Ronan Fox

PPEPR: plug and play electronic patient records

The integration of Electronic Patient Record (EPR) systems is at the centre of many of the new regional and national initiatives to integrate clinical processes across department, region, and national levels. Web Service technologies offer significant solutions to provide an interoperable communication infrastructure but are unable to support precise definitions for healthcare messages, functionality, and standards, required for making meaningful integration. The lack of interoperability within healthcare standards adds complexity to the initiatives. This heterogeneity exists within two versions of same standard (e.g. HL7), and also between standards (e.g. HL7, openEHR, CEN TC/251 13606). We therefore introduce an integration platform PPEPR (Plug and Play Electronic Patient Records), which is based on the principles of a semantic Service-Oriented Architecture (sSOA). PPEPR solves the problem of interoperability at the semantic level. A key focus of PPEPR is that once a patient information is captured, should be available for use across all potential care processes.

A methodological approach for ontologising and aligning health level seven (HL7) applications

Healthcare applications are complex in the way data and schemas are organised in their internal systems. Widely deployed healthcare standards like Health Level Seven (HL7) V2 are designed using flexible schemas which allow several choices when constructing clinical messages. The recently emerged HL7 V3 has a centrally consistent information model that controls terminologies and concepts shared by V3 applications. V3 information models are arranged in several layers (abstract to concrete layers). V2 and V3 systems raise interoperability challenges: firstly, how to exchange clinical messages between V2 and V3 applications, and secondly, how to integrate globally defined clinical concepts with locally constructed concepts. The use of ontologies for interoperable healthcare applications has been advocated by domain and knowledge representation specialists. This paper addresses two main areas of an ontology-based integration framework: (1) an ontology building methodology for the HL7 standard where ontologies are developed in separated global and local layers; and (2) aligning V2 and V3 ontologies. We propose solutions that: (1) provide a semi-automatic mechanism to build HL7 ontologies; (2) provide a semi-automatic mechanism to align HL7 ontologies and transform underlying clinical messages. The proposed methodology has developed HL7 ontologies of 300 concepts in average for each version. These ontologies and their alignments are deployed and evaluated under a semantically-enabled healthcare integration framework.

Creating a Virtual Personal Health Record Using Mashups

In the telehealth domain, caregiver networks provide support to the patient in the community, often through a personal health record (PHR). Current PHR systems typically are used where data and services are delivered through a single integrated data store that limits choice, is a fixed solution, and forces providers to conform to a specific data interface. Sqwelch is a mashup maker that enables trusted collaboration between a caregiver networks members through a virtual, distributed PHR. Sqwelch provides an intuitive means for the caregiver network to create personalized mashups, while the patient retains privacy control through trust specifications.

S3QL: A distributed domain specific language for controlled semantic integration of life sciences data

BackgroundThe value and usefulness of data increases when it is explicitly interlinked with related data. This is the core principle of Linked Data. For life sciences researchers, harnessing the power of Linked Data to improve biological discovery is still challenged by a need to keep pace with rapidly evolving domains and requirements for collaboration and control as well as with the reference semantic web ontologies and standards. Knowledge organization systems (KOSs) can provide an abstraction for publishing biological discoveries as Linked Data without complicating transactions with contextual minutia such as provenance and access control.We have previously described the Simple Sloppy Semantic Database (S3DB) as an efficient model for creating knowledge organization systems using Linked Data best practices with explicit distinction between domain and instantiation and support for a permission control mechanism that automatically migrates between the two. In this report we present a domain specific language, the S3DB query language (S3QL), to operate on its underlying core model and facilitate management of Linked Data.ResultsReflecting the data driven nature of our approach, S3QL has been implemented as an application programming interface for S3DB systems hosting biomedical data, and its syntax was subsequently generalized beyond the S3DB core model. This achievement is illustrated with the assembly of an S3QL query to manage entities from the Simple Knowledge Organization System. The illustrative use cases include gastrointestinal clinical trials, genomic characterization of cancer by The Cancer Genome Atlas (TCGA) and molecular epidemiology of infectious diseases.ConclusionsS3QL was found to provide a convenient mechanism to represent context for interoperation between public and private datasets hosted at biomedical research institutions and linked data formalisms.

