Electronic Health Record (EHR) systems currently in use are not designed for widely interoperable longitudinal health data. Therefore, EHR data cannot be properly shared, managed and analyzed. In this article, we propose two approaches to making EHR data more comprehensive and FAIR (Findable, Accessible, Interoperable, and Reusable) and thus more useful for diagnosis and clinical research. Firstly, the data modeling based on the LinkML framework makes the data interoperability more realistic in diverse environments with various experts involved. We show the first results of how diverse health data can be integrated based on an easy-to-understand data model and without loss of available clinical knowledge. Secondly, decentralizing EHRs contributes to the higher availability of comprehensive and consistent EHR data. We propose a technology stack for decentralized EHRs and the reasons behind this proposal. Moreover, the two proposed approaches empower patients because their EHR data can become more available, understandable, and usable for them, and they can share their data according to their needs and preferences. Finally, we explore how the users of the proposed solution could be involved in the process of its validation and adoption.
- MeSH
- Data Management MeSH
- Electronic Health Records * MeSH
- Humans MeSH
- Semantic Web * MeSH
- Software MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
With biodiversity research activities being increasingly shifted to the web, the need for a system of persistent and stable identifiers for physical collection objects becomes increasingly pressing. The Consortium of European Taxonomic Facilities agreed on a common system of HTTP-URI-based stable identifiers which is now rolled out to its member organizations. The system follows Linked Open Data principles and implements redirection mechanisms to human-readable and machine-readable representations of specimens facilitating seamless integration into the growing semantic web. The implementation of stable identifiers across collection organizations is supported with open source provider software scripts, best practices documentations and recommendations for RDF metadata elements facilitating harmonized access to collection information in web portals. Database URL: : http://cetaf.org/cetaf-stable-identifiers.
- MeSH
- Biodiversity * MeSH
- Databases, Factual * MeSH
- Semantic Web * MeSH
- Software * MeSH
- Natural Language Processing * MeSH
- Publication type
- Journal Article MeSH
Objectives: The purpose of this paper is to present and discuss the adoption and use of medical terminologies and coding systems in Italy, focusing on their management and integration for guaranteeing semantic interoperability among Electronic Health Records (EHRs). Semantic interoperability guarantees meaningful exchange of data between two or more healthcare information systems, ensuring that data content is not only understandable within its original context, but also in the destination one, and is capable of supporting health service management, clinical decision-making care collaboration, as well as public health reporting, and improving clinical research. Methods: The approach used for the coding systems management and integration in the Italian Fascicolo Sanitario Elettronico (FSE)a use case is presented according to the current Italian regulations on federated EHRs. Results: Results show the need to promote an advanced approach, in conformance to the literature best cases, which takes care about a better integration and maintenance of medical terminologies and coding systems through the use of standardized models of terminology services. Conclusion: The paper presents terminology interoperability issues arisen from the described approach and related requirements to propose a solution that could allow, through sophisticated terminology services framework, to achieve also in Italy semantic interoperability.
Objectives: A significant portion of care related to cardiorespiratory diseases is provided at home, usually but not exclusively, after the discharge of a patient from hospital. It is the purpose of the present study to present the technical means which we have developed, in order to support the adaptation of the continuity of care of cardiorespiratory diseases at home. Methods: We have developed an integrated system that includes: first, a prototype laptop-based portable monitoring system that comprises low-cost commercially available components, which enable the periodical or continuous monitoring of vital signs at home; second, software supporting medical decision-making related to tachycardia and ventricular fibrillation, as well as fuzzy-rules-based software supporting home-ventilation optimization; third, a typical continuity of care record (CCR) adapted to support also the creation of a homecare plan; and finally, a prototype ontology, based upon the HL7 clinical document architecture (CDA), serving as basis for the development of semantically annotated web services that allow for the exchange and retrieval of homecare information. Results: The flexible design and the adaptable data-exchange mechanism of the developed system result in a useful and standard-compliant tool, for cardiorespiratory disease-related homecare. Conclusions: The ongoing laboratory testing of the system shows that it is able to contribute to an effective and low-cost package solution, supporting patient supervision and treatment. Furthermore, semantic web technologies prove to be the perfect solution for both the conceptualization of a continuity of care data exchange procedure and for the integration of the structured medical data.
- MeSH
- Information Systems standards MeSH
- Internet MeSH
- Cardiovascular Diseases MeSH
- Continuity of Patient Care MeSH
- Humans MeSH
- Semantics MeSH
- Home Care Services MeSH
- Systems Integration MeSH
- Telemetry methods instrumentation MeSH
- Information Storage and Retrieval methods MeSH
- Quality Assurance, Health Care methods MeSH
- Check Tag
- Humans MeSH
Ciele: Výmena dát v prostredí českého zdravotníctva je väčšinou založená na národných štandardoch. Tento článok popisuje využitie medzinárodných štandardov a nomenklatúr na skonštruovanie pilotnej platformy sémantickej interoperability (PSI), ktorá by slúžila na výmenu informácií medzi systémami elektronických zdravotných záznamov (EZZ) v českom zdravotníctve. Táto práca bola zastrešená národným výskumným projektom programu „Informačná spoločnosť“. Metódy: Na začiatku projektu boli formulované požiadavky, ktoré by mala PSI splňovať. Bolo analyzovaných niekoľko komunikačných štandardov (openEHR, HL7 v3, DICOM) a HL7 v3 bol zvolený pre naše riešenie na výmenu medicínskych záznamov. Do pilotného prostredia boli zahrnuté dva systémy: WinMedicalc 2000 a EZZ ADAMEKj. Výsledky: Na popis informačného obsahu oboch systémov boli vytvorené Lokálne Informačné Modely (LIM) založené na HL7. Koncepty z našich pôvodných informačným modelov boli namapované na kódovacie systémy podporované HL7 (LOINC, SNOMED CT and ICD-10) a výmena dát pomocou správ HL7 v3 bola naimplementovaná a otestovaná pomocou dotazov na pacientove administratívne údaje. Ako brána medzi lokálnymi systémami EZZ (sEZZ) a infraštruktúrou založenou na správach HL7 slúžil nami vyvinutý konfigurovateľný HL7 broker. Záver: Celonárodná implementácia PSI v plnej veľkosti založená na HL7 v3 by zahrňovala prijatie a preklad príslušných medzinárodných kódovacích systémov a nomenklatúr, vytvorenie implementačných postupov uľahčujúcich migráciu od národných štandardov po tie medzinárodné. Naša pilotná štúdia ukázala, že náš prístup je uskutočniteľný, ale úplná integrácia systému českého zdravotníctva do európskeho kontextu e-zdravia bude vyžadovať ešte veľké úsilie.
Objectives: The data interchange in the Czech healthcare environment is mostly based on national standards. This paper describes a utilization of international standards and nomenclatures for building a pilot semantic interoperability platform (SIP) that would serve to exchange information among electronic health record systems (EHR-Ss) in Czech healthcare. The work was performed by the national research project of the „Information Society" program. Methods: At the beginning of the project a set of requirements the SIP should meet was formulated. Several communication standards (openEHR, HL7 v3, DICOM) were analyzed and HL7 v3 was selected to exchange health records in our solution. Two systems were included in our pilot environment: WinMedicalc 2000 and ADAMEKj EHR. Results: HL7-based local information models were created to describe the information content of both systems. The concepts from our original information models were mapped to coding systems supported by HL7 (LOINC, SNOMED CT and ICD-10) and the data exchange via HL7 v3 messages was implemented and tested by querying patient administration data. As a gateway between local EHR systems and the HL7 message-based infrastructure, a configurable HL7 Broker was developed. Conclusions: A nationwide implementation of a full-scale SIP based on HL7 v3 would include adopting and translating appropriate international coding systems and nomenclatures, and developing implementation guidelines facilitating the migration from national standards to international ones. Our pilot study showed that our approach is feasible but it would demand a huge effort to fully integrate the Czech healthcare system into the European e-health context.
- MeSH
- Medical Records Systems, Computerized standards MeSH
- Financing, Organized MeSH
- Information Systems trends utilization MeSH
- Hospital Information Systems standards utilization MeSH
- Programming Languages MeSH
- Semantics MeSH
- Systems Integration MeSH
- Information Storage and Retrieval MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Czech Republic MeSH
Das Erreichen der semantischen Interoperabilität erfordert nicht nur den Einsatz von Kommunikationsstandards wie HL7 mit den dazugehörigen Modellen und Spezifikationen, sondern für die Instanziierung auch die Einschränkung dieser Modelle in ihren Eigenschaften, Datentypen und den verwendeten Werten und Codesystemen. Die Anwendung dieser Strategien kann aber trotzdem zu unterschiedlichen und damit ggf. inkompatiblen Modellen führen. Dieses Papier gibt einen kurzen Überblick über unterschiedliche Modellierungsansätze, die anhand der Score und Assessment-Systeme erläutert werden. Es werden die Vor- und Nachteile der verschiedenen Ansätze demonstriert. Die präsentierten Ergebnisse berücksichtigen die Übermittlung derselben Basisinformationen mittels HL7 v2.x und V3, um die Implementierungsaufwendungen insgesamt zu reduzieren.
Objectives: Achieving semantic interoperability requires not only the use of communication standards like HL7 with its underlying models and specifications, but also to constrain those models to instances including permitted attributes, data types, values and code systems. Even the application of both strategies may lead to different modeling approaches and therefore incompatible results, however. Methods: This paper analyzes the different ways to create a model exemplified at score and assessment systems. Results: The different approaches have advantages and disadvantages. The presented results allow for transmitting the same basic information facilitating HL7 v2.x and V3 in a way reducing implementation efforts. Conclusions: Establishing a generic approach to communicate the details of score systems driven by an appropriate set of codes is the best solution for implementers.
OBJECTIVES: The data interchange in the Czech healthcare environment is mostly based on national standards. This paper describes a utilization of international standards and nomenclatures for building a pilot semantic interoperability platform (SIP) that would serve to exchange information among electronic health record systems (EHR-Ss) in Czech healthcare. The work was performed by the national research project of the "Information Society" program. METHODS: At the beginning of the project a set of requirements the SIP should meet was formulated. Several communication standards (openEHR, HL7 v3, DICOM) were analyzed and HL7 v3 was selected to exchange health records in our solution. Two systems were included in our pilot environment: WinMedicalc 2000 and ADAMEKj EHR. RESULTS: HL7-based local information models were created to describe the information content of both systems. The concepts from our original information models were mapped to coding systems supported by HL7 (LOINC, SNOMED CT and ICD-10) and the data exchange via HL7 v3 messages was implemented and tested by querying patient administration data. As a gateway between local EHR systems and the HL7 message-based infrastructure, a configurable HL7 Broker was developed. CONCLUSIONS: A nationwide implementation of a full-scale SIP based on HL7 v3 would include adopting and translating appropriate international coding systems and nomenclatures, and developing implementation guidelines facilitating the migration from national standards to international ones. Our pilot study showed that our approach is feasible but it would demand a huge effort to fully integrate the Czech healthcare system into the European e-health context.
To improve patient outcomes after trauma, the need to decrypt the post-traumatic immune response has been identified. One prerequisite to drive advancement in understanding that domain is the implementation of surgical biobanks. This paper focuses on the outcomes of patients with one of two diagnoses: post-traumatic arthritis and osteomyelitis. In creating surgical biobanks, currently, many obstacles must be overcome. Roadblocks exist around scoping of data that is to be collected, and the semantic integration of these data. In this paper, the generic component model and the Semantic Web technology stack are used to solve issues related to data integration. The results are twofold: (a) a scoping analysis of data and the ontologies required to harmonize and integrate it, and (b) resolution of common data integration issues in integrating data relevant to trauma surgery.
- Publication type
- Journal Article MeSH
The article deals with and discusses two main approaches in building semantic structures for electrophysiological metadata. It is the use of conventional data structures, repositories, and programming languages on one hand and the use of formal representations of ontologies, known from knowledge representation, such as description logics or semantic web languages on the other hand. Although knowledge engineering offers languages supporting richer semantic means of expression and technological advanced approaches, conventional data structures and repositories are still popular among developers, administrators and users because of their simplicity, overall intelligibility, and lower demands on technical equipment. The choice of conventional data resources and repositories, however, raises the question of how and where to add semantics that cannot be naturally expressed using them. As one of the possible solutions, this semantics can be added into the structures of the programming language that accesses and processes the underlying data. To support this idea we introduced a software prototype that enables its users to add semantically richer expressions into a Java object-oriented code. This approach does not burden users with additional demands on programming environment since reflective Java annotations were used as an entry for these expressions. Moreover, additional semantics need not to be written by the programmer directly to the code, but it can be collected from non-programmers using a graphic user interface. The mapping that allows the transformation of the semantically enriched Java code into the Semantic Web language OWL was proposed and implemented in a library named the Semantic Framework. This approach was validated by the integration of the Semantic Framework in the EEG/ERP Portal and by the subsequent registration of the EEG/ERP Portal in the Neuroscience Information Framework.
- Publication type
- Journal Article MeSH
Background: In the range of Semantic Web, the idea of linking and sharing the resources generated by different authors, like ontologies, knowledge bases, or datasets, is referred to “Linked data”. Then, an ambitious project within the “Linked Data” paradigm is the “Linking Open Data” community project. It aims at publishing open data sets on the Web and semantically connecting data items belonging to different data sources. Objectives: The purpose of this paper is to present a literature review on the subject of Linked Open Data in Health and Clinical Care. In fact, the availability of open data would increase evidence of the results of biomedical research, and consequently, of clinical practice. Methods: Selection criteria have been defined and searching in PubMed/Medline and Scopus citation databases - for all years the database were available - journals papers have been retrieved. Finally, an evaluation grid has been defined for analysing the retrieved papers, to answer some defined research questions. Results: Nine journal articles have been analysed according to the defined evaluation grid. In five out of nine papers, the main contributions are strategies and methodologies for the integration of systems, including bridging the information gap among forms for clinical research and the one for patient care. Then, in three papers the main contributions are the development of consistent triple stores according to the “Linked Data” paradigm. Finally, the last paper aims at building an open dataset for public health purposes. Conclusions: The review was able to answer the research questions, despite the limited number of included papers.
