Active Semantic Electronic Medical Record

The healthcare industry is rapidly advancing towards the widespread use of electronic medical records systems to manage the increasingly large amount of patient data and reduce medical errors. In addition to patient data there is a large amount of data describing procedures, treatments, diagnoses, drugs, insurance plans, coverage, formularies and the relationships between these data sets. While practices have benefited from the use of EMRs, infusing these essential programs with rich domain knowledge and rules can greatly enhance their performance and ability to support clinical decisions. Active Semantic Electronic Medical Record (ASEMR) application discussed here uses Semantic Web technologies to reduce medical errors, improve physician efficiency with accurate completion of patient charts, improve patient safety and satisfaction in medical practice, and improve billing due to more accurate coding. This results in practice efficiency and growth by enabling physicians to see more patients with improved care. ASEMR has been deployed and in daily use for managing all patient records at the Athens Heart Center since December 2005. This showcases an application of Semantic Web in health care, especially small clinics

Active Semantic Electronic Medical Record

The healthcare industry is rapidly advancing towards the widespread use of electronic medical records systems to manage the increasingly large amount of patient data and reduce medical errors. In addition to patient data there is a large amount of data describing procedures, treatments, diagnoses, drugs, insurance plans, coverage, formularies and the relationships between these data sets. While practices have benefited from the use of EMRs, infusing these essential programs with rich domain knowledge and rules can greatly enhance their performance and ability to support clinical decisions. Active Semantic Electronic Medical Record (ASEMR) application discussed here uses Semantic Web technologies to reduce medical errors, improve physician efficiency with accurate completion of patient charts, improve patient safety and satisfaction in medical practice, and improve billing due to more accurate coding. This results in practice efficiency and growth by enabling physicians to see more patients with improved care. ASEMR has been deployed and in daily use for managing all patient records at the Athens Heart Center since December 2005. This showcases an application of Semantic Web in health care, especially small clinics

Report on the EHCR (Deliverable 26.2)

This deliverable is the second for Workpackage 26. The first, submitted after Month 12, summarised the areas of research that the partners had identified as being relevant to the semantic indexing of the EHR. This second one reports progress on the key threads of work identified by the partners during the project to contribute towards semantically interoperable and processable EHRs. This report provides a set of short summaries on key topics that have emerged as important, and to which the partners are able to make strong contributions. Some of these are also being extended via two new EU Framework 6 proposals that include WP26 partners: this is also a measure of the success of this Network of Excellence

The European Institute for Innovation through Health Data

The European Institute for Innovation through Health Data (i~HD, www.i-hd.eu) has been formed as one of the key sustainable entities arising from the Electronic Health Records for Clinical Research (IMI-JU-115189) and SemanticHealthNet (FP7-288408) projects, in collaboration with several other European projects and initiatives supported by the European Commission. i~HD is a European not-for-profit body, registered in Belgium through Royal Assent. i~HD has been established to tackle areas of challenge in the successful scaling up of innovations that critically rely on high-quality and interoperable health data. It will specifically address obstacles and opportunities to using health data by collating, developing, and promoting best practices in information governance and in semantic interoperability. It will help to sustain and propagate the results of health information and communication technology (ICT) research that enables better use of health data, assessing and optimizing their novel value wherever possible. i~HD has been formed after wide consultation and engagement of many stakeholders to develop methods, solutions, and services that can help to maximize the value obtained by all stakeholders from health data. It will support innovations in health maintenance, health care delivery, and knowledge discovery while ensuring compliance with all legal prerequisites, especially regarding the insurance of patient's privacy protection. It is bringing multiple stakeholder groups together so as to ensure that future solutions serve their collective needs and can be readily adopted affordably and at scale

Knowledge-based best of breed approach for automated detection of clinical events based on German free text digital hospital discharge letters

OBJECTIVES: The secondary use of medical data contained in electronic medical records, such as hospital discharge letters, is a valuable resource for the improvement of clinical care (e.g. in terms of medication safety) or for research purposes. However, the automated processing and analysis of medical free text still poses a huge challenge to available natural language processing (NLP) systems. The aim of this study was to implement a knowledge-based best of breed approach, combining a terminology server with integrated ontology, a NLP pipeline and a rules engine. METHODS: We tested the performance of this approach in a use case. The clinical event of interest was the particular drug-disease interaction "proton-pump inhibitor [PPI] use and osteoporosis". Cases were to be identified based on free text digital discharge letters as source of information. Automated detection was validated against a gold standard. RESULTS: Precision of recognition of osteoporosis was 94.19%, and recall was 97.45%. PPIs were detected with 100% precision and 97.97% recall. The F-score for the detection of the given drug-disease-interaction was 96,13%. CONCLUSION: We could show that our approach of combining a NLP pipeline, a terminology server, and a rules engine for the purpose of automated detection of clinical events such as drug-disease interactions from free text digital hospital discharge letters was effective. There is huge potential for the implementation in clinical and research contexts, as this approach enables analyses of very high numbers of medical free text documents within a short time period