Heterogeneity and Context in Semantic-Web-Enabled HCLS Systems

The need for semantics preserving integration of complex data has been widely recognized in the healthcare domain. While standards such as Health Level Seven (HL7) have been developed in this direction, they have mostly been applied in limited, controlled environments, still being used incoherently across countries, organizations, or hospitals. In a more mobile and global society, data and knowledge are going to be commonly exchanged between various systems at Web scale. Specialists in this domain have increasingly argued in favor of using Semantic Web technologies for modeling healthcare data in a well formalized way. This paper provides a reality check in how far current Semantic Web standards can tackle interoperability issues arising in such systems driven by the modeling of concrete use cases on exchanging clinical data and practices. Recognizing the insufficiency of standard OWL to model our scenario, we survey theoretical approaches to extend OWL by modularity and context towards handling heterogeneity in Semantic-Web-enabled health care and life sciences (HCLS) systems. We come to the conclusion that none of these approaches addresses all of our use case heterogeneity aspects in its entirety. We finally sketch paths on how better approaches could be devised by combining several existing techniques.

PPEPR for Enterprise Healthcare Integration

PPEPR is software to connect healthcare enterprises. Healthcare is a complex domain and any integration system that connects healthcare enterprise applications must facilitate heterogeneous healthcare systems at all levels - data, services, processes, healthcare vendors, standards, legacy systems, and new information systems, all of which must interoperate to provide healthcare services. The lack of interoperability within healthcare standards (e.g. HL7) adds complexity to the interoperability initiatives. HL7’s user base has been growing since the early 2000s. There are many interoperability issues between the widely adopted HL7 v2 and its successor, HL7 v3, in terms of consistency, data/message modeling, precision, and useability. We have proposed an integration platform called PPEPR: (Plug and Play Electronic Patient Records) which is based on a semantic Service-oriented Architecture (sSOA). PPEPR connects HL7 (v2 & v3) compliant healthcare enterprises. Our main goal is to provide seamless integration between healthcare enterprises without imposing any constraint on existing or proposed EPRs.

Collaborative development of trusted mashups

We identify the gap that currently exists between enterprise and consumer-focused mashup tools. We describe how Sqwelch, a semantically-enabled mashup maker, addresses this gap during the design of mashups and in their execution. Sqwelch enables the composition of mashups based on the concept of trust explicitly specified by users through a visual interface. Taxonomies are used to enable lightweight mediation of payloads delivered through a publish/subscribe mechanism. We demonstrate the use of Sqwelch as a proof of concept in the remote delivery of healthcare, and how we have used Sqwelch to address areas of trust and collaboration in the delivery of telehealth services.

Ontologising Interaction Behavior for Service-Oriented Enterprise Healthcare Integration

In this paper we analyse the HL7 healthcare standard as an integration mechanism to connect service-oriented healthcare enterprises. Healthcare enterprises differ in their process model even if they follow same standard. This difference is due to the way in which healthcare is influenced by various stakeholders within regional clinical practices. Thus the design of the interaction behaviour i.e., HL7 interactions, of communicating healthcare enterprises is subject to local implementation. We present an example scenario that shows how heterogeneous process models evolve, even if healthcare care enterprises follow a similar standard such as HL7. We present an approach that enables the ldquoseparation of the process layerrdquo from HL7 profiles to enable control and to resolve the heterogeneity of the enterprise interaction behavior. We apply semantics on top of HL7 profiles to resolve ambiguity and heterogeneity in the service and process definitions of HL7 compliant healthcare enterprises. We propose an integration platform called PPEPR: Plug and Play Electronic Patient Records, which is based on the principals of semantic Service-Oriented Architecture (sSOA).

Remote healthcare delivery with sqwelch

In this paper, we describe the architecture of Sqwelch, and show how it can be applied in the delivery of healthcare to patients in the community and to support their caregiver networks. We show, through a detailed scenario, how personalized web applications can be composed by non technical users on our website: www.sqwelch.com (on which we have a demonstration video). Sqwelch uses lightweight semantics to effect mediation between heterogeneous components.