research-article

Semantic interoperability in standardized electronic health record databases

Authors:

Shelly Sachdeva,

Subhash BhallaAuthors Info & Claims

Journal of Data and Information Quality (JDIQ), Volume 3, Issue 1

Article No.: 1, Pages 1 - 37

https://doi.org/10.1145/2166788.2166789

Published: 07 May 2012 Publication History

Abstract

Different clinics and hospitals have their own information systems to maintain patient data. This hinders the exchange of data among systems (and organizations). Hence there is a need to provide standards for data exchange. In digitized form, the individual patient's medical record can be stored, retrieved, and shared over a network through enhancement in information technology. Thus, electronic health records (EHRs) should be standardized, incorporating semantic interoperability. A subsequent step requires that healthcare professionals and patients get involved in using the EHRs, with the help of technological developments. This study aims to provide different approaches in understanding some current and challenging concepts in health informatics. Successful handling of these challenges will lead to improved quality in healthcare by reducing medical errors, decreasing costs, and enhancing patient care. The study is focused on the following goals: (1) understanding the role of EHRs; (2) understanding the need for standardization to improve quality; (3) establishing interoperability in maintaining EHRs; (4) examining a framework for standardization and interoperability (the openEHR architecture; (5) identifying the role of archetypes for knowledge-based systems; and (6) understanding the difficulties in querying HER data.

References

[1]

AQB 2009. Archetype query builder. http://www.oceaninformatics.com/Solutions/ocean-products/Clinical-Modelling/Ocean-Query-Builder.html. (Accessed 12/09).

[2]

AQL 2009. Archetype query language. http://www.openehr.org/wiki/display/spec/Archetype+Query+ Language+Description. (Accessed 12/09).

[3]

Archetype editor tool. 2009. http://wiki.oceaninformatics.com/confluence/display/TTL/Archetype+Editor+ Releases. (Accessed 12/09).

[4]

Atalag, K., Kingsford, D., Paton, C., and Warren, J. 2010. Putting health record interoperability standards to work. J. Health Inf. 5, 1 (e-jhi).

[5]

Batini, C. and Scannapieco, M. 2006. Data Quality: Concepts, Methodologies, and Techniques. Springer, Berlin.

Digital Library

[6]

Beale, T. 2008. The openEHR archetype model: Archetype object model. In the openEHR release 1.0.2, openEHR Foundation.

[7]

Beale, T. 2010. OpenEHR to ISO 13606-1, ISO 21090 mapping. http://www.openehr.org/wiki/display/stds/openEHR+to+ISO+13606-1%2C+ISO+21090+mapping.

[8]

Beale, T. and Frankel, H. 2007. The openEHR reference model: Extract information model. The openEHR release 1, openEHR Foundation.

[9]

Beale, T. and Heard, S. 2005. Archetype definitions and principles. In the openEHR release 1.0.2, openEHR Foundation.

[10]

Beale, T. and Heard, S. 2008a. The openEHR architecture: Architecture overview. In the openEHR release 1.0.2, openEHR Foundation.

[11]

Beale, T., and Heard, S. 2008b. The openEHR archetype model-archetype definition language ADL 1.4. In openEHR release 1.0.2 (issue date: 12/08).

[12]

Beale, T., Heard, S., Kalra, D., and Llyod, D. 2008. The openEHR reference model: EHR information model. In the openEHR release 1.0.2., openEHR Foundation.

[13]

Beale, T. and Heard, S. 2009. The openEHR archetype model: openEHR Templates. In openEHR release 1.0.2. (issue date 4/20/09).

[14]

Bhalla, S. and Hasegawa, M. 2006. Query interface for ubiquitous access to database resources. In Proceedings of the 13^th International Conference on Management of Data (COMAD).

[15]

Bisbal, J. and Berry, D. 2009. Archetype alignment: A two-level driven semantic matching approach to interoperability in the clinical domain. In HEALTHINFO, 216--221.

[16]

Blobel, B. G. M. E. and Pharow, P. 2008. Analysis and evaluation of EHR approaches. In eHealth Beyond the Horizon: Get It There (MIE'08).

[17]

Bott, O. J. 2004. The electronic health record: Standardization and implementation. In Proceedings of the 2^nd OpenECG Workshop.

