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![Terminology Binding Syntax
oUniform Resource Identifier (URI) standard:
•Simple and extensible means for identifying a resource (ftp:, mailto:, news:, etc.), in this case terminology artefacts
•Logical identifier of a resource, without specifying the physical location and the access mechanism
•Both human and machine readable, with the syntax: <scheme name>:<hierarchical part>[?<query>][#<fragment>]
•Obtaining a representation of the resource is done by Resolvers
oScheme for terminology binding: terminology:<code system id>[:version]?<query type>= <query expression>[&<extension key>=extensionvalue]*
oSNOMED CT query types:
•concept, conceptlist, refset, refsetlist, escg, ocl](https://image.slidesharecdn.com/ihtsdoshowcase2012logicalmodeldesigner-141205070934-conversion-gate01/85/The-Logical-Model-Designer-Binding-Information-Models-to-Terminology-19-320.jpg)
![Terminology Binding Examples
Examples:
SNOMED CT
oterminology:2.16.840.1.113883.6.96:20110123?concept=284296006
oterminology:2.16.840.1.113883.6.96:20110123?refset=284296007&scope=A01324
oterminology:2.16.840.1.113883.6.96:20110123?escg=<<284296006
ATC
oTerminology:2.16.840.1.113883.6.3:20110123?code=A01
Singapore Data Dictionary
oterminology:data_dictionary_id?value_domain_id#code
terminology:<code system id>[:version]?<query type>= <query expression>[&<extension key>=extensionvalue]*](https://image.slidesharecdn.com/ihtsdoshowcase2012logicalmodeldesigner-141205070934-conversion-gate01/85/The-Logical-Model-Designer-Binding-Information-Models-to-Terminology-20-320.jpg)
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The Logical Model Designer - Binding Information Models to Terminology
The presentation discusses the Logical Model Designer (LMD) which aims to enhance healthcare information management by binding information models to standardized terminology. It covers the development of a logical information model, tools for terminology binding, and the integration of healthcare systems through a national electronic health record. The document outlines the architecture, timeline, and various applications of the LMD to improve patient-centered care in Singapore's healthcare landscape.
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The Logical Model Designer - Binding Information Models to Terminology
- 1. The Logical ModelDesigner (LMD) – Binding Information Models to Terminology Linda Bird, Hendry Wijaya, Teck Wei Chin - MOH Holdings Balazs Banfai – B2i 25th October 2012 (10:45 – 11:30)
- 2. Agenda •Background •LogicalInformation Model •LMD Tooling •Terminology Binding •Demonstration •Platform Software Architecture •Project Timeline
- 3. Healthcare landscape ofthe future Strategic vision of patients moving seamlessly across the healthcare system, receiving coordinated patient-centric care at the most appropriate settings. RH CH Polyclinics NH FPs Home Care Rehab & support services Screening & Prevention Palliative Care RH CH Polyclinics NH FPs Home Care Rehab & support services Screening & Prevention Palliative Care RH CH Polyclinics NH FPs Home Care Rehab & support services Screening & Prevention Palliative Care RH CH Polyclinics NH FPs Home Care Rehab & support services Screening & Prevention Palliative Care RH CH Polyclinics NH FPs Home Care Rehab & support services Screening & Prevention Palliative Care RH CH Polyclinics NH FPs Home Care Rehab & support services Screening & Prevention Palliative Care Enabled by the National Electronic Health Record (EHR)
- 4. Sharing Information AcrossSingapore Event Summary, Referral & Screening Documents EHR Summary Record Name NRIC No. Primary Care Provider Care Coordinator Allergies Diagnoses Current Medications Procedures Recent Events Recent Referrals Care Plan Date of Birth Gender Detailed Reports / Images Shared Services / Functionality Business Intelligence Data Warehouse National Scorecard Link Share Data DA / ADR Module Immunisation Medications Reconciliation Problem List Reconciliation Laboratory Reports Procedure Reports Radiology Reports / Images Drill Down Drill Down SOC to AIC Referral Community Hosp Disch. Summ. Referral to SOC SOC Event Summary Inpatient Disch. Summ. GP Event Summary ED Event Summary Investigations Immunisations Applications that are not a part of the EHR solution, but will be integrated with the EHR Care Co-ordinator Emergency Department General Practitioner Emergency Department Acute-Care Hospital General Practioner Community Hospital
- 5. Use Case forStandards oMessaging – safe exchange of transactional data oDocument Exchange – safe exchange of documents oPersistence – storing data in clinical systems oInteroperability – ability to interpret semantics of data received from other clinical systems and store in native data stores oQuerying & Analytics – over multiple heterogeneous sources oDecision Support – ability to define and apply decision support rules over shared data
- 6. MOHHoldings Standards Products •Diagnosis - SNOMED CT* •Drugs - Singapore Drug Dictionary (SDD) •Allergic Reactions - SNOMED CT* •Allergens - SNOMED CT* + SDD •Laboratory Results - LOINC (TBD) •Data Dictionary - MOHH Data Dictionary •Procedures - TBD •Reason for visit - SNOMED CT* •Symptoms and Problems - SNOMED CT* •Laboratory Reports - Smart SNOMED CT* •Laboratory Orders - SNOMED CT* •Radiology Orders - SNOMED CT* SNOMED CT* includes Singapore Extension
- 7. 1.A common, implementation-independentmodel of all shared healthcare information in Singapore. 2.A ‘single source of truth’ that articulates our clinician and business information requirements 3.Implementation artefacts are generated from common semantics Logical Information Model
- 8.
- 9.
