Timothy Wayne Cook

Use of XML Schema Definition for the Development of Semantically Interoperable Healthcare Applications

Multilevel modeling has been proven in software as a viable solution for semantic interoperability, without imposing any specific programming languages or persistence models. The Multilevel Healthcare Information Modeling MLHIM specifications have adopted the XML Schema Definition 1.1 as the basis for its reference implementation, since XML technologies are consistent across all platforms and operating systems, with tools available for all mainstream programming languages. In MLHIM, the healthcare knowledge representation is defined by the Domain Model, expressed as Concept Constraint Definitions CCDs, which provide the semantic interpretation of the objects persisted according to the generic Reference Model classes. This paper reports the implementation of the MLHIM Reference Model in XML Schema Definition language version 1.1 as well as a set of examples of CCDs generated from the National Cancer Institute --- Common Data Elements NCI CDE repository. The set of CCDs was the base for the simulation of semantically coherent data instances, according to independent XML validators, persisted on an eXistDB database. This paper shows the feasibility of adopting XML technologies for the achievement of semantic interoperability in real healthcare scenarios, by providing application developers with a significant amount of industry experience and a wide array of tools through XML technologies.

Knowledge engineering of healthcare applications based on minimalist multilevel models

The long-term maintenance of electronic health records within their original context of information is an ethical requirement that conflicts with the constant need to migrate the information into new systems as they are developed and improved. The specifics of every particular healthcare setting preclude the feasibility of a monolithic health record, and the achievement of interoperability between systems is the primary challenge faced by health informatics researchers. Different multilevel modeling approaches have been studied to deal with this complexity. Nevertheless, the original multilevel modeling specifications are targeted to the development of hospital-based electronic medical records, which adds complexity to the development of simpler purpose-specific applications for extra-hospital healthcare situations. This paper presents the knowledge engineering of a minimalist multilevel model that can be implemented by developers across the broader spectrum of healthcare applications. By using industry standard technologies, this approach enables the wider adoption of interoperable technology for healthcare.

Health Informatics: The Relevance of Open Source and Multilevel Modeling

Health information features significant spatial-temporal and domain complexities, which brings challenges to the implementation of patient-centered, interoperable and semantically coherent healthcare information systems. This position paper supports the idea that the multilevel modeling approach is essential to ensure interoperability at the semantic level, but true interoperability is only achieved by the adoption of open standards, and open source implementations are needed for promote competition based on software quality. The Multilevel Healthcare Information Modelling (MLHIM) specifications are presented as the fully open source multilevel modeling reference implementation, and best practices for the development of multilevel-based open source healthcare applications are suggested.

Implementing a specification for exceptional data in multilevel modeling of healthcare applications

Missing information are key issues for interoperability and semantic coherence in healthcare information systems. This paper presents the implementation of the Exceptional Package in the Multilevel Healthcare Information Modeling (MLHIM) specifications, and it describes two use cases where missing information is critical for decision-making and healthcare technology assessment.

Modeling of nursing knowledge for multilevel information systems

This paper presents the modeling strategy of nursing knowledge, based on multilevel modeling of health systems. Through a systematic review, nursing record instruments were obtained. and one was chose for knowledge modeling according to the Multilevel Healthcare Information Modeling (MLHIM) specifications.

Migration of a pre-hospital cardiology emergency system from data model to multilevel modeling

This paper presents the migration of a prehospital cardiology emergency system from a data model to multilevel modeling. The clinical concepts of data model-based system were identified and modeled according to the Multilevel Healthcare Information Modeling (MLHIM) specifications. This migration is been developed in order to provide the system with the required features of interoperability and semantic coherence.