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Werner Ceusters, MD Office Line Engineering nv

MIE 2006 Tutorial Standards and Ontology Part 5: RIDE A Roadmap for Interoperability of eHealth Systems in Support of COM 356 with Special Emphasis on Semantic Interoperability Sunday August 27th, 2006. Werner Ceusters, MD Office Line Engineering nv. European Commission.

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Werner Ceusters, MD Office Line Engineering nv

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  1. MIE 2006 TutorialStandards and OntologyPart 5: RIDEA Roadmap for Interoperability of eHealth Systems in Support of COM 356 with Special Emphasis on Semantic InteroperabilitySunday August 27th, 2006 Werner Ceusters, MD Office Line Engineering nv

  2. European Commission RIDE: a European Project  SIXTH FRAMEWORK PROGRAMME PRIORITY 2.4.11 “Integrated biomedical information for better health”: eHealth MIE 2006 Tutorial Standards and Ontologies

  3. Motivation • Action plan of the eHealth Communication COM (2004) 356: • “eHealth – Making Healthcare Better for European Citizens: An Action Plan for a European e-Health Area” • RIDE = Roadmap Project • Conducts research in interoperability of eHealth systems • Goal: make recommendations for actions to be taken at the European level to achieve eHealth interoperability in member states and the associated states. MIE 2006 Tutorial Standards and Ontologies

  4. eHealth Communication COM (2004) 356’s main topic for RIDE • By end 2006, Member States, in collaboration with the European Commission, should identify and outline interoperability standards for health data messages and electronic health records, taking into account best practices and relevant standardization efforts. MIE 2006 Tutorial Standards and Ontologies

  5. Middle East Technical University, Software Development and Research Center OFFIS e.V. Healthcare Information and Communication Systems Saarland University -Institute for Formal Ontology and Medical Information Science European Institute for Health Records National Council for Research, Institute for Biomedical Technology National Technical University of Athens, Institute of Communication and Computer Systems National University of Ireland, Digital Enterprise Research Institute IHE-D e.V., Integrating the Healthcare Enterprise Office Line Engineering NV Turkey Germany Germany France Italy Greece Ireland Germany Belgium RIDE Partnership MIE 2006 Tutorial Standards and Ontologies

  6. Activity domain MIE 2006 Tutorial Standards and Ontologies

  7. Organisation of efforts MIE 2006 Tutorial Standards and Ontologies

  8. Work plan activities (1) • Identify thecurrent barriers for semantic interoperability in standards for health data messages and electronic health records as well as tools for semantic interoperability with the goal to set priorities for further in-depth studies • Assess the European best practices in providing semantic interoperability for eHealth domain • Identify the goals and the economical, legal, financial and technological challenges of the industry for the 21st century for achieving semantic interoperability in eHealth solutions • Identify the limitations of the policies and strategies currently used in deploying eHealth solutions in clinical settings MIE 2006 Tutorial Standards and Ontologies

  9. Work plan activities (2) • Provide a shared vision for building a Europe-wide semantically interoperable eHealth infrastructure • Assess the gaps between the “as-is” situation in eHealth and the “to-be” eHealth vision • Identify the emerging trends and opportunities to achieve the vision statement • Identify key actors and stakeholders and prepare co-operation between them • Create a wide consensus at the European level for semantic interoperability in eHealth domain through RIDE dissemination activities MIE 2006 Tutorial Standards and Ontologies

  10. Timeline Jan 1, 2006 – Dec 31, 2007 • M1 Creation of RIDE Project Portal (Month2) • M2 Analysis of state of the art research, technology and standards (Month4) • M3 Collection of User Requirements (Month 6) • M4 Goals and Challenges for semantic interoperability in eHealth Domain v1 (Month 8) • M5 Vision for a Europe-wide semantically interoperable eHealth infrastructure v1 (Mth 8) • M6 First version of Roadmaps (Month 12) • M7 Final Goals and Challenges for semantic interoperability in eHealth Domain (Mth 12) • M8 Final Vision for a Europe-wide semantically interoperable eHealth infrastructure (Month 14) • M9 Final Gap Analysis (Month 16) • M10 Final Trends and Opportunities (Month 18) • M11 Second version of Roadmaps(Month 20) • M12 Final RIDE Roadmaps(Month 24) • M13 Final RIDE Workshop(Month 24) • M14 Proposals to Standardization Bodies (Month 24) • M15 Final Project Report (Month 24) MIE 2006 Tutorial Standards and Ontologies

