Care pathway records with ontologies: Potential uses in medical research and health care

This is one of a series of papers arising in part out of the SHARE (Supporting and structuring Healthgrid Activities and Research in Europe) project; in previous work, we have examined the use of integrated care pathways (ICPs), a fine-grained form of medical guideline including the explicit recording of any deviation, or ‘variance’, for research purposes. In particular, we explored how feeding the results of the analysis of variance into the development of a pathway might be an effective way of capturing ‘evidence from practice’.Building on this concept, in our principal case study we propose an information system for extracting data from ICPs using ontologies and a method for inferring ICPs from other patient records, combining these with data collected for retrospective and prospective studies in preimplantation genetic diagnosis (PGD) and screening (PGS) for assisted reproduction. We also look at the problem of selecting alternatives when drug interactions occur when multiple pathways are used in parallel

Pattern Reification as the Basis for Description-Driven Systems

One of the main factors driving object-oriented software development for information systems is the requirement for systems to be tolerant to change. To address this issue in designing systems, this paper proposes a pattern-based, object-oriented, description-driven system (DDS) architecture as an extension to the standard UML four-layer meta-model. A DDS architecture is proposed in which aspects of both static and dynamic systems behavior can be captured via descriptive models and meta-models. The proposed architecture embodies four main elements - firstly, the adoption of a multi-layered meta-modeling architecture and reflective meta-level architecture, secondly the identification of four data modeling relationships that can be made explicit such that they can be modified dynamically, thirdly the identification of five design patterns which have emerged from practice and have proved essential in providing reusable building blocks for data management, and fourthly the encoding of the structural properties of the five design patterns by means of one fundamental pattern, the Graph pattern. A practical example of this philosophy, the CRISTAL project, is used to demonstrate the use of description-driven data objects to handle system evolution.Comment: 20 pages, 10 figure

Privacy compliance in European healthgrid domains: an ontology-based approach

The integration of different European medical systems by means of grid technologies will continue to be challenging if technology does not intervene to enhance interoperability between national regulatory frameworks on data protection. Achieving compliance in European healthgrid domains is crucial but challenging because of the diversity and complexity of Member State legislation across Europe. Lack of automation and inconsistency of processes across health¬care organizations increase the complexity of the compliance task. In the absence of automation, the compliance task entails human intervention. In this paper we present an approach to automate privacy requirements for the sharing of patient data between Member States across Europe in a healthgrid domain and ensure its enforcement internally and within external domains where the data might travel. This approach is based on the semantic modelling of privacy obligations that are of legal, ethical or cultural nature. Our model reflects both similarities and conflicts, if any, between the different Member States. This will allow us to reason on the safeguards a data controller should demand from an organization belonging to another Member State before disclosing medical data to them. The system will also generate the relevant set of policies to be enforced at the process level of the grid to ensure privacy compliance before allowing access to the data