Semantic similarity-based alignment between clinical archetypes and SNOMED CT: An application to observations

García, María Meizoso; Allones, José Luis Iglesias; Hernández, Diego Martínez; Taboada, M.

doi:10.1016/j.ijmedinf.2012.02.007

Cited by 26 publications

(11 citation statements)

References 12 publications

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“…First we coded our information items (e.g., information item “therapy GDM” was associated with code “AAArche::105”) and then bound the Archetype nodes to these codes in the Archetypes’ term-binding sections (e.g., Archetype node “at0009” representing item “therapy GDM” was bound to code “AAArche::105”). The manual selection of suitable codes from a standardized terminology such as SNOMED-CT to represent a set of information items is complex and time-consuming [45]. As this task was also not in the main focus of our project, we decided to use a self-defined, proprietary terminology as a proxy for a standardized terminology instead.…”

Section: Methodsmentioning

confidence: 99%

The EHR-ARCHE project: Satisfying clinical information needs in a Shared Electronic Health Record System based on IHE XDS and Archetypes

Duftschmid

Rinner

Köhler

et al. 2013

International Journal of Medical Informatics

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Section: Methodsmentioning

confidence: 99%

The EHR-ARCHE project: Satisfying clinical information needs in a Shared Electronic Health Record System based on IHE XDS and Archetypes

Duftschmid

Rinner

Köhler

et al. 2013

International Journal of Medical Informatics

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“…In this concern, archetype management platforms came into being, such as openEHR CKM [ 43 ] and NHS-CfH repository [ 44 ]. The openEHR CKM, as an international archetype repository for archetype management and reuse, has been used widely [ 1 , 23 , 24 , 26 , 45 – 48 ] around the world. Although the openEHR CKM has accumulated nearly 500 archetypes for the most common international requirements, some modification and newly development require to be developed to meet the localized requirements of different countries.…”

Section: Discussionmentioning

confidence: 99%

Modeling EHR with the openEHR approach: an exploratory study in China

Min

Tian

Lü

et al. 2018

BMC Med Inform Decis Mak

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BackgroundThe openEHR approach can improve the interoperability of electronic health record (EHR) through two-level modeling. Developing archetypes for the complete EHR dataset is essential for implementing a large-scale interoperable EHR system with the openEHR approach. Although the openEHR approach has been applied in different domains, the feasibility of archetyping a complete EHR dataset in a hospital has not been reported in academic literature, especially in a country where using openEHR is still in its infancy stage, like China. This paper presents a case study of modeling an EHR in China aiming to investigate the feasibility and challenges of archetyping a complete EHR dataset with the openEHR approach.MethodsWe proposed an archetype modeling method including an iterative process of collecting requirements, normalizing data elements, organizing concepts, searching corresponding archetypes, editing archetypes and reviewing archetypes. Two representative EHR systems from Chinese vendors and the existing Chinese EHR standards have been used as resources to identify the requirements of EHR in China, and a case study of modeling EHR in China has been conducted. Based on the models developed in this case study, we have implemented a clinical data repository (CDR) to verify the feasibility of modeling EHR with archetypes.ResultsSixty four archetypes were developed to represent all requirements of a complete EHR dataset. 59 (91%) archetypes could be found in Clinical Knowledge Manager (CKM), of which 35 could be reused directly without change, and 23 required further development including two revisions, two new versions, 18 extensions and one specialization. Meanwhile, 6 (9%) archetypes were newly developed. The legacy data of the EHR system in hospitals could be integrated into the CDR developed with these archetypes successfully.ConclusionsThe existing archetypes in CKM can faithfully represent most of the EHR requirements in China except customizations for local hospital management. This case study verified the feasibility of modeling EHR with the openEHR approach and identified the fact that the challenges such as localization, tool support, and an agile publishing process still exist for a broader application of the openEHR approach.

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“…1) implementing algorithms for pre-coordination and post-coordination using SNOMED CT’s extensive hierarchy, the former helping to find useful relationships (e.g. is-a relationships) between terms in order to avoid the need to manually identify all fitting term concepts, and the latter making it possible to aggregate terms for forming unavailable ones; 2) using lexical and context-based techniques to find suitable terms in a terminology to bind to archetype data elements, as Meizoso García et al demonstrated with promising success [42]; 3) identifying interesting terms through visualisation techniques [43]. Secondly, current GDL editing and execution tooling does not support using other standard information models than the openEHR RM.…”

Section: Discussionmentioning

confidence: 99%

Retrospective checking of compliance with practice guidelines for acute stroke care: a novel experiment using openEHR’s Guideline Definition Language

Anani

Chen

Moreira

et al. 2014

BMC Med Inform Decis Mak

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BackgroundProviding scalable clinical decision support (CDS) across institutions that use different electronic health record (EHR) systems has been a challenge for medical informatics researchers. The lack of commonly shared EHR models and terminology bindings has been recognised as a major barrier to sharing CDS content among different organisations. The openEHR Guideline Definition Language (GDL) expresses CDS content based on openEHR archetypes and can support any clinical terminologies or natural languages. Our aim was to explore in an experimental setting the practicability of GDL and its underlying archetype formalism. A further aim was to report on the artefacts produced by this new technological approach in this particular experiment. We modelled and automatically executed compliance checking rules from clinical practice guidelines for acute stroke care.MethodsWe extracted rules from the European clinical practice guidelines as well as from treatment contraindications for acute stroke care and represented them using GDL. Then we executed the rules retrospectively on 49 mock patient cases to check the cases’ compliance with the guidelines, and manually validated the execution results. We used openEHR archetypes, GDL rules, the openEHR reference information model, reference terminologies and the Data Archetype Definition Language. We utilised the open-sourced GDL Editor for authoring GDL rules, the international archetype repository for reusing archetypes, the open-sourced Ocean Archetype Editor for authoring or modifying archetypes and the CDS Workbench for executing GDL rules on patient data.ResultsWe successfully represented clinical rules about 14 out of 19 contraindications for thrombolysis and other aspects of acute stroke care with 80 GDL rules. These rules are based on 14 reused international archetypes (one of which was modified), 2 newly created archetypes and 51 terminology bindings (to three terminologies). Our manual compliance checks for 49 mock patients were a complete match versus the automated compliance results.ConclusionsShareable guideline knowledge for use in automated retrospective checking of guideline compliance may be achievable using GDL. Whether the same GDL rules can be used for at-the-point-of-care CDS remains unknown.

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Semantic similarity-based alignment between clinical archetypes and SNOMED CT: An application to observations

Cited by 26 publications

References 12 publications

The EHR-ARCHE project: Satisfying clinical information needs in a Shared Electronic Health Record System based on IHE XDS and Archetypes

The EHR-ARCHE project: Satisfying clinical information needs in a Shared Electronic Health Record System based on IHE XDS and Archetypes

Modeling EHR with the openEHR approach: an exploratory study in China

Retrospective checking of compliance with practice guidelines for acute stroke care: a novel experiment using openEHR’s Guideline Definition Language

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