  11. Number of ‘relevant’ standards in eHealth • U.S. National Alliance for Health Information Technology (NAHIT) • Directory of eHealth Standards • On April 26, 2006 • 2104 standards related to ICT in healthcare, • produced by 436 separate organizations. ? MIE 2006 Tutorial Standards and Ontologies http://www.nahit.org/hitsdir/pgLCA,

  12. NAHIT eHealth Standards Directory • 874transferring messages • 496 code sets, classification systems, and nomenclatures • 295 uniform protection of healthcare information • 191patient records (data content and storage format) • 144 computer-readable data technology • 96 message format for administrative and financial transactions • 73 data requirements for content; core elements of a data set • 63 drug and prescription related • 57imaging data in healthcare such as x-rays and other clinical images • 49uniquely identifying patient, provider, site of care • 40integration of information technology in healthcare quality measures • 36 auto-identification technologies (RFID, EPC) • 32 wireless communications • 28electronic collection, storage and transmission of data for the distribution channel of a product • 83 ‘other’ MIE 2006 Tutorial Standards and Ontologies

  13. Problem to solve: making this scenario possible • An ophtalmologist is going to visit a diabetic patient. • He receives • from the GP in charge of that patient all relevant information about history and active problems • from the diabetologist the pertinent information about current state of complications. • Issues of confidentiality and security are solved, • Clinical information is directly exchanged between the computers of the above professionals, through the web. • The record system of the ophtalmologist • rearranges each unit of information under the proper section • prepares links to potentially relevant guidelines, to a drug database, and to information for patients MIE 2006 Tutorial Standards and Ontologies Cimino JJ, Elhanan GE, Zeng Q. Supporting infobuttons with terminological knowledge. J Am Med Inform Assoc Symp Suppl 1997;528-32

  14. Future scenarios • Data entered about a successful treatment of a case in X generates a suggestion for a similar case in Y; • Submission of a new paper to Pubmed on some ADR triggers an alert in EHR systems worldwide for those patients that might be at risk; • …  From reactive care to proactive care MIE 2006 Tutorial Standards and Ontologies

  15. Main Focus of RIDE:Semantic Interoperability • Working definition: Two information systems are semantically interoperable if and only if each can carry out the tasksfor which it was designed using data and information taken from the other as seemlessly as using its own data and information. MIE 2006 Tutorial Standards and Ontologies

  16. Expected benefits of semantic interoperability • Healthcare professionals • Patients • Service delivery organisations • National and regional authorities • Educators • Researchers • Vendors • System integrators • Standard developments organisations • Public health organisations Canada Health Infoway, Electronic Health Record (EHR) Standards Needs Analysis, Toronto, Ontario, March 31, 2004 MIE 2006 Tutorial Standards and Ontologies

  17. Expected benefits of semantic interoperability • For healthcare professionals: • Improved quality and consistency of care through timely access to comparable data from multiple sources; • Increased use of structured and measurable information rather than free-text only, • Reduced reliance on verbal and anecdotal exchange of health information; • More accurate and effective communication among providers; • Reduced duplication of effort; • Better ability to consolidate clinical findings; • Shorter elapsed time between steps in the care process; • Higher probability of positive patient outcomes. MIE 2006 Tutorial Standards and Ontologies Canada Health Infoway, Electronic Health Record (EHR) Standards Needs Analysis, Toronto, Ontario, March 31, 2004

  18. Identified key areas • The structured content of Patient Summary, • Ontology languages and tools, • Terminologies and coding schemes, i.e. classifications, nomenclatures and thesauri MIE 2006 Tutorial Standards and Ontologies

  19. Some Ontology Representation Languages • LOOM: based on DLs and production rules, and provides automatic classifications of concepts. (1991) • KIF: based on first order logic created as an interchange format for diverse KR systems. No reasoning support. (1992) • OCML: built for developing executable ontologies and models in problem solving methods. (1993) • SHOE: extension of HTML (1996) • XOL: XMLization of a small subset of primitives from the OKBC protocol, called OKBC-Lite. (1999) • RDF OIL  DAML-ONT  OWL (2004) MIE 2006 Tutorial Standards and Ontologies

  20. XML  XML(S)  RDF  RDF(s)  OWL • XML provides a surface syntax for structured documents, but imposes no semantic constraints on the meaning of these documents. • XML Schema is a language for restricting the structure of XML documents. • RDF is a datamodel with simple semantics for objects ("resources") and relations between them that can be represented in (thus constrained by!) XML syntax. • RDF Schema is a vocabulary for describing properties and classes of RDF resources, with a semantics for generalization-hierarchies of such properties and classes. • OWL adds more vocabulary for describing properties and classes: among others, relations between classes (e.g. disjointness), cardinality (e.g. "exactly one"), equality, richer typing of properties, characteristics of properties (e.g. symmetry), and enumerated classes. MIE 2006 Tutorial Standards and Ontologies

  21. OWL language basics • OWL Lite supports a classification hierarchy and simple constraints. It only permits cardinality values of 0 or 1. • OWL DL(so named due to its correspondence with description logics)provides maximum expressiveness while retaining • computational completeness (all conclusions are guaranteed to be computed) and • decidability (all computations will finish in finite time). • OWL Fullgives maximum expressiveness and the syntactic freedom of RDF with no computational guarantees. OWL Full allows an ontology to augment the meaning of the pre-defined (RDF or OWL) vocabulary. MIE 2006 Tutorial Standards and Ontologies

  22. The use of such languages does not guarantee building error-free systems • Smith B, Williams J, Schulze-Kremer S. The ontology of the gene ontology. In: Musen MA, editor. AMIA 2003. Proceedings of AMIA 2003 Annual Symposium; 2003 Nov 8-12, Washington D.C., USA. AMIA; 2003. p. 609-13. • Grenon P, Smith B, Goldberg L. Biodynamic ontology: Applying BFO in the Biomedical Domain, in Pisanelli DM (ed). Ontologies in Medicine. Proceedings of the Workshop on Medical Ontologies, Rome October 2003. IOS Press, Studies in Health Technology and Informatics, vol 102, 2004. p. 20-38. • Ceusters W, Smith B, Kumar A, Dhaen C. Ontology-Based Error Detection in SNOMED-CT®. In: M. Fieschi, E. Coiera and Y-C.J. Li, editors. MEDINFO 2004. Proceedings of the 11th World Congress on Medical Informatics; 2004 Sep 7-11, San Francisco, CA, USA. Amsterdam: IOS Press; 2004. p. 482-6. • Smith B, Rosse C. The role of foundational relations in the alignment of biomedical ontologies. In: M. Fieschi, E. Coiera and Y-C.J. Li, editors. MEDINFO 2004. Proceedings of the 11th World Congress on Medical Informatics; 2004 Sep 7-11, San Francisco, CA, USA. Amsterdam: IOS Press; 2004. p. 444-8. • Kumar A, Schulze-Kremer S, Smith B. Revising the UMLS Semantic Network. In: M. Fieschi, E. Coiera and Y-C.J. Li, editors. MEDINFO 2004. Proceedings of the 11th World Congress on Medical Informatics; 2004 Sep 7-11, San Francisco, CA, USA. Amsterdam: IOS Press; 2004. p. 1700-4. • Ceusters W, Smith B. A Terminological and Ontological Analysis of the NCI Thesaurus. Methods of Information in Medicine 2005; 44: 498-507. MIE 2006 Tutorial Standards and Ontologies

  23. Standardisation efforts concerning biomedical ontologies • Bioinformatics Data Structures - Framework and Overview (BSR/IEEE 1953-200x) • Standard for Sequence Ontology (BSR/IEEE 1953.1-200x) • Open Biomedical Ontologies • The OBO Foundry • caDSR: uses the ISO/IEC 11179 metadata repository standard to standardise the way identical kinds of data are collected across different cancer research studies. MIE 2006 Tutorial Standards and Ontologies

  24. Available deliverables • D 2.1.1 European Current practices in providing semantic interoperability in eHealth domain: Survey of eHealth Practices (Czech Republic) • Survey of 27 countries and States • D1.1.8-ProjectPresentation • D2.2.1 Standardization efforts for providing semantic interoperability in eHealth domain • D.5.3.1 – Proposals to Standardization Bodies: ebBP Profile for Integrating Healthcare Enterprise (IHE) MIE 2006 Tutorial Standards and Ontologies

  25. MIE 2006 Tutorial Standards and Ontologies

  26. Contact http://www.srdc.metu.edu.tr/webpage/projects/ride/index.php

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