Use of the Data Model
for Communication among Components of a
Distributed Decision-support System
Arturo González-Ferrer, ...
Partner’s logo2
• UNIVERSITY OF HAIFA (HU), Israel
• BEN-GURION UNIVERSITY OF THE NEGEV (BGU), Israel
• UNIVERSITA DEGLI S...
THE MOBIGUIDE SYSTEM
International IEEE Conference on Biomedical and Healthcare Informatics
(BHI), Valencia, Spain - June ...
• Our presentation focuses on showing how to make the
most of the HL7 vMR standard to develop
• A SOA Ubiquitous Guidance ...
HL7 VIRTUAL MEDICAL RECORD
International IEEE Conference on Biomedical and Healthcare Informatics
(BHI), Valencia, Spain -...
A REAL SCENARIO FROM GDM PRACTICE GUIDELINE
International IEEE Conference on Biomedical and Healthcare Informatics
(BHI), ...
A REAL SCENARIO FROM GDM PRACTICE GUIDELINE
International IEEE Conference on Biomedical and Healthcare Informatics
(BHI), ...
A REAL SCENARIO FROM GDM PRACTICE GUIDELINE
International IEEE Conference on Biomedical and Healthcare Informatics
(BHI), ...
A REAL SCENARIO FROM GDM PRACTICE GUIDELINE
International IEEE Conference on Biomedical and Healthcare Informatics
(BHI), ...
A REAL SCENARIO FROM GDM PRACTICE GUIDELINE
International IEEE Conference on Biomedical and Healthcare Informatics
(BHI), ...
A REAL SCENARIO FROM GDM PRACTICE GUIDELINE
International IEEE Conference on Biomedical and Healthcare Informatics
(BHI), ...
A REAL SCENARIO FROM GDM PRACTICE GUIDELINE
International IEEE Conference on Biomedical and Healthcare Informatics
(BHI), ...
• The “workflow management” raises new interoperability
issues for distributed CDSS while keeping the usual need to
link a...
VMR USE AND EXTENSION
International IEEE Conference on Biomedical and Healthcare Informatics
(BHI), Valencia, Spain - June...
International IEEE Conference on Biomedical and Healthcare Informatics
(BHI), Valencia, Spain - June 2 2014 15
CONCLUSIONS...
International IEEE Conference on Biomedical and Healthcare Informatics
(BHI), Valencia, Spain - June 2 2014 16
Questions?
...
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Use of the Virtual Medical Record Data Model for Communication among Components of a Distributed Decision-support System

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Presentation in the 2nd IEEE Biomedical and Healthcare Informatics Conference, Valencia, June 1st-

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Use of the Virtual Medical Record Data Model for Communication among Components of a Distributed Decision-support System

