Computerization of workflows, guidelines and care pathways: a review of implementation challenges for process-oriented health information systems

There is a need to integrate the various theoretical frameworks and formalisms for modeling clinical guidelines, workflows, and pathways, in order to move beyond providing support for individual clinical decisions and toward the provision of process-oriented, patient-centered, health information systems (HIS). In this review, we analyze the challenges in developing process-oriented HIS that formally model guidelines, workflows, and care pathways. A qualitative meta-synthesis was performed on studies published in English between 1995 and 2010 that addressed the modeling process and reported the exposition of a new methodology, model, system implementation, or system architecture. Thematic analysis, principal component analysis (PCA) and data visualisation techniques were used to identify and cluster the underlying implementation ‘challenge’ themes. One hundred and eight relevant studies were selected for review. Twenty-five underlying ‘challenge’ themes were identified. These were clustered into 10 distinct groups, from which a conceptual model of the implementation process was developed. We found that the development of systems supporting individual clinical decisions is evolving toward the implementation of adaptable care pathways on the semantic web, incorporating formal, clinical, and organizational ontologies, and the use of workflow management systems. These architectures now need to be implemented and evaluated on a wider scale within clinical settings

Generic unified modelling process for developing semantically rich, dynamic and temporal models

Models play a vital role in supporting a range of activities in numerous domains. We rely on models to support the design, visualisation, analysis and representation of parts of the world around us, and as such significant research effort has been invested into numerous areas of modelling; including support for model semantics, dynamic states and behaviour, temporal data storage and visualisation. Whilst these efforts have increased our capabilities and allowed us to create increasingly powerful software-based models, the process of developing models, supporting tools and /or data structures remains difficult, expensive and error-prone. In this paper we define from literature the key factors in assessing a model’s quality and usefulness: semantic richness, support for dynamic states and object behaviour, temporal data storage and visualisation. We also identify a number of shortcomings in both existing modelling standards and model development processes and propose a unified generic process to guide users through the development of semantically rich, dynamic and temporal models

Common vocabularies for collective intelligence - work in progress

Web based applications and tools offer a great potential to increase the efficiency of information flow and communication among different agents during emergencies. Among the different factors, technical and non technical, that hinder the integration of an information model in emergency management sector, is a lack of a common, shared vocabulary. This paper furthers previous work in the area of ontology development, and presents a summary and overview of the goal, process and methodology to construct a shared set of metadata that can be used to map existing vocabulary. This paper is a work in progress report

Towards a New Science of a Clinical Data Intelligence

In this paper we define Clinical Data Intelligence as the analysis of data generated in the clinical routine with the goal of improving patient care. We define a science of a Clinical Data Intelligence as a data analysis that permits the derivation of scientific, i.e., generalizable and reliable results. We argue that a science of a Clinical Data Intelligence is sensible in the context of a Big Data analysis, i.e., with data from many patients and with complete patient information. We discuss that Clinical Data Intelligence requires the joint efforts of knowledge engineering, information extraction (from textual and other unstructured data), and statistics and statistical machine learning. We describe some of our main results as conjectures and relate them to a recently funded research project involving two major German university hospitals.Comment: NIPS 2013 Workshop: Machine Learning for Clinical Data Analysis and Healthcare, 201

User-centered visual analysis using a hybrid reasoning architecture for intensive care units

One problem pertaining to Intensive Care Unit information systems is that, in some cases, a very dense display of data can result. To ensure the overview and readability of the increasing volumes of data, some special features are required (e.g., data prioritization, clustering, and selection mechanisms) with the application of analytical methods (e.g., temporal data abstraction, principal component analysis, and detection of events). This paper addresses the problem of improving the integration of the visual and analytical methods applied to medical monitoring systems. We present a knowledge- and machine learning-based approach to support the knowledge discovery process with appropriate analytical and visual methods. Its potential benefit to the development of user interfaces for intelligent monitors that can assist with the detection and explanation of new, potentially threatening medical events. The proposed hybrid reasoning architecture provides an interactive graphical user interface to adjust the parameters of the analytical methods based on the users' task at hand. The action sequences performed on the graphical user interface by the user are consolidated in a dynamic knowledge base with specific hybrid reasoning that integrates symbolic and connectionist approaches. These sequences of expert knowledge acquisition can be very efficient for making easier knowledge emergence during a similar experience and positively impact the monitoring of critical situations. The provided graphical user interface incorporating a user-centered visual analysis is exploited to facilitate the natural and effective representation of clinical information for patient care

