Policy-Driven Management of Personal Health Information for Enhancing Interoperability

Based on a system-theoretical approach, aspects of real world systems have been introduced. In this context, the relations between a system's architecture, i.e. its components, their functions and relations, formally represented by domain-specific ontologies considering all domains relevant in the system's use case on the one hand and the system's behaviour ruled by the applied policies on the other hand have been described. A refinement of policies ruling a clinical setting has been exemplified. It could be shown that ubiquitous health systems must be designed and managed following a thoroughly systems-oriented, architecture-centric, ontology-based and policy-driven approach. The feasibility of the approach has been practically demonstrated

Mecanismos de Anotación semántica de Contenidos en Plataformas de Redes Sociales

La mayoría de la información que se encuentra en Internet es textual y sin ninguna estructura formal que permita a las máquinas entender y aprovechar dicha información de manera automática. En una red social todos los contenidos que están compartiendo son valiosos, por lo tanto es necesario definir mecanismos para dar estructura y enriquecer semánticamente la información existente, para que esta sea aprovechada por otras aplicaciones software. En este artículo se propone un mecanismo basado en ontologías de dominio para la anotación semántica de contenidos en plataformas de redes sociales que pueda ser implementado en plataformas existentes de código abierto para redes sociales. El mecanismo está basado en técnicas de Procesamiento de Lenguaje Natural y Anotaciones semánticas automatizadas de la Web semántica.La mayoría de la información que se encuentra en Internet es textual y sin ninguna estructura formal que permita a las máquinas entender y aprovechar dicha información de manera automática. En una red social todos los contenidos que están compartiendo son valiosos, por lo tanto es necesario definir mecanismos para dar estructura y enriquecer semánticamente la información existente, para que esta sea aprovechada por otras aplicaciones software. En este artículo se propone un mecanismo basado en ontologías de dominio para la anotación semántica de contenidos en plataformas de redes sociales que pueda ser implementado en plataformas existentes de código abierto para redes sociales. El mecanismo está basado en técnicas de Procesamiento de Lenguaje Natural y Anotaciones semánticas automatizadas de la Web semántica

A Knowledge-Constrained Role-Based Access Control model for protecting patient privacy in hospital information systems

Current access control mechanisms of the hospital information system can hardly identify the real access intention of system users. A relaxed access control increases the risk of compromise of patient privacy. To reduce unnecessary access of patient information by hospital staff, this paper proposes a Knowledge-Constrained Role-Based Access Control (KCRBAC)model in which a variety of medical domain knowledge is considered in access control. Based on the proposed Purpose Tree and knowledge-involved algorithms, the model can dynamically define the boundary of access to the patient information according to the context, which helps protect patient privacy by controlling access. Compared with the Role-Based Access Control model, KC-RBAC can effectively protectpatient information according to the results of the experiments

A Flexible Solution for Privilege Management and Access Control in EHR Systems

Background: Inter-organizational healthcare businesses are ruled by a huge set of policies: legal policies, organizational policies, medical policies, ethical policies, etc., which are quite static, patients policy and process, social and environmental conditions, which are highly dynamic. In the context of a business case, those different policies must be harmonized to enable privilege management and access control decisions. Objectives: The authors offer a methodology to achieve interoperability through policies harmonization in a privilege management and access control solution for EHR systems, to be later on implemented in a cancer care network using HL7 specifications. Methods: To meet the objective, the authors make use of a system-theoretical, architecture-centric, ontology-based approach to formally representing the aforementioned polices for harmonization. Results: Because of its flexibility and generality, a policy-driven RBAC model is used to formally represent all the other access control models such as MAC, DAC, RBAC, ABAC, HL7 Data Segmentation and Labeling Services. All the policies deployed in the context of an inter-organizational collaboration for cancer care can be formalized and then harmonized. Conclusions: The authors provide an implementation-independent methodology to enable policies harmonization in EHR systems. The methodology described in the paper is independent on the maturity of organizations\u2019 privilege management and access control system. Furthermore, it does not hamper organizations progressing to more advanced solutions over the time. Even dynamic policies can be harmonized at run time, allowing an advancement towards a patient-centered care

Challenges and Solutions for Designing and Managing pHealth Ecosystems

For improving quality and safety of healthcare as well as efficiency and efficacy of care processes, health systems turn toward personalized, preventive, predictive, participative precision medicine. The related pHealth ecosystem combines different domains represented by a huge variety of different human and non-human actors belonging to different policy domains, coming from different disciplines. Those actors deploy different methodologies, terminologies, and ontologies, offering different levels of knowledge, skills, and experiences, acting in different scenarios and accommodating different business cases to meet the intended business objectives. Core challenge is the formal representation and management of multiple domains' knowledge. For correctly modeling such systems and their behavior, a system-oriented, architecture-centric, ontology-based, policy-driven approach is inevitable, thereby following established Good Modeling Best Practices. The ISO Interoperability Reference Architecture model and framework offers such approach. The paper describes and classifies the ongoing paradigm changes. It presents requirements and solutions for designing and implementing advanced pHealth ecosystems, thereby correctly adopting and integrating existing pHealth interoperability standards, specifications and projects

