Thomas Beale

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.

Modeling for Health Care

The world is complex. Health information systems are complex, and their interaction even more so. Differences in technologies, software, policies, and practices of care all converge to create an environment that is particularly complex. Modeling is a vehicle for managing complexity, allowing us to focus on areas of interest while intentionally concealing details not germane to the purpose. Models add clarity to our understanding. Much like tools—for that is what they are— models exist for a purpose and within a context. Producing a model for the sake of doing so, or because some methodology dictates that it is “the way things should be done” delivers little or no returned value. Alternatively, using models to sharpen our understanding allows us to better navigate through difficult problems and situations and select what to include and exclude. The entire process is about determining the best way to express what is of interest while ignoring what is not. Models allow us to formalize our understanding of a problem, and enable effective communication by sharing that understanding with a broad community. Using formal expressions to communicate is nothing new. Both mathematics and music have long relied upon specialized notation. Although these languages have little in common at the surface, they share an ability to capture, document, and communicate meaning to their target audiences clearly and concisely. Health care is a uniquely complex domain. It is the confluence of so many things: the biological intricacies of the human organism, disease states, the social dimensions of care delivery in a finite-resource economy, and the consequences of world events such as epidemics and war. Not surprisingly, the discipline of health informatics is complex. It attempts to provide solutions at numerous levels and in multiple disciplines—real-time monitoring of intensive care unit patients, clinical decision support, and distributed interoperable health records, to mention a few. Modeling is a cornerstone to understanding these complexities.