[18]

Braga, D., Campi, A., and Ceri, S. 2005. XQBE (XQueryBy example): A visual interface to the standard XML query language. ACM Trans. Datab. Syst. 30, 2, 398--443.

Digital Library

[19]

CEN TC/251. European standardization of health informatics. ENV 13606 Electronic Health Record Communication. http://www.centc251.org/.

[20]

Ceri, S., Comai, S., Damiani, E., Fraternali, P., Paraboschi, S., and Tanca L. 1999. XML-GL: A graphical language of querying and restructuring XML documents. In Proceedings of the WWW.

Digital Library

[21]

Chunlan, M., Frankel, H., Beale, T., and Heard S. 2007. EHR query language (EQL): A query language for archetype-based health records. In MEDINFO.

[22]

CKM. Clinical Knowledge Manager. http://www.openehr.org/knowledge/. (Accessed 12/09).

[23]

EHR Standards. Electronic health records standards. http://en.wikipedia.org/wiki/Electronic_health_record&num;Standards. (Accessed 12/09).

[24]

Eichelberg, M., Aden, T., Riesmeier, J., Dogac, A., and Laleci, G. B. 2005. A survey and analysis of electronic healthcare record standards. ACM Comput. Surv. 37, 4, 277--315.

Digital Library

[25]

EUROREC. 2010. European Record Institute. http://www.eurorec.org/.

[26]

GEHR. Good electronic health record project. http://www.gehr.org/.

[27]

Gendron, M. S. and D'Onofrio, M. J. 2001. Data quality in the healthcare industry. Data Quality J. 7, 1.

[28]

Gök, M. 2008. Introducing an openEHR-based electronic health record system in a hospital. Masters thesis, University of Goettingen.

[29]

HL7. Health level 7. www.hl7.org. (Accessed 11/10).

[30]

HL7. CDA. Clinical document architecture. Release 2 http://www.hl7.org/v3ballot/html/infrastructure/cda/cda.htm.

[31]

Hristidis, V. 2009. Data quality and integration issues in EHRs. In Information Discovery on Electronic Health Records, Chapman & Hall, Ch. 4.

[32]

IHTSDO 2009. IHTSDO and openEHR collaboration. http://www.openehr.org/292-OE.html&quest;branch=1&language=1.

[33]

ISO 13606-1. 2008. Health informatics: Electronic health record communication. Part 1: RM (1st Ed.).

[34]

ISO 13606-2. 2008. Health informatics: Electronic health record communication. Part 2: Archetype interchange specification (1st Ed.).

[35]

ISO/TC 215 Technical Report. 2003. Electronic health record definition, scope, and context. (2nd. draft, Aug.).

[36]

Jayapandian, M. and Jagadish, H. V. 2009. Automating the design and construction of query forms. IEEE Trans. Knowl. Data Eng. 21, 10, 1389--1402.

Digital Library

[37]

Kalra, D., Taipuria, A., Freriks, G., Mennerat, F. and Devlies J. 2008. Management and maintenance policies for EHR interoperability resources. Q-REC Project IST 027370 3.3. The European Commission, Brussels.

[38]

Kennelly, R.J. 1998. IEEE 1073, Standard for medical device communications. In Proceedings of the IEEE Systems Readiness Technology Conference (AUTOTESTCON ‘98). IEEE, Los Alamitos, CA, 335--336.

[39]

Kerr, K.A., Norris, T., and Stockdale, R. 2008. The strategic management of data quality in healthcare. Health Inform. J. 14, 259.

[40]

Lee, Y., Strong, D., Kahn, B., and Wang, R. 2002. AIMQ: A methodology for information quality assessment. Inform. Manage. 40, 2, 133--146.

Digital Library

[41]

Leslie, H. and Heard S. 2006. Archetypes 101. In Proceedings of the HIC and HINZ. Health Informatics Society of Australia, 18--23.

[42]

Lewis, G. A., Morris, E., Simanta, S., and Wrage, L. 2008. Why standards are not enough to guarantee end-to-end interoperability. In Proceedings of the IEEE 7th International Conference on Composition-based Software Systems. IEEE, Los Alamitos, CA.

Digital Library

[43]

Madnick, S. E., Wang, R. Y., Lee, Y. W., and Zhu, H. 2009. Overview and framework for data and information quality research. ACM J. Data Inf. Quality 1, 1, Article 2.

Digital Library

[44]

Maldonadoa, J. A., Monera, D., Tomása, D., Ánguloa, C., Roblesa, M., and Fernándezb, J. T. 2007. Framework for clinical data standardization based on archetypes. In MEDINFO.

[45]

Microsoft Connected Health Framework. http://www.microsoft.com/industry/healthcare/technology/HealthFrameok.mspx. (Accessed 11/09).

[46]

Miettinen, M. and Korhonen, M. 2008. Information quality in healthcare: Coherence of data compared between organization’s electronic patient records. In Proceedings of the 21st IEEE International Symposium on Computer-Based Medical Systems. IEEE, Los Alamitos, CA.

Digital Library

[47]

Mikkelsen, G. and Aasly, J. 2005. Consequences of impaired data quality on information retrieval in electronic patient records. Int. J. Med. Inf. 74, 5, 387--394.

[48]

MOSS8. 2009. Eight Medical Open Source Software Seminar. http://www.openehr.org/293-OE.html&quest;branch=1&language=1.

[49]

NEHTA. 2006. Review of shared electronic health records standards. National E-Health Transition Authority.

[50]

NHIN. 2005. NHIN: Interoperability for the National Health Information Network. IEEE, E-books.

[51]

Ocean Informatics. 2010. http://www.oceaninformatics.com/. (Accessed 1/10).

[52]

OpenEHR Community. http://www.openehr.org/. (Accessed 5/09).

[53]

Orfanidis, L., Bamidis, P.D., and Eaglestone, B. 2004. Data quality issues in electronic health records: An adaptation framework for the Greek health system. Health Inform. J. 10, 1, 23.

[54]

Øvretveit, J. 2003. What are the best strategies for ensuring quality in hospitals&quest; In WHO Regional Office for Europe's Health Evidence Network (HEN).

[55]

Øvretveit, J., Scott, T., Rundall, G. T., Shortell, S. M., and Brommels, M. 2007. Improving quality through effective implementation of information technology in healthcare. Int. J. Quality Health Care 19, 5, 259--266.

[56]

Patrick, J., Ly, R., and Truran, D. 2006. Evaluation of a persistent store for openEHR. In Proceedings of the HIC and HINZ. Health Informatics Society of Australia, 83--89.

[57]

Pishev, O. 2006. The openEHR advantage. White paper. http://www.oceaninformatics.com/ocean-informatics-resources/ocean-documentation/Published-Articles/The-iopeniEHR-advantage2.html.

[58]

Poissant, L., Pereira, J., Tamblyn, R., and Kawasumi, Y. 2005. The impact of electronic health records on time efficiency of physicians and nurses: A systematic review. J. Amer. Med. Inform. Assoc. 12, 505--516.

[59]

Rahman, S. A., Bhalla, S., and Hashimoto, T. 2006. Query-by-object Interface for information requirement elicitation in M-commerce. Int. J. Hum. Comput. Interact.

[60]

Sachdeva, S. and Bhalla, S. 2010. Semantic Interoperability in healthcare information for EHR databases. In Proceedings of the 6th International Workshop, Databases in Networked Information Systems (DNIS). 157--173.

Digital Library

[61]

Sachdeva, S. and Bhalla, S. 2009. Implementing high-level query language interfaces for archetype-based electronic health records database. In Proceedings of the International Conference on Management of Data (COMAD). 235--238.

[62]

Silberschatz, A., Korth, H. F., and Sudarshan, S. 2010. Database Systems Concepts 6th Ed., McGraw Hill, New York.

[63]

Simonov, M., Sammartino, L., Ancona, M., Pini, S., Cazzola, W., and Frascio, M. 2005. Information, knowledge and interoperability for healthcare domain. In Proceedings of the 1st International Conference on Automated Production of Cross Media Content for Multi-Channel Distribution (AXMEDIS'05). IEEE, Los Alamitos, CA.

Digital Library

[64]

SNOMED. Clinical terms. Systematized nomenclature of medicine. http://www.snomed.org/documents/snomed_overview.pdf.

[65]

Sokolowski, R. 1999. Expressing health care objects in XML. In Proceedings of the 8th Workshop on Enabling Technologies on Infrastructure for Collaborative Enterprises.

