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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

Clinical information modeling processes for semantic interoperability of electronic health records: systematic review and inductive analysis

This is a pre-copyedited, author-produced PDF of an article accepted for publication in Journal of the American Medical Informatics Association following peer review. The version of record is available online at: http://dx.doi.org/10.1093/jamia/ocv008[EN] [Objective] This systematic review aims to identify and compare the existing processes and methodologies that have been published in the literature for defining clinical information models (CIMs) that support the semantic interoperability of electronic health record (EHR) systems. [Material and Methods] Following the preferred reporting items for systematic reviews and meta-analyses systematic review methodology, the authors reviewed published papers between 2000 and 2013 that covered that semantic interoperability of EHRs, found by searching the PubMed, IEEE Xplore, and ScienceDirect databases. Additionally, after selection of a final group of articles, an inductive content analysis was done to summarize the steps and methodologies followed in order to build CIMs described in those articles. [Results] Three hundred and seventy-eight articles were screened and thirty six were selected for full review. The articles selected for full review were analyzed to extract relevant information for the analysis and characterized according to the steps the authors had followed for clinical information modeling. [Discussion] Most of the reviewed papers lack a detailed description of the modeling methodologies used to create CIMs. A representative example is the lack of description related to the definition of terminology bindings and the publication of the generated models. However, this systematic review confirms that most clinical information modeling activities follow very similar steps for the definition of CIMs. Having a robust and shared methodology could improve their correctness, reliability, and quality. [Conclusion] Independently of implementation technologies and standards, it is possible to find common patterns in methods for developing CIMs, suggesting the viability of defining a unified good practice methodology to be used by any clinical information modeler.This research has been partially funded by the Instituto de Salud Carlos III (Platform for Innovation in Medical Technologies and Health), grant PT13/0006/0036 and the Spanish Ministry of Economy and Competitiveness, grants TIN2010-21388-C02-01 and PTQ-12-05620.Moreno-Conde, A.; Moner Cano, D.; Da Cruz, WD.; Santos, MR.; Maldonado Segura, JA.; Robles Viejo, M.; Kalra, D. (2015). 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Electronical Health Record's Systems. Interoperability

Understanding the importance that the electronic medical health records system has, with its various structural types and grades, has led to the elaboration of a series of standards and quality control methods, meant to control its functioning. In time, the electronic health records system has evolved along with the medical data's change of structure. Romania has not yet managed to fully clarify this concept, various definitions still being encountered, such as "Patient's electronic chart", "Electronic health file". A slow change from functional interoperability (OSI level 6) to semantic interoperability (level 7) is being aimed at the moment. This current article will try to present the main electronic files models, from a functional interoperability system's possibility to be created perspective. \ud \u

OntoCR: A CEN/ISO-13606 clinical repository based on ontologies

Objective: To design a new semantically interoperable clinical repository, based on ontologies, conforming to CEN/ISO 13606 standard. Materials and Methods: The approach followed is to extend OntoCRF, a framework for the development of clinical repositories based on ontologies. The meta-model of OntoCRF has been extended by incorporating an OWL model integrating CEN/ISO 13606, ISO 21090 and SNOMED CT structure. Results: This approach has demonstrated a complete evaluation cycle involving the creation of the meta-model in OWL format, the creation of a simple test application, and the communication of standardized extracts to another organization. Discussion: Using a CEN/ISO 13606 based system, an indefinite number of archetypes can be merged (and reused) to build new applications. Our approach, based on the use of ontologies, maintains data storage independent of content specification. With this approach, relational technology can be used for storage, maintaining extensibility capabilities. Conclusions: The present work demonstrates that it is possible to build a native CEN/ISO 13606 repository for the storage of clinical data. We have demonstrated semantic interoperability of clinical information using CEN/ISO 13606 extracts

OpenEHR modeling: improving clinical records during the COVID-19 pandemic

The COVID-19 pandemic had put pressure on various national healthcare systems, due to the lack of health professionals and exhaustion of those avaliable, as well as lack of interoperability and inability to restructure their IT systems. Therefore, the restructuring of institutions at all levels is essential, especially at the level of their information systems. Furthermore, the COVID-19 pandemic had arrived in Portugal at March 2020, with a breakout on the northern region. In order to quickly respond to the pandemic, the CHUP healthcare institution, known as a research center, has embraced the challenge of developing and integrating a new approach based on the openEHR standard to interoperate with the institution’s existing information and its systems. An openEHR clinical modelling methodology was outlined and adopted, followed by a survey of daily clinical and technical requirements. With the arrival of the virus in Portugal, the CHUP institution has undergone through constant changes in their working methodologies as well as their openEHR modelling. As a result, an openEHR patient care workflow for COVID-19 was developed.This work has been supported by FCT - Fundacao para a Ciuencia e Tecnologia within the R&D Units Project Scope: UIDB/00319/2020