Microsoft powerpoint - semantic_technical_issues.ppt
Semantic and Technical Architecture and Implementation Issues Use Cases
Data set (for doctors)for unscheduled care as a minumum data set from Patient Summary
Getting a medication based on a prescription from another country
Local doctor to prescribe medicine to foreign patient
• Starting point is to be build on existing elements
based on regional / national infra-info structure
• local/regional/national system and data have
• several possibles models : - EU central database - or a portal ? : no
as it mixes semantic & technical elements
• Medical Information exists on diverse
forms : free text & some coding part
• it is one of the reason to try to focus on a
small set of data in the cross border patient summary
• Do not reinvent the wheel• Use a model suitable for all the countries (but
• For patient summary : need something which
• But avoiding possible errors (e-medication) :
• Need of non ambigous terms : coding (but not
always possible for doctors in daily routine)
• EU interoperability engine would fail if too
complete structured eHR but about a tiny amount of data contained in the patient summary
• key issue : what kind of generic cooperation model is not
• Terminologies are necessary but not sufficient• and not only one (as different purposes exist
• as not all the info is structured (free text)• need to ‘ instrument this with ICT to be able to
• a model of software ‘ construction ’ is needed
– no central EU DB
– central contact/service point in each country
– linguistic & semantic interoperability : one concept should have only one common ‘ index ’ which points on a term tranlated in different languages, diverse terminologies, relaying on what is used at the national level safe information should be derived on automatic ‘ translation ’ (including semantic)
• Agree on a reference model• with migration path from heterogenous
– the number of existing standards with the reason
– the complexity of building a national central service
In order to experiment a possible way of working
• try to build a minimum list of data for emergency
• with possible slight ‘ deviations ’ due to national
• and compare the diverse national versions in
order to understand the differences and their reason (legal, specific national system, orga.)
• Allergies (penicillin,. . . )• Immunizations (Tetanus, Flu, Hep.B)• Regular medications (insulin, anti-epilleptics,
------------------------------------------------------• (unmedicated )Active problems (or specific
situations : pregnancy, (mental) handicap, operated anevrism,.
• Cross border services needs to use Language translation :
– headings are fixed (easy to translate)
– translation of the other terms is needed to build
/use the index (and not to rely on specific language with ambiguities
Choices & priorities to be made at national level
• to have an agreed index system to be able to
• possibly usage of a ‘ pivot ’ language
• based on the previous assumption a reference model should be used
• including semantic description of the security
issues with cross national recognition (trust ID)
Semantic and Technical Architecture and Implementation Issues Main Requirements
Integrated eHealth services are required providing patient and health professional transparent access to knowledge (patient summary including medication record).
Semantic mediation services must support (on local site) semantic interoperability (human interpretable and machine processable).
Semantic and Technical Architecture and Implementation Issues How to proceed Develop an integrated (knowledge base) reference model for services
Security Architecture (semantic and technical)
Service Oriented Architecture (SOA) -
are suitable and available to support the
– from object oriented design & development
– through component oriented – to SERVICE design
• included ‘ methodology design ’,
independent of the ‘ technical choices ’ : which increases perrenity
This is the question• should be (at least) language independent
• except in flamish/dutch SOA = ‘ sexual transmissible disease ’ ?
Conclusion : avoid mis-interpretation by
using non ambigous term(inology )& code
• Member States interested to be part :
France, Germany, Italy, Norway, Slovakia, Slovenia, Spain, Sweden, UK
• Coordination of the drafting process :
• Need of an automatic extraction to organise the
• need to define and enriche the minimum list of
terms needed to be translated without any ambiguity
• attention not to make things too simple• avoid the small is beautifull syndrom
-pre-organise the structure on the national
intermediation services platform only ondemand in real time
The new england journal of medicineClopidogrel versus Aspirin and Esomeprazole Francis K.L. Chan, M.D., Jessica Y.L. Ching, M.P.H., Lawrence C.T. Hung, M.D., Vincent W.S. Wong, M.D., Vincent K.S. Leung, M.D., Nelson N.S. Kung, M.D.,Aric J. Hui, M.D., Justin C.Y. Wu, M.D., Wai K. Leung, M.D., Vivian W.Y. Lee, Pharm.D., Kenneth K.C. Lee, Ph.D., Yuk T. Lee, M.D., James Y.W. Lau, M.D., Ka F.
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