Transcript Document

Towards semantic interoperability solutions
Dipak Kalra
Health information flows needing semantic interoperability
Wellness
Fitness
Complementary health
Citizen in the
community
rapid bench to bed translation
Social care
Occupational health
School health
real-time knowledge directed care
Point of care
delivery
Teaching
Research
Clinical trials
explicit consent
implied consent
Disease registries
Screening recall
systems
Continuing care
(within the institution)
Education
Research
Epidemiology
Data mining
de-identified
implied consent
+/- consent
Public health
Health care
management
Clinical audit
Long-term shared care
(regional national, global)
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Drivers for trans-border information and
knowledge sharing
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Cross-border health care
–
emergency care
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elective care
–
consistent care pathways and standards of care
Population health
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public health measures: prevention, immunisations etc.
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detecting and tracking critical events: antibiotic resistance, infectious outbreaks, bio-terrorism etc.
Comparisons
–
treatment effectiveness
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clinical outcomes
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safety signals
Research
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epidemiology
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multi-national clinical studies
Common products and services
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cross-border EHR systems and services
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consistent implementation of clinical guidelines and decision support
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The EHR landscape - for archetypes
Treatment
Medication and prescriptions
Symptoms
and history
Body physical
examination findings
Advice and education
Hypotheses,
Self management and
health issues
home monitoring
Chronic
and
Conventional (problems
medical summary
Prevention
and
Well-being
and fitness,
disease
diagnoses), risks
screening,
rehabilitation
after illness
management
population health
Tests and investigations
measures
Care planning
Social welfare, culture, religion,
attitudes, expectations, hopes,
fears
Procedures and operations
Protocols, guidelines, care
pathways
Communication, team-based collaboration
Consent, permissions, disclosures, complaints
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Hospital admission
Treatment
Medication and prescriptions
Symptoms
and history
Advice and education
Hypotheses,
Self management and
health issues
Chronic
home monitoring
Prevention and
and
disease
Conventional (problems
medical summary
Well-beingscreening,
and fitness,
diagnoses),
risksrehabilitation after illness
management
population health
measures
Tests and investigations
Care planning
Social welfare, culture, religion,
attitudes, expectations, hopes,
fears
Mental health
Body physical
examination findings
Procedures and operations
Cardiovascular medicine
Protocols, guidelines, care
pathways
Communication, team-based collaboration
Consent, permissions, disclosures, complaints
record structure
and context
Resources needed to support rich semantic interoperability
architecture
identifiers for people
policy models
structural roles
functional roles
purposes of use
care settings
pseudonymisation
reference models
data types
archetypes
templates
near-patient device interoperability
Consistent
workflow
guidelines
care pathways
decision support
algorithms
clinical terminology systems
classification systems
terminology sub-sets
value sets and micro-vocabularies
post-co-ordination
multi-lingual mappings
semantic context model
categorial structures
clinical
terminology
privacy
Rich EHR
representation, access
interoperability
and
interpretation
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Initiatives striving for harmonisation
• Clinical Information Modeling Initiative (CIMI)
• SemanticHealthNet
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Clinical Information Modeling Initiative
(CIMI)
• International collaboration of several SDO’s, national
eHealth programmes, and large providers e.g. IHC, VA,
Kaiser
– providing a common format for the specification of clinical
models
– so that semantically interoperable information may be
created and shared in health records, messages and
documents
• Building on the openEHR archetype approach as its
starting point
• Specifications will be openly accessible, freely usable
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• European Commission sponsored Network of
Excellence in Semantic Interoperability
– Dec 2011 to Nov 2014
– 3m Euro
– 17 Partners
– > 40 internationally recognised experts
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SemanticHealthNet concept and objectives
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Leverage a clinically-driven work-plan
– heart failure, exemplifying chronic disease management, evidence based care
and shared care
– cardiovascular prevention, exemplifying public health and national / global
strategies
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Bring together the globally best of breed semantic resource
producers including commitment from the top SDOs
– to develop harmonised resources meeting the clinical needs,
adapting their standards as necessary
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Engage stakeholders: patients, clinicians, industry, ministry,
insurance, on priorities, scope, governance, adoption
• Establish a scalable, sustainable, well-governed European Virtual
Organisation for semantic interoperability
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