  1. 1. Use of the Data Model for Communication among Components of a Distributed Decision-support System Arturo González-Ferrer, Mor Peleg, Enea Parimbelli, Erez Shalom, Carlos Marcos, Guy Klebanov, Iñaki Martínez-Sarriegui, Nick Lik San Fung, Tom Broens Special Session on EHR interoperability International Conference on Biomedical and Healthcare Informatics (BHI) International IEEE Conference on Biomedical and Healthcare Informatics (BHI), Valencia, Spain - June 2 2014
  2. 2. Partner’s logo2 • UNIVERSITY OF HAIFA (HU), Israel • BEN-GURION UNIVERSITY OF THE NEGEV (BGU), Israel • UNIVERSITA DEGLI STUDI DI PAVIA (UNIPV), Italy • UNIVERSITEIT TWENTE (UT), Netherlands • TECHNISCHE UNIVERSITAET WIEN (TUV), Austria • MOBIHEALTH BV (MHBV), Netherlands • FONDAZIONE SALVATORE MAUGERI CLINICA DEL LAVORO E DELLA RIABILITAZIONE (FSM), Italy • UNIVERSIDAD POLITECNICA DE MADRID (UPM), Spain • CORPORACIO SANITARIA PARC TAULI DE SABADELL (CSPT), Spain • ATOS SPAIN SA (ATOS), Spain • BEACON TECH LTD (BTL), Israel • ZorgGemak BV (ZORG), Netherlands • ASSOCIACIO DE DIABETICS DE CATALUNYA (ADC), Spain www.mobiguide-project.eu 6 universities, 4 companies, 2 hospitals, 1 patients association clinical domains: GDM (Spanish hospital) and AF (Italian hospital) MOBIGUIDE (2011-2015)
  3. 3. THE MOBIGUIDE SYSTEM International IEEE Conference on Biomedical and Healthcare Informatics (BHI), Valencia, Spain - June 2 2014 3 DSS PHR Computer-interpretable guideline (CIG) BAN EMR1 EMR2 Personalized
  4. 4. • Our presentation focuses on showing how to make the most of the HL7 vMR standard to develop • A SOA Ubiquitous Guidance System • Target users: physicians and patients • Many devices/systems: Smartphone linked to BAN devices, DSS, PHR, EMRs, Caregiver UI, etc. • The standard is used to store patient data and for coordination between system components • Manage the complex workflow needed to support guidance of patients, Anytime and Everywhere INTRODUCTION International IEEE Conference on Biomedical and Healthcare Informatics (BHI), Valencia, Spain - June 2 2014 4
  5. 5. HL7 VIRTUAL MEDICAL RECORD International IEEE Conference on Biomedical and Healthcare Informatics (BHI), Valencia, Spain - June 2 2014 5 • Two axes: clinical + workflow-related
  6. 6. A REAL SCENARIO FROM GDM PRACTICE GUIDELINE International IEEE Conference on Biomedical and Healthcare Informatics (BHI), Valencia, Spain - June 2 2014 6 Register diet compliance pattern detection (≥2 non-compliance events in 7 days) DSS recommends the physician sending feedback to patient
  7. 7. A REAL SCENARIO FROM GDM PRACTICE GUIDELINE International IEEE Conference on Biomedical and Healthcare Informatics (BHI), Valencia, Spain - June 2 2014 7 specification of the non-compliance event that needs to be detected for the pattern to be calculated observationResult instance observationFocus= increased carbs SNOMED 123995008 observationValue: +/++
  8. 8. A REAL SCENARIO FROM GDM PRACTICE GUIDELINE International IEEE Conference on Biomedical and Healthcare Informatics (BHI), Valencia, Spain - June 2 2014 8 The extended DSS automatically generates the query and when any component stores a matching data item in the PHR a notification event is sent back to the extended DSS. observationResult instance observationFocus= increased carbs SNOMED 123995008 observationValue: +/++
  9. 9. A REAL SCENARIO FROM GDM PRACTICE GUIDELINE International IEEE Conference on Biomedical and Healthcare Informatics (BHI), Valencia, Spain - June 2 2014 9 the extended DSS generates a recommendation to the caregiver asking if he wants to send a message to the patient about the importance of diet compliance ProcedureProposal instance procedureCode: Notification (UMLS C0422202) target: Physician (UMLS:C0031831) DSS_ID (extension): 111
  10. 10. A REAL SCENARIO FROM GDM PRACTICE GUIDELINE International IEEE Conference on Biomedical and Healthcare Informatics (BHI), Valencia, Spain - June 2 2014 10 this new recommendation is then retrieved from the PHR by the caregiver GUI ProcedureProposal instance procedureCode: Notification (UMLS C0422202) target: Physician (UMLS:C0031831) DSS_ID (extension): 111
  11. 11. A REAL SCENARIO FROM GDM PRACTICE GUIDELINE International IEEE Conference on Biomedical and Healthcare Informatics (BHI), Valencia, Spain - June 2 2014 11 The physician accepts the recommendation and saves an order into the PHR. Note that DSS_ID is the same ProcedureOrder Instance procedureCode: Notification (UMLSC0422202) target: Patient (UMLSC0030705) originalText: “…” DSS_ID (extension): 111
  12. 12. A REAL SCENARIO FROM GDM PRACTICE GUIDELINE International IEEE Conference on Biomedical and Healthcare Informatics (BHI), Valencia, Spain - June 2 2014 12 The message with the recommendation is sent to the patient who receives it in the smartphone ProcedureEvent Instance procedureCode: Notification (UMLSC0422202) target: Patient (UMLSC0030705) originalText: “…” DSS_ID (extension): 112
  13. 13. • The “workflow management” raises new interoperability issues for distributed CDSS while keeping the usual need to link a back-end DSS with a PHR using standards. • The pattern Proposal-Order-Event can be applied to substance administrations, encounters, observations, etc. • Pattern Proposal-Result can be issued when no confirmation is required by physicians • Including propietary extensions (e.g. GL-ID, DSS-ID) • allows to follow workflow and • identify responses to concrete recommendations easily MANAGING CDSS WORKFLOW WITH VMR International IEEE Conference on Biomedical and Healthcare Informatics (BHI), Valencia, Spain - June 2 2014 13
  14. 14. VMR USE AND EXTENSION International IEEE Conference on Biomedical and Healthcare Informatics (BHI), Valencia, Spain - June 2 2014 14
  15. 15. International IEEE Conference on Biomedical and Healthcare Informatics (BHI), Valencia, Spain - June 2 2014 15 CONCLUSIONS • We used HL7 vMR to cope with the workflow needs of distributed CDSS with multiple systems and user roles • HL7 vMR needs to be extended in several cases, but it provides standard mechanisms to include these extensions • The technical solution showed relates to a concrete DSS (Picard) and a particular guideline, but it could be easily adapted to other architectures and clinical domains • It is being validated with a pilot implementation of two guidelines within the project (to start in February 2015)
  16. 16. International IEEE Conference on Biomedical and Healthcare Informatics (BHI), Valencia, Spain - June 2 2014 16 Questions? Arturo González-Ferrer arturogf@gmail.com

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