Ontology driven health information systems architectures enable pHealth for empowered patients

The paradigm shift from organization-centered to managed care and on to personal health settings increases specialization and distribution of actors and services related to the health of patients or even citizens before becoming patients. As a consequence, extended communication and cooperation is required between all principals involved in health services such as persons, organizations, devices, systems, applications, and components. Personal health (pHealth) environments range over many disciplines, where domain experts present their knowledge by using domain-specific terminologies and ontologies. Therefore, the mapping of domain ontologies is inevitable for ensuring interoperability. The paper introduces the care paradigms and the related requirements as well as an architectural approach for meeting the business objectives. Furthermore, it discusses some theoretical challenges and practical examples of ontologies, concept and knowledge representations, starting general and then focusing on security and privacy related services. The requirements and solutions for empowering the patient or the citizen before becoming a patient are especially emphasized

An ontology-driven approach for structuring scientific knowledge for predicting treatment adherence behaviour: a case study of tuberculosis in Sub-Saharan African communities.

Doctor of Philosophy in Mathematics, Statistics and Computer Science. University of KwaZulu-Natal, Durban 2016.Poor adherence to prescribed treatment is a complex phenomenon and has been identified as a major contributor to patients developing drug resistance and failing treatment in sub-Saharan African countries. Treatment adherence behaviour is influenced by diverse personal, cultural and socio-economic factors that may vary drastically between communities in different regions. Computer based predictive models can be used to identify individuals and communities at risk of non-adherence and aid in supporting resource allocation and intervention planning in disease control programs. However, constructing effective predictive models is challenging, and requires detailed expert knowledge to identify factors and determine their influence on treatment adherence in specific communities. While many clinical studies and abstract conceptual models exist in the literature, there is no known concrete, unambiguous and comprehensive computer based conceptual model that categorises factors that influence treatment adherence behaviour. The aim of this research was to develop an ontology-driven approach for structuring knowledge of factors that influence treatment adherence behaviour and for constructing adherence risk prediction models for specific communities. Tuberculosis treatment adherence in sub-Saharan Africa was used as a case study to explore and validate the approach. The approach provides guidance for knowledge acquisition, for building a comprehensive conceptual model, its formalisation into an OWL ontology, and generation of probabilistic risk prediction models. The ontology was evaluated for its comprehensiveness and correctness, and its effectiveness for constructing Bayesian decision networks for predicting adherence risk. The approach introduces a novel knowledge acquisition step that guides the capturing of influencing factors from peer-reviewed clinical studies and the scientific literature. Furthermore, the ontology takes an evidence based approach by explicitly relating each factor to published clinical studies, an important consideration for health practitioners. The approach was shown to be effective in constructing a flexible and extendable ontology and automatically generating the structure of a Bayesian decision network, a crucial step towards automated, computer based prediction of adherence risk for individuals in specific communities

Quality framework for semantic interoperability in health informatics: definition and implementation

Aligned with the increased adoption of Electronic Health Record (EHR) systems, it is recognized that semantic interoperability provides benefits for promoting patient safety and continuity of care. This thesis proposes a framework of quality metrics and recommendations for developing semantic interoperability resources specially focused on clinical information models, which are defined as formal specifications of structure and semantics for representing EHR information for a specific domain or use case. This research started with an exploratory stage that performed a systematic literature review with an international survey about the clinical information modelling best practice and barriers. The results obtained were used to define a set of quality models that were validated through Delphi study methodologies and end user survey, and also compared with related quality standards in those areas that standardization bodies had a related work programme. According to the obtained research results, the defined framework is based in the following models: Development process quality model: evaluates the alignment with the best practice in clinical information modelling and defines metrics for evaluating the tools applied as part of this process. Product quality model: evaluates the semantic interoperability capabilities of clinical information models based on the defined meta-data, data elements and terminology bindings. Quality in use model: evaluates the suitability of adopting semantic interoperability resources by end users in their local projects and organisations. Finally, the quality in use model was implemented within the European Interoperability Asset register developed by the EXPAND project with the aim of applying this quality model in a broader scope to contain any relevant material for guiding the definition, development and implementation of interoperable eHealth systems in our continent. Several European projects already expressed interest in using the register, which will now be sustained by the European Institute for Innovation through Health Data