Developing HL7 CDA-Based Data Warehouse for the Use of Electronic Health Record Data for Secondary Purposes

Background The growing availability of clinical and administrative data collected in electronic health records (EHRs) have led researchers and policy makers to implement data warehouses to improve the reuse of EHR data for secondary purposes. This approach can take advantages from a unique source of information that collects data from providers across multiple organizations. Moreover, the development of a data warehouse benefits from the standards adopted to exchange data provided by heterogeneous systems. Objective This article aims to design and implement a conceptual framework that semiautomatically extracts information collected in Health Level 7 Clinical Document Architecture (CDA) documents stored in an EHR and transforms them to be loaded in a target data warehouse. Results The solution adopted in this article supports the integration of the EHR as an operational data store in a data warehouse infrastructure. Moreover, data structure of EHR clinical documents and the data warehouse modeling schemas are analyzed to define a semiautomatic framework that maps the primitives of the CDA with the concepts of the dimensional model. The case study successfully tests this approach. Conclusion The proposed solution guarantees data quality using structured documents already integrated in a large-scale infrastructure, with a timely updated information flow. It ensures data integrity and consistency and has the advantage to be based on a sample size that covers a broad target population. Moreover, the use of CDAs simplifies the definition of extract, transform, and load tools through the adoption of a conceptual framework that load the information stored in the CDA in the data warehouse

A system of concepts to support the integration of Health and social care and assistive domotics services: the Health@Home project.

The main objective of this work is to define a common shared conceptual model that describes the health care environment using the ContSys standard, harmonizing it with the social care and assistive domotics concepts. The development of this model supports the integration of services, the interoperability among systems and the continuity of care across domains.Starting from the identification and extraction of the portion of the ContSys model suitable for the healthcare part, the article provides the methodology adopted to extend it with social and home automation concepts and to integrate them in a unique framework that supports the continuity of care.The integrated model defined in this paper has been adopted in the design phase of an interoperable open platform, called Health@Home, that organizes the provision of a set of health, social and home automation integrated services provided at home.Our model is a starting point to analyze the various determinants of wellbeing able to guarantee a high-level individual's quality of life. At the moment the Health@Home system is at the implementation phase

A medical device domain analysis model based on HL7 RIM

Clinical investigations (CIs) are carried out to demonstrate safety and efficacy of new Medical Devices (MDs). The presence of many stakeholders participating in CIs makes it necessary to develop a common standard language to achieve semantic interoperability among systems and organizations. In Italy the National Research Council is carrying out a project supported by Ministry of Health aiming to develop an information system (MEDIS) that manages MD clinical investigations. In order to develop a flexible and interoperable system, MEDIS design has been based on the application of HL7 (Health Level 7) v.3 standards. This paper presents the results of the MEDIS design: the MD DAM based on HL7 RIM

An intersectional approach to analyse gender productivity and open access: a bibliometric analysis of the Italian National Research Council

AbstractGender equality and Open Access (OA) are priorities within the European Research Area and cross-cutting issues in European research program H2020. Gender and openness are also key elements of responsible research and innovation. However, despite the common underlying targets of fostering an inclusive, transparent and sustainable research environment, both issues are analysed as independent topics. This paper represents a first exploration of the inter-linkages between gender and OA analysing the scientific production of researchers of the Italian National Research Council under a gender perspective integrated with the different OA publications modes. A bibliometric analysis was carried out for articles published in the period 2016–2018 and retrieved from the Web of Science. Results are presented constantly analysing CNR scientific production in relation to gender, disciplinary fields and OA publication modes. These variables are also used when analysing articles that receive financial support. Our results indicate that gender disparities in scientific production still persist particularly in STEM disciplines, while the gender gap is the closest to parity in medical and agricultural sciences. A positive dynamic toward OA publishing and women's scientific production is shown when disciplines with well-established open practices are related to articles supported by funds. A slightly higher women's propensity toward OA is shown when considering Gold OA, or authorships with women in the first and last article by-line position. The prevalence of Italian funded articles with women's contributions published in Gold OA journals seems to confirm this tendency, especially if considering the weak enforcement of the Italian OA policies

Assessment of level-walking aperiodicity

BACKGROUND: In gait analysis, walking is assumed to be periodic for the sake of simplicity, despite the fact that, strictly speaking, it can only approximate periodicity and, as such, may be referred to as pseudo-periodic. This study aims at: 1) quantifying gait pseudo-periodicity using information concerning a single stride; 2) investigating the effects of walking pathway length on gait periodicity; 3) investigating separately the periodicity of the upper and lower body parts movement; 4) verifying the validity of foot-floor contact events as markers of the gait cycle period. METHODS: Ten young healthy subjects (6 males, 23 ± 5 years) were asked to perform various gait trials, first along a 20-m pathway that allowed reaching a steady-state condition, and then along an 8-m pathway. A stereophotogrammetric system was used to reconstruct the 3D position of reflective markers distributed over the subjects' body. Foot contact was detected using an instrumented mat. Three marker clusters were used to represent the movement of the whole body, the upper body (without upper limbs), and the lower body, respectively. Linear and rotational kinetic, and gravitational and elastic potential "energy-like" quantities were used to calculate an index J(t) that described the instantaneous "mechanical state" of the analysed body portion. The variations of J(t) in time allowed for the determination of the walking pseudo-period and for the assessment of gait aperiodicity. RESULTS: The suitability of the proposed approach was demonstrated, and it was shown that, for young, healthy adults, a threshold of physiological pseudo-periodicity of walking at natural speed could be set. Higher pseudo-periodicity values were found for the shorter pathway only for the upper body. Irrespective of pathway length, the upper body had a larger divergency from periodicity than the lower body. The error that can be made in estimating the gait cycle duration for the upper body from the heel contacts was shown to be significant. CONCLUSION: The proposed method can be easily implemented in gait laboratories to verify the consistency of a recorded stride with the hypothesis of periodicity

Integrating CERIF Entities in a Multidisciplinary e-infrastructure for Environmental Research Data

AbstractThe paper proposes different solutions to integrate CERIF in the environmental dataset domain, based on the quality of semantic mapping as well as on the characteristics of the CERIF data model. A two-way crosswalk is described resulting in the identification of a core of corresponding metadata and a proposal of extensions of the CERIF model. Extensions of ISO concepts are also described to provide contextual research information in the domain of environmental research data. Finally, the crosswalk has been implemented in the GI-cat discovery broker framework. Successful tests demonstrated the possibility for CERIF information to be integrated in ISO compliant infrastructures and for INSPIRE information to be captured in CERIF

Understanding petri nets in health sciences education. The health issue network perspective

Scarce literature exists as to the use of Petri Nets (PN) to model the dynamic evolution of health issues in a deterministic way. Starting from the HIN (Health Issue Network) approach, the paper aims at describing the suitability of PN in supporting the Case–Based Learning method for improving an educational simulation environment in which students can manage realistic clinical data related to the evolution of a patient's health state over time