Digital Library

[66]

Sun, J. 2003. Information requirement elicitation in M-Commerce: An interactive approach to facilitate information search for mobile users. Comm. ACM 46, 12, 45--47.

Digital Library

[67]

Tayi, G. K. and Ballou, D. P. 1998. Examining data quality. Comm. ACM 41, 2, 54--57.

Digital Library

[68]

The openEHR .Net knowledge tools project. http://www.openehr.org/projects/dotnet.html.

[69]

The openEHR Java reference implementation project. http://www.openehr.org/projects/java.html.

[70]

Thurston, L. M. 2006. Flexible and extensible display of archetyped data: The openEHR presentation challenge. In Proceedings of HIC and HINZ. Health Informatics Society of Australia, 28--36.

[71]

Walker, J., Pan, E., Johnston, D., Adler-Milstein, J., Bates, D.W., and Middleton, B. 2005. The value of health care information exchange and interoperability health affairs.

[72]

http://content.healthaffairs.org/cgi/content/abstract/hlthaff.w5.10.

[73]

Wang, S. J., Middleton, B., Prosser. L. A., Bardon, C. G., Spurr, C. D., Carchidi, P. J., Kittler, A. F., Goldszer, R. C., Fairchild, D. G., Sussman, A. J., Kuperman, G. J., and Bates, D. W. 2003. A cost-benefit analysis of electronic medical records in primary care. Amer. J. Med. 114. 5, 397--403.

[74]

Wang, R. Y. 1998. A product perspective on total data quality management. Comm. ACM 41, 2, 58--65.

Digital Library

[75]

Wang, R. Y. and Strong, D. M. 1996. Beyond accuracy: What data quality means to data consumers. J. Manage. Inf. Syst. 12, 4, 5--33.

Digital Library

[76]

Wang, R. Y., Zaid, M., and Lee, Y. W. 2001. Data Quality, Kluwer, Amsterdam.

[77]

Zloof, M. M. 1975. Query-by-example. In Proceedings of AFIPS'75.

Digital Library

Cited By

Hajebrahimi MLangarizadeh MNikseresht A(2024)Development of a minimum data set for a blockchain-based personal health records (PHRs), for patient/physician interaction in family medicineJournal of Education and Health Promotion10.4103/jehp.jehp_1180_2313:1Online publication date: Oct-2024
https://doi.org/10.4103/jehp.jehp_1180_23
Mahdi MWalshe RFarrell SPandit H(2024)Comprehensive Review and Future Research Directions on ICT StandardisationInformation10.3390/info1511069115:11(691)Online publication date: 2-Nov-2024
https://doi.org/10.3390/info15110691
Sachdeva SVasava J(2024)Plugging and Playing with Variety of Data using Multi-Model Database and Polyglot Persistence2024 Third International Conference on Electrical, Electronics, Information and Communication Technologies (ICEEICT)10.1109/ICEEICT61591.2024.10718481(1-8)Online publication date: 24-Jul-2024
https://doi.org/10.1109/ICEEICT61591.2024.10718481
Show More Cited By

Recommendations

A survey and analysis of Electronic Healthcare Record standards

Medical information systems today store clinical information about patients in all kinds of proprietary formats. To address the resulting interoperability problems, several Electronic Healthcare Record standards that structure the clinical content for ...
Semantic interoperability
Interoperability

Comments

Information & Contributors

Information

Published In

cover image Journal of Data and Information Quality

Journal of Data and Information Quality Volume 3, Issue 1

April 2012

54 pages

ISSN:1936-1955

EISSN:1936-1963

DOI:10.1145/2166788

Issue’s Table of Contents

Copyright © 2012 ACM.

Permission to make digital or hard copies of all or part of this work for personal or classroom use is granted without fee provided that copies are not made or distributed for profit or commercial advantage and that copies bear this notice and the full citation on the first page. Copyrights for components of this work owned by others than ACM must be honored. Abstracting with credit is permitted. To copy otherwise, or republish, to post on servers or to redistribute to lists, requires prior specific permission and/or a fee. Request permissions from [email protected]

Publisher

Association for Computing Machinery

New York, NY, United States

Publication History

Published: 07 May 2012

Accepted: 01 January 2012

Revised: 01 December 2010

Received: 01 January 2010

Published in JDIQ Volume 3, Issue 1

Permissions

Request permissions for this article.