Ontology as the core discipline of biomedical informatics: Legacies of the past and recommendations for the future direction of research

The automatic integration of rapidly expanding information resources in the life sciences is one of the most challenging goals facing biomedical research today. Controlled vocabularies, terminologies, and coding systems play an important role in realizing this goal, by making it possible to draw together information from heterogeneous sources – for example pertaining to genes and proteins, drugs and diseases – secure in the knowledge that the same terms will also represent the same entities on all occasions of use. In the naming of genes, proteins, and other molecular structures, considerable efforts are under way to reduce the effects of the different naming conventions which have been spawned by different groups of researchers. Electronic patient records, too, increasingly involve the use of standardized terminologies, and tremendous efforts are currently being devoted to the creation of terminology resources that can meet the needs of a future era of personalized medicine, in which genomic and clinical data can be aligned in such a way that the corresponding information systems become interoperable

ARGOS policy brief on semantic interoperability

Semantic interoperability requires the use of standards, not only for Electronic Health Record (EHR) data to be transferred and structurally mapped into a receiving repository, but also for the clinical content of the EHR to be interpreted in conformity with the original meanings intended by its authors. Accurate and complete clinical documentation, faithful to the patient’s situation, and interoperability between systems, require widespread and dependable access to published and maintained collections of coherent and quality-assured semantic resources, including models such as archetypes and templates that would (1) provide clinical context, (2) be mapped to interoperability standards for EHR data, (3) be linked to well specified, multi-lingual terminology value sets, and (4) be derived from high quality ontologies. Wide-scale engagement with professional bodies, globally, is needed to develop these clinical information standards

Exploiting Sentence Embedding for Medical Question Answering

Despite the great success of word embedding, sentence embedding remains a not-well-solved problem. In this paper, we present a supervised learning framework to exploit sentence embedding for the medical question answering task. The learning framework consists of two main parts: 1) a sentence embedding producing module, and 2) a scoring module. The former is developed with contextual self-attention and multi-scale techniques to encode a sentence into an embedding tensor. This module is shortly called Contextual self-Attention Multi-scale Sentence Embedding (CAMSE). The latter employs two scoring strategies: Semantic Matching Scoring (SMS) and Semantic Association Scoring (SAS). SMS measures similarity while SAS captures association between sentence pairs: a medical question concatenated with a candidate choice, and a piece of corresponding supportive evidence. The proposed framework is examined by two Medical Question Answering(MedicalQA) datasets which are collected from real-world applications: medical exam and clinical diagnosis based on electronic medical records (EMR). The comparison results show that our proposed framework achieved significant improvements compared to competitive baseline approaches. Additionally, a series of controlled experiments are also conducted to illustrate that the multi-scale strategy and the contextual self-attention layer play important roles for producing effective sentence embedding, and the two kinds of scoring strategies are highly complementary to each other for question answering problems.Comment: 8 page

Semantic Integration of Cervical Cancer Data Repositories to Facilitate Multicenter Association Studies: The ASSIST Approach

The current work addresses the unifi cation of Electronic Health Records related to cervical cancer into a single medical knowledge source, in the context of the EU-funded ASSIST research project. The project aims to facilitate the research for cervical precancer and cancer through a system that virtually unifi es multiple patient record repositories, physically located in different medical centers/hospitals, thus, increasing fl exibility by allowing the formation of study groups “on demand” and by recycling patient records in new studies. To this end, ASSIST uses semantic technologies to translate all medical entities (such as patient examination results, history, habits, genetic profi le) and represent them in a common form, encoded in the ASSIST Cervical Cancer Ontology. The current paper presents the knowledge elicitation approach followed, towards the defi nition and representation of the disease’s medical concepts and rules that constitute the basis for the ASSIST Cervical Cancer Ontology. The proposed approach constitutes a paradigm for semantic integration of heterogeneous clinical data that may be applicable to other biomedical application domains