Supporting patient screening to identify suitable clinical trials.

To support the efficient execution of post-genomic multi-centric clinical trials in breast cancer we propose a solution that streamlines the assessment of the eligibility of patients for available trials. The assessment of the eligibility of a patient for a trial requires evaluating whether each eligibility criterion is satisfied and is often a time consuming and manual task. The main focus in the literature has been on proposing different methods for modelling and formalizing the eligibility criteria. However the current adoption of these approaches in clinical care is limited. Less effort has been dedicated to the automatic matching of criteria to the patient data managed in clinical care. We address both aspects and propose a scalable, efficient and pragmatic patient screening solution enabling automatic evaluation of eligibility of patients for a relevant set of trials. This covers the flexible formalization of criteria and of other relevant trial metadata and the efficient management of these representations

Analysis of the suitability of existing medical ontologies for building a scalable semantic interoperability solution supporting multi-site collaboration in oncology

Semantic interoperability is essential to facilitate efficient collaboration in heterogeneous multi-site healthcare environments. The deployment of a semantic interoperability solution has the potential to enable a wide range of informatics supported applications in clinical care and research both within as ingle healthcare organization and in a network of organizations. At the same time, building and deploying a semantic interoperability solution may require significant effort to carryout data transformation and to harmonize the semantics of the information in the different systems. Our approach to semantic interoperability leverages existing healthcare standards and ontologies, focusing first on specific clinical domains and key applications, and gradually expanding the solution when needed. An important objective of this work is to create a semantic link between clinical research and care environments to enable applications such as streamlining the execution of multi-centric clinical trials, including the identification of eligible patients for the trials. This paper presents an analysis of the suitability of several widely-used medical ontologies in the clinical domain: SNOMED-CT, LOINC, MedDRA, to capture the semantics of the clinical trial eligibility criteria, of the clinical trial data (e.g., Clinical Report Forms), and of the corresponding patient record data that would enable the automatic identification of eligible patients. Next to the coverage provided by the ontologies we evaluate and compare the sizes of the sets of relevant concepts and their relative frequency to estimate the cost of data transformation, of building the necessary semantic mappings, and of extending the solution to new domains. This analysis shows that our approach is both feasible and scalable

Implementation of the HL7 standard for consulting university medical records. Case study: University Welfare Division - Industrial University of Santander

Con la creación de la ley 1438 del 2011 el gobierno colombiano establece la reglamentación de la historia clínica digital, pero ésta no plantea lineamientos claros de cómo debe ser el almacenamiento, comunicación y seguridad de la información médica entre las instituciones clínicas del país. En la actualidad países como Japón, Canadá y Corea del sur han desarrollado proyectos nacionales para el manejo de la información médica, los cuales soportados bajo estándares internacionales como el EN13606, DICOM, open EHR y HL7 han podido comunicar las diferentes instituciones prestadoras de salud (clínicas, hospitales, centros de salud, laboratorios clínicos) a lo largo del territorio nacional. En este proyecto se plantea una arquitectura que permita la consulta y seguridad de la información clínica estudiantil de la Universidad Industrial de Santander utilizando el estándar CDA HL7, mediante el desarrollo de un prototipo funcional basado en java, que soporte la asignación de permisos de consulta a la información clínica de los estudiantes, la generación de llaves de acceso a la historia clínica estudiantil bajo el estándar CDA, la consulta de las descargas realizadas de los documentos clínicos para llevar una auditoria de quienes han accedido a la información y la validación de los documentos generados utilizando herramientas en línea como las de open health toolsINTRODUCCIÓN 5 2. MARCO TEÓRICO 6 2.1 openEHR: 6 2.2 ISO/EN 13606 6 2.3 HL7. 7 2.4 LOINC 8 2.5 CIE 10 8 2.6 OID 8 2.7 CDA 9 2.7.1 IDENTIFICACIÓN DEL ESQUEMA CDA 10 2.4. ATENCION MÉDICA. 16 2.5 SEGURIDAD 18 2.5.1 PERMISOS DE ACCESO 18 2.5.2 ENCRIPTAMIENTO 18 2.5.2.1 SSL 18 3 ESTADO DEL ARTE 19 3.1 HL7 Y LA INTEROPERABILIDAD EN EL MUNDO: 20 3.1.1 JAPON 20 3.1.2 CANADA 21 3.1.3 COREA DEL SUR 21 3.1.4 MEXICO 21 3.2 HL7 Y LA INTEROPERABILIDAD EN COLOMBIA: 21 3.2.1 REGLAMENTACIÓN COLOMBIANA 22 3.2.2 INTEROPERABILIDAD DE LA HISTORIA UNIVERSITARIA. 22 3.3 METODO DE INVESTIGACION 23 3.3.1 PLANTEAMIENTO DEL PROBLEMA Y JUSTIFICACIÓN. 23 3.3.2 ANÁLISIS DE INTERESADOS. 25 3.3.3 IMPACTO. 26 3.4 ALCANCE DEL PROYECTO 26 3.4.1 OBJETIVO GENERAL 26 3.4.2 OBJETIVOS ESPECÍFICOS 26 3.4.3 PREGUNTA DE INVESTIGACIÓN 27 3.4.4 HIPÓTESIS 27 3.5 MODELO DE DESARROLLO 27 3.5.1 ACTIVIDADES 27 3.6 HERRAMIENTAS UTILIZADAS 28 3.6.1 ENTERPRISE ARCHITECT 28 3.6.2 JAVA EE5 29 3.6.3 Servidor de Aplicaciones JBOSS (JBOSSAS) 29 4 RESULTADOS 30 4.1 DEFINICIÓN DE LOS ESCENARIOS DE CALIDAD. 30 4.1.1 INTEROPERABILIDAD 30 4.1.2 DISPONIBILIDAD 30 4.1.3 MODIFICABILIDAD 31 4.1.4 SEGURIDAD 31 4.2 DEFINICIÓN DE LA ARQUITECTURA. 33 4.2.1 DIAGRAMA DE CAPAS 33 4.2.2 DIAGRAMA DE DESPLIEGUE 34 4.3.1 DIAGRAMAS DE CASOS DE USO 35 4.3.2 DIAGRAMAS DE SECUENCIA 46 4.4 PROTOTIPO FUNCIONAL 57 4.4.1 MODULO DE ADMINISTRACIÓN. 59 4.4.2 MODULO DE CONSULTA HC 60 4.2.3 MODULO DE GENERACION HC 62 4.4VALIDACION 65 5 DISCUSION 67 5.1 APORTES DEL PROYECTO 67 5.2 LIMITACIONES 68 6 CONCLUSIONES 69 7 TRABAJO FUTURO 70 8 BIBLIOGRAFIA 71MaestríaWith the creation of Law 1438 of 2011, the Colombian government establishes the regulation of digital medical records, but this does not establish clear guidelines on how the storage, communication and security of medical information should be among the country's clinical institutions. Currently, countries such as Japan, Canada and South Korea have developed national projects for the management of medical information, which, supported by international standards such as EN13606, DICOM, open EHR and HL7, have been able to communicate the different health provider institutions ( clinics, hospitals, health centers, clinical laboratories) throughout the national territory. This project proposes an architecture that allows the consultation and security of the student clinical information of the Industrial University of Santander using the CDA HL7 standard, through the development of a functional prototype based on java, which supports the assignment of consultation permissions to the clinical information of the students, the generation of access keys to the student medical history under the CDA standard, the consultation of the downloads made of the clinical documents to carry out an audit of those who have accessed the information and the validation of the documents generated using online tools such as open health tool