Request Permissions

Check for updates

Author Tags

Qualifiers

Research-article
Research
Refereed

Contributors

Other Metrics

View Article Metrics

Bibliometrics & Citations

Bibliometrics

Article Metrics

53
Total Citations
View Citations
2,711
Total Downloads

Downloads (Last 12 months)85
Downloads (Last 6 weeks)7

Reflects downloads up to 08 Mar 2025

Other Metrics

View Author Metrics

Citations

Cited By

Hajebrahimi MLangarizadeh MNikseresht A(2024)Development of a minimum data set for a blockchain-based personal health records (PHRs), for patient/physician interaction in family medicineJournal of Education and Health Promotion10.4103/jehp.jehp_1180_2313:1Online publication date: Oct-2024
https://doi.org/10.4103/jehp.jehp_1180_23
Mahdi MWalshe RFarrell SPandit H(2024)Comprehensive Review and Future Research Directions on ICT StandardisationInformation10.3390/info1511069115:11(691)Online publication date: 2-Nov-2024
https://doi.org/10.3390/info15110691
Sachdeva SVasava J(2024)Plugging and Playing with Variety of Data using Multi-Model Database and Polyglot Persistence2024 Third International Conference on Electrical, Electronics, Information and Communication Technologies (ICEEICT)10.1109/ICEEICT61591.2024.10718481(1-8)Online publication date: 24-Jul-2024
https://doi.org/10.1109/ICEEICT61591.2024.10718481
Torab-Miandoab ASamad-Soltani TJodati AAkbarzadeh FRezaei-Hachesu P(2024)A unified component-based data-driven framework to support interoperability in the healthcare systemsHeliyon10.1016/j.heliyon.2024.e3503610:15(e35036)Online publication date: Aug-2024
https://doi.org/10.1016/j.heliyon.2024.e35036
Pawar VSachdeva S(2024) PEBS : An efficient patient‐enabled blockchain system Concurrency and Computation: Practice and Experience10.1002/cpe.8287Online publication date: 16-Sep-2024
https://doi.org/10.1002/cpe.8287
Sachdeva S(2023)Standard-based personalized healthcare delivery for kidney illness using deep learningPhysiological Measurement10.1088/1361-6579/ace09f44:8(084001)Online publication date: 10-Aug-2023
https://doi.org/10.1088/1361-6579/ace09f
Kawu AHederman LDoyle JO'Sullivan D(2023)Patient generated health data and electronic health record integration, governance and socio-technical issues: A narrative reviewInformatics in Medicine Unlocked10.1016/j.imu.2022.10115337(101153)Online publication date: 2023
https://doi.org/10.1016/j.imu.2022.101153
Klappe EJoukes ECornet Rde Keizer N(2023)Effective and feasible interventions to improve structured EHR data registration and exchange: A concept mapping approach and exploration of practical examples in the NetherlandsInternational Journal of Medical Informatics10.1016/j.ijmedinf.2023.105023173(105023)Online publication date: May-2023
https://doi.org/10.1016/j.ijmedinf.2023.105023
MacKay CKlement WVanberkel PLamond NUrquhart RRigby M(2023)A framework for implementing machine learning in healthcare based on the concepts of preconditions and postconditionsHealthcare Analytics10.1016/j.health.2023.1001553(100155)Online publication date: Nov-2023
https://doi.org/10.1016/j.health.2023.100155
Junaid SImam AShuaibu ABasri SKumar GSurakat YBalogun AAbdulkarim MGarba ASahalu YMohammed AMohammed YAbdulkadir BAbba AKakumi NAlazzawi A(2022)Artificial Intelligence, Sensors and Vital Health Signs: A ReviewApplied Sciences10.3390/app12221147512:22(11475)Online publication date: 11-Nov-2022
https://doi.org/10.3390/app122211475
Show More Cited By

View Options

Login options

Check if you have access through your login credentials or your institution to get full access on this article.

Full Access

Get this Article

View options

PDF

View or Download as a PDF file.

eReader

View online with eReader.

Figures

Tables

Media

View Issue’s Table of Contents