Pieter E. Zanstra

An ontology driven collaborative development for biomedical terminologies: From the French CCAM to the Australian ICHI coding system

The CCAM French coding system of clinical procedures was developed between 1994 and 2004 using, in parallel, a traditional domain experts consensus method on one hand, and advanced methodologies of ontology driven semantic representation and multilingual generation on the other hand. These advanced methodologies were applied under the framework of an European Union collaborative research project named GALEN and produced a new generation of biomedical terminology. Following the interest in several countries and in WHO, the GALEN network has tested the application of the ontology driven tools to the existing reduced Australian ICHI coding system for interventions presently under investigation by WHO to check its ability and appropriateness to become the reference international coding system for procedures. The initial results are presented and discussed in terms of feasibility and quality assurance for sharing and maintaining consistent medical knowledge and allowing diversity in linguistic expressiveness of end users.

The development of CCAM: The new French coding system of clinical procedures

A new French coding system of clinical procedures, the Classification Commune Des Actes Medicaux (CCAM), has been developed at the turn of the millennium (between 1996 and 2001). Two methodologies were used: a traditional domain-experts consensus method, and an artificial-intelligence-based semantic representation. An economic evaluation of clinical procedures was also undertaken for the rating for fee-for-service payment. We present the methodologies used and stress how the European Union research project, ‘European Consortium, Generalised Architecture for Languages, Encyclopaedias and Nomenclatures in Medicine’ (GALEN), facilitated the sharing and maintaining of consistent medical knowledge. This country case study highlights the significant cost to individual countries in developing their own classifications in isolation. It also demonstrates the benefits of contributing to international efforts such as GALEN that enable harmonisation, yet still allow for diversity.

A deployment and research roadmap for semantic interoperability: The EU semanticHEALTH project

The purpose of this EU funded project is to describe a short and medium term Research and Deployment Roadmap for Semantic Interoperability in e-health. It started by defining 4 levels and 3 dimensions for Semantic Interoperability. The vision is to reconcile the needs for the direct patient care safety, biomedical and clinical research and for public health by the reuse of direct care data: from gene to individuals and populations. The methodology is presented and preliminary results and milestones for the short and the long term are set. We conclude by statements on the main characteristics and needs of the roadmap to sustain better health for individual and populations in the changing EU health care systems.