Training of Crisis Mappers and Map Production from Multi-sensor Data: Vernazza Case Study (Cinque Terre National Park, Italy)

This aim of paper is to presents the development of a multidisciplinary project carried out by the cooperation between Politecnico di Torino and ITHACA (Information Technology for Humanitarian Assistance, Cooperation and Action). The goal of the project was the training in geospatial data acquiring and processing for students attending Architecture and Engineering Courses, in order to start up a team of "volunteer mappers". Indeed, the project is aimed to document the environmental and built heritage subject to disaster; the purpose is to improve the capabilities of the actors involved in the activities connected in geospatial data collection, integration and sharing. The proposed area for testing the training activities is the Cinque Terre National Park, registered in the World Heritage List since 1997. The area was affected by flood on the 25th of October 2011. According to other international experiences, the group is expected to be active after emergencies in order to upgrade maps, using data acquired by typical geomatic methods and techniques such as terrestrial and aerial Lidar, close-range and aerial photogrammetry, topographic and GNSS instruments etc.; or by non conventional systems and instruments such us UAV, mobile mapping etc. The ultimate goal is to implement a WebGIS platform to share all the data collected with local authorities and the Civil Protectio

PlanetOnto: from news publishing to integrated knowledge management support

Given a scenario in which members of an academic community collaboratively construct and share an archive of news items, several knowledge management challenges arise. The authors' integrated suite of tools, called PlanetOnto, supports a speedy but high quality publishing process, allows ontology-driven document formalization and augments standard browsing and search facilities with deductive knowledge retrieva

Knowledge formalization in experience feedback processes : an ontology-based approach

Because of the current trend of integration and interoperability of industrial systems, their size and complexity continue to grow making it more difficult to analyze, to understand and to solve the problems that happen in their organizations. Continuous improvement methodologies are powerful tools in order to understand and to solve problems, to control the effects of changes and finally to capitalize knowledge about changes and improvements. These tools involve suitably represent knowledge relating to the concerned system. Consequently, knowledge management (KM) is an increasingly important source of competitive advantage for organizations. Particularly, the capitalization and sharing of knowledge resulting from experience feedback are elements which play an essential role in the continuous improvement of industrial activities. In this paper, the contribution deals with semantic interoperability and relates to the structuring and the formalization of an experience feedback (EF) process aiming at transforming information or understanding gained by experience into explicit knowledge. The reuse of such knowledge has proved to have significant impact on achieving themissions of companies. However, the means of describing the knowledge objects of an experience generally remain informal. Based on an experience feedback process model and conceptual graphs, this paper takes domain ontology as a framework for the clarification of explicit knowledge and know-how, the aim of which is to get lessons learned descriptions that are significant, correct and applicable

GSO: Designing a Well-Founded Service Ontology to Support Dynamic Service Discovery and Composition

A pragmatic and straightforward approach to semantic service discovery is to match inputs and outputs of user requests with the input and output requirements of registered service descriptions. This approach can be extended by using pre-conditions, effects and semantic annotations (meta-data) in an attempt to increase discovery accuracy. While on one hand these additions help improve discovery accuracy, on the other hand complexity is added as service users need to add more information elements to their service requests. In this paper we present an approach that aims at facilitating the representation of service requests by service users, without loss of accuracy. We introduce a Goal-Based Service Framework (GSF) that uses the concept of goal as an abstraction to represent service requests. This paper presents the core concepts and relations of the Goal-Based Service Ontology (GSO), which is a fundamental component of the GSF, and discusses how the framework supports semantic service discovery and composition. GSO provides a set of primitives and relations between goals, tasks and services. These primitives allow a user to represent its goals, and a supporting platform to discover or compose services that fulfil them