- 10. Archetypes oReusable clinicalmodels oDefined as a set of constraints on the reference model oFor example: –Observation, Diagnosis, Alert, Adverse Reaction, Investigation Result oCan be further constrained – e.g. Heart rate, Microbiology Result Templates oGroup together a set of archetypes for a specific use case oApply additional use-case specific constraints oCan be used to standardise the elements, constraints and terminology for a given message type, user interface etc oFor example: –Discharge summary, Investigation Report, Prescription Archetypes and Templates 10
- 11.
- 12. Terminology Challenges Example:“Suspected Lung Cancer” We need a consistent semantic representation.
- 13. IsoSemantic Models (exampleinstances) e.g. “Suspected Lung Cancer”
- 14. Problem Diagnosis =$ProblemDiagnosisName: 246090004 |associated finding| = (404684003|Clinical Finding|: 363698007 |finding site | = ($BodySite: 272741003 |laterality| = $Laterality), 246112005 |severity| = $Severity), 408729009 |finding context | = $FindingContext GP Problem Diagnosis = 86049000|Cancer| : 246090004 |associated finding| = (404684003|Clinical Finding| 363698007 |finding site | = 39607008|Lung|), 408729009 |finding context | = 415684004|Suspected| Polyclinic Problem Diagnosis = 162572001 |Suspected cancer|: 246090004|associated finding| = (404684003|Clinical Finding|: 363698007 |finding site | = 39607008|Lung|) RH Problem Diagnosis = 162573006 |Suspected lung cancer| IsoSemantic Models (constructor binding)
- 15. oCommon model –sharedhealthcare information in Singapore oCommon queries –Provides a common vocabulary for querying multiple data sources oCommon meaning –Each clinical meaning is represented just once and reused many times oConsistent terminology –National reference terminology bound to a clinical meaning oImplementation independent –Information model independent of exchange format and proprietary information models oMachine processable model –Allows information to be defined once, and used many times (consistently) oConformance Testing –Enables the automation of Conformance Testing to ensure quality of data Benefits of the LIM 15
- 16. Logical Model Designer Clinician Verification Logical Reference Model (LRM) ISO-13606 + ISO-21090 T e r m i n o l o g y S e r v e r Clinical Archetypes Logical-Object Model (LOM) Constrained Clinical Archetypes Logical-Object Model (LOM) Template Definition Logical-Object Model (LOM) Compiled Template Hierarchy Logical-Object Model (LOM) Implementation Artefact Logical-XML, HL7 v2, Java Documentation Artefact Word, Excel, HTML Snow Logical Model Designer (LMD) Owl Value sets Examples Constraints Meaning
- 17. Logical Model Designer Clinician Verification Logical Reference Model (LRM) Composition, Entry, Cluster, Element T e r m i n o l o g y S e r v e r Clinical Archetypes Observation Constrained Clinical Archetypes Heart Rate Template Definition Discharge Summary Compiled Template Hierarchy Discharge Summary Hierarchy Implementation Artefact Discharge Summary LXML + Java CC Testing Documentation Artefact Discharge Summary Hierarchy (Excel, HTML) Snow Logical Model Designer (LMD) Owl Value sets Examples Constraints Meaning
- 18. oValue set binding •National: For national queries over heterogeneous data •Local: For generating conformance/compliance software for messages populated using local value sets (mapped to national) oConstraint binding •Assumed, fixed and default values •OCL and ESCG constraints oSemantic binding •Enables querying data using more general or specific meanings •Enables searching models, and identifying semantic overlap oRelationship bindings •Defines meaning of relationship between parent to child node •Used to construct design pattern bindings (aka constructor bindings) oDesign pattern bindings (aka ‘constructor bindings’) •Extended compositional grammar expression with path-based slots •Used to normalise data that may either be precoordinated or postcoordinated in the structure, into a canonical form Types of Terminology Binding
- 19. Terminology Binding Syntax oUniform Resource Identifier (URI) standard: •Simple and extensible means for identifying a resource (ftp:, mailto:, news:, etc.), in this case terminology artefacts •Logical identifier of a resource, without specifying the physical location and the access mechanism •Both human and machine readable, with the syntax: <scheme name>:<hierarchical part>[?<query>][#<fragment>] •Obtaining a representation of the resource is done by Resolvers oScheme for terminology binding: terminology:<code system id>[:version]?<query type>= <query expression>[&<extension key>=extensionvalue]* oSNOMED CT query types: •concept, conceptlist, refset, refsetlist, escg, ocl
- 20. Terminology Binding Examples Examples: SNOMED CT oterminology:2.16.840.1.113883.6.96:20110123?concept=284296006 oterminology:2.16.840.1.113883.6.96:20110123?refset=284296007&scope=A01324 oterminology:2.16.840.1.113883.6.96:20110123?escg=<<284296006 ATC oTerminology:2.16.840.1.113883.6.3:20110123?code=A01 Singapore Data Dictionary oterminology:data_dictionary_id?value_domain_id#code terminology:<code system id>[:version]?<query type>= <query expression>[&<extension key>=extensionvalue]*
- 21. Binding Terminology toa Coded Datatype Concept Id 2.16.840.1.113883.6.96 SNOMED CT 20110701 Preferred Term Description Id Assumed value: PT RefSet Id RefSetVersion SNOMED CT
- 22. Binding Terminology toa Coded Datatype Code 2.16.840.1.113883.6.3 ICD-10 2008 Description Assumed value: Desc Value Domain Id Value Domain Ver ICD-10
- 23. Binding Terminology toa Coded Datatype Code DD OID MOH Data Dictionary 20120101 Description Assumed value: Desc Value Domain Id Value Domain Ver DD Value Domain
- 24. oSnow Owl ̶Referencesets and Extension concepts oLogical Reference Model (LRM) ̶Editable view oArchetype – Observation ENTRY ̶Add semantic and value domain bindings ̶Node meaning, relationship meaning, constraint & constructor bindings oConstