This document introduces a course on interoperability and semantic technologies. It defines interoperability and its different levels, including functional and semantic interoperability. It also discusses challenges related to standardization in healthcare like the variety of standards, the need for translation between standards, and the high costs of a lack of interoperability. Finally, it presents how semantic technologies like RDF, SPARQL and OWL can help address these challenges by providing flexible models and languages that can embrace change and translation.

1. E. Della Valle – http://emanueledellavalle.org - @manudellavalle
Interoperability and Semantic Technologies 2015-16
Introduction
Emanuele Della Valle
DEIB - Politecnico di Milano
http://emanueledellavalle.org - @manudellavalle

2. E. Della Valle – http://emanueledellavalle.org - @manudellavalle
Share, Remix, Reuse — Legally
This work is licensed under the Creative Commons Attribution
3.0 Unported License.
Your are free:
to Share — to copy, distribute and transmit the work
to Remix — to adapt the work
Under the following conditions
Attribution — You must attribute the work by inserting
“by E. Della Valle – http://emanueledellavalle.org -
@manudellavalle”
at the end of each reused slide
To view a copy of this license, visit
http://creativecommons.org/licenses/by/3.0/
2

3. E. Della Valle – http://emanueledellavalle.org - @manudellavalle
Definitions of Interoperability
• Interoperability
• the ability of information and communication technology (ICT) systems
to exchange data and to enable sharing of information and knowledge
• Functional interoperability
• Information has to be transmitted reliably between heterogeneous
applications
• Semantic interoperability
• Transmission must occur without loss of meaning, and thus without
loss of computability
• E.g., Semantic Interoperability in healthcare information systems
• It is the ability to share information without loss of computable
meaning, across multiple applications concerned with
clinical (primary use) and related administrative, financial, and
research domains (secondary uses).
3

4. E. Della Valle – http://emanueledellavalle.org - @manudellavalle
Once upon a time …
4
…, in an happy organization, users
were happy of the application the IT
department prepared for them, but …
application
[…]
… the organization was not alone.
Another organization developed a
complementary application …
complementary application
[…]
… so, one day, the two organizations
decided to integrate the two
applications.
Organizational
boundaries
application
[…]
complementary application
[…]
Organizational
boundaries
application
[…]
?
Having much to gain the happy
organization decided to invest in a
bi-lateral solution
complementary application
[…]
Organizational
boundaries
application
[…]
adapter
!

5. E. Della Valle – http://emanueledellavalle.org - @manudellavalle
… this went on for a while, but …
5
[…]
!
… the more bi-lateral integrations, the sadder the organizations
became.
[…]
[…]
[…]
[…]
[…]
[…]
!
!
!!
!!
!!
!?!
!!!
!
!!
!?!?!?
?!?
?!? ! OK
!! Good
!!! Very Good
!?! Very Good …
?!? Have I done the
right thing?
??? Does it make
sence?
?#@ Why am I
doying it!!!
Legend

6. E. Della Valle – http://emanueledellavalle.org - @manudellavalle
… So, they standardized and …
6
[…]
[…]
[…]
[…]
[…]
[…]
[…]
standard
… and they lived happily ever after!

7. E. Della Valle – http://emanueledellavalle.org - @manudellavalle
Well, not really :-( Actually …
7
[…]
[…]
[…]
[…]
[…]
[…]
[…]
??? KEEP
CALM
AND
WAIT FOR
1 YEARS10100

8. E. Della Valle – http://emanueledellavalle.org - @manudellavalle
Why? The Standardization dilemma!
Comprehensive
Handles all use cases
Good
High quality
Timely
Completed quickly
Pick two!
Pick two!
8

9. E. Della Valle – http://emanueledellavalle.org - @manudellavalle
There are a variety of them
9
Standards are like plumbs

10. E. Della Valle – http://emanueledellavalle.org - @manudellavalle
Over 100 in the Healthcare domain!
AIR ALT AOD AOT BI CCC CCPSS CCS CDT CHV COSTAR CPM CPT
CPTSP CSP CST DDB DMDICD10 DMDUMD DSM3R DSM4 DXP FMA
HCDT HCPCS HCPT HL7V2.5 HL7V3.0 HLREL ICD10 ICD10AE ICD10AM
ICD10AMAE ICD10CM ICD10DUT ICD10PCS ICD9CM ICF ICF-CY ICPC
ICPC2EDUT ICPC2EENG ICPC2ICD10DUT ICPC2ICD10ENG ICPC2P
ICPCBAQ ICPCDAN ICPCDUT ICPCFIN ICPCFRE ICPCGER ICPCHEB
ICPCHUN ICPCITA ICPCNOR ICPCPOR ICPCSPA ICPCSWE JABL KCD5
LCH LNC_AD8 LNC_MDS30 MCM MEDLINEPLUS MSHCZE MSHDUT
MSHFIN MSHFRE MSHGER MSHITA MSHJPN MSHLAV MSHNOR
MSHPOL MSHPOR MSHRUS MSHSCR MSHSPA MSHSWE MTH MTHCH
MTHHH MTHICD9 MTHICPC2EAE MTHICPC2ICD10AE MTHMST
MTHMSTFRE MTHMSTITA NAN NCISEER NIC NOC OMS PCDS PDQ
PNDS PPAC PSY QMR RAM RCD RCDAE RCDSA RCDSY SNM SNMI
SOP SPN SRC TKMT ULT UMD USPMG UWDA WHO WHOFRE WHOGER
WHOPOR WHOSPA
10
[source: dbooth.org/2014/yosemite/yosemite-project-slides.pdf]

