web technologies.

A collaborative workflow for building ontologies: A case study in the biomedical field

Much medical knowledge is contained within available literature, such as clinical guidelines and protocols. Recently, an interest has been developed in automatic content extraction to construct ontologies of this knowledge to make it more widely available. With groups of domain experts distributed geographically, and the growing amount of medical literature, an important challenge is to develop collaborative workflows to support ways for domain experts to contribute in the ontology learning process. This paper presents a collaborative workflow for ontology learning based on coupling an Ontology Learning Tool (OntoLancs) with and Ontology engineer (Protégé) to provide semi-automatic support for text mining and a collaborative tool to model formal ontologies. The work presented in this paper was evaluated with a case study on a Clinical Practice Guideline of Diabetic Retinopathy. The major benefits of coupling OntoLancs with Protégé are: a) a higher level of automation in the creation of domain ontologies and models, and b) strengthened communication and information exchange among domain experts that are physically distributed. Validations of user experiences indicate the applicability of our approach.

Executing Medical Guidelines on the Web: Towards Next Generation Healthcare

There is still a lack of full integration between current Electronic Health Records (EHRs) and medical guidelines that encapsulate evidence-based medicine. Thus, general practitioners (GPs) and specialised physicians still have to read document-based medical guidelines and decide among various options for managing common non-life-threatening conditions where the selection of the most appropriate therapeutic option for each individual patient can be a difficult task. This paper presents a simulation framework and computational test-bed, called V.A.F. Framework, for supporting simulations of clinical situations that boosted the integration between Health Level Seven (HL7) and Semantic Web technologies (OWL, SWRL, and OWL-S) to achieve content layer interoperability between online clinical cases and medical guidelines, and therefore, it proves that higher integration between EHRs and evidence-based medicine can be accomplished which could lead to a next generation of healthcare systems that provide more support to physicians and increase patients’ safety.

Zero tolerance in general practice: a policy in conflict?

Workplace violence is a serious problem within the National Health Service (NHS). To combat this and to reduce the incidence of abuse and aggression shown to staff, a zero tolerance public campaign was introduced in 2007 within the UK. The campaign endorsed employer‐led zero tolerance policies, despite any evidence of the effectiveness of this approach and concerns that it is discriminatory and denies health care to those who most need it. Decisions to exclude patients from GP registers are subject to varied interpretations regarding what is deviant behaviour and the blacklisting of patients is unregulated and subject to ambiguity. Furthermore, staff training programmes, which emphasise de‐escalation strategies, have not proven to be effective and can even increase violent incidences. Initiatives to provide safe havens for those excluded, while initially believed to be effective, raise many ethical arguments about the ‘ghettoising’ of health care for those already socially excluded. Research is needed into these centres in the hope of providing some of the answers, particularly around the triggers of violence, how violence is perceived and how it can be prevented.

Enabling smooth integration between HL7 CDA and medical guidelines on the web with an initial focus on women’s health in general practice

Since the 1990s many researchers have proposed frameworks for modelling clinical guidelines and protocols in a computer-interpretable and computer-executable format. Nowadays, the various guideline representation languages and related frameworks also need to address compatibility with healthcare information systems that aim to be interoperable on nation-wide and even international-levels. This paper presents a simulation framework and computational test-bed, called V.A.F. Framework, that makes use of health level seven (HL7) and takes advantages of both CommonKADS methodology and Semantic Web technologies (OWL, SWRL, and OWL-S) to express a wide-spectrum of medical guidelines in an executable form compatible with HL7 clinical document architecture (CDA). To validate the proposal, which goes beyond interoperability of eHealth services and explores how to open up new capabilities in areas such as decision support and patient safety alerts, the research has focused on medical guidelines related to womenpsilas health in general practice.