11. E. Della Valle – http://emanueledellavalle.org - @manudellavalle
And they keep changing :-(
11
[Credits: Rafael Richards]

12. E. Della Valle – http://emanueledellavalle.org - @manudellavalle
Why?
12
[source http://xkcd.com/927/ ]

13. E. Della Valle – http://emanueledellavalle.org - @manudellavalle
… sometime the variety is required
13
standards are like plumbs

14. E. Della Valle – http://emanueledellavalle.org - @manudellavalle
Why variety is required
14
[Source: http://www.slideshare.net/HINZ/hl7-whats-hot-and-whats-not ]

15. E. Della Valle – http://emanueledellavalle.org - @manudellavalle
One standard does not fit all
Different use cases need need different data, granularity and representations
15
[source: dbooth.org/2014/yosemite/yosemite-project-slides.pdf]

16. E. Della Valle – http://emanueledellavalle.org - @manudellavalle
… thus translation is needed
16
standards are like plumbs

17. E. Della Valle – http://emanueledellavalle.org - @manudellavalle
And counting on translation between standards is even convenient while
working on increasing the comprehensiveness of a standard over time
17
Translation is unavoidable!
Comprehensive
0%
100%
Time
Translation
Standard

18. E. Della Valle – http://emanueledellavalle.org - @manudellavalle
But be aware of the cost of ad hoc translation!
18
standards are like plumbs

19. E. Della Valle – http://emanueledellavalle.org - @manudellavalle
…in healthcare costs $30000 Million per year in USA
[source: http://www.calgaryscientific.com/blog/bid/284224/Interoperability-Could-
Reduce-U-S-Healthcare-Costs-by-Thirty-Billion]
19
The luck of interoperability …

20. E. Della Valle – http://emanueledellavalle.org - @manudellavalle
So What?!?
“It is not necessarily
the strongest of the
species that survives
nor the most intelligent,
but the one that is
most responsive to change.”
--- Charles Darwin
“The Origin of Species”
20

21. E. Della Valle – http://emanueledellavalle.org - @manudellavalle
Embrace change!
21

22. E. Della Valle – http://emanueledellavalle.org - @manudellavalle
Semantic Technologies embrace change
22
subject objectobject
property
Proposing a simple data model: RDF
E.g.,
Flexible enough to represent:
Tables
Amoxi-
cillin
bacterial
disease
bacterial
disease
treats
Trees Graphs

23. E. Della Valle – http://emanueledellavalle.org - @manudellavalle
Providing a powerful query language: SPARQL
E.g., what does Amoxicillin treat?
?x={Bacterial disease, Urinary tract infection, Sinus infection, …}
Flexible enough to query RDF data even without knowing the schema
E.g., can you describe Amoxicillin ?
?p={treats} ?x={Bacterial disease, Urinary tract infection, Sinus infection, …}
?p={hasSideEffects} ?x={Diarrhoea}
?p={belongsTo} ?x={β-Lactam antibiotic, Penicillin-class Antibacterial}
…
Semantic Technologies embrace change
23
Amoxi-
cillin
?x?x
treats
Amoxi-
cillin
?x?x
?p

24. E. Della Valle – http://emanueledellavalle.org - @manudellavalle
Providing a formal language for conceptual modelling: OWL
E.g., Heart
Heart is a muscular
organ that is part of
the circulatory system
∀x.[ Heart(x)→
MuscolarOrgan(x)∧
∃y.[isPartOf(x,y )∧
CirculatorySystem(y)]]
OWL is a modular standard that offers different trade-offs
OWL-QL OWL-RL OWL-EL
Semantic Technologies embrace change
24
TermsData
Terms
Data Terms
Data

25. E. Della Valle – http://emanueledellavalle.org - @manudellavalle
Semantic Technologies embrace change
25
Standard in OWL
[…]
Ontology Based Data Access as a prototypical solution to interoperability
problems
<XML><XML>
Translator Translator Translator

26. E. Della Valle – http://emanueledellavalle.org - @manudellavalle
Semantic Technologies embrace change
26
Standard in OWL
[…]
SPARQL Queries
Ontology Based Data Access as a prototypical solution to interoperability
problems
RDBMS <XML><XML>
Translator Translator Translator

27. E. Della Valle – http://emanueledellavalle.org - @manudellavalle
Semantic Technologies embrace change
27
Standard in OWL
Results
{ , , }
Ontology Based Data Access as a prototypical solution to interoperability
problems
[…]
RDBMS <XML><XML>
Translator Translator Translator

28. E. Della Valle – http://emanueledellavalle.org - @manudellavalle
Those ideas at work at scale
28
Google for "amoxicillin"
Model: Google knowledge graph
A variety of sources:
•http://www.fda.gov/Drugs/
•http://www.nlm.nih.gov/research/umls/
•http://dailymed.nlm.nih.gov/dailymed/
•http://micromedex.com/

29. E. Della Valle – http://emanueledellavalle.org - @manudellavalle
Interoperability and Semantic Technologies 2015-16
Introduction
Emanuele Della Valle
DEIB - Politecnico di Milano
http://emanueledellavalle.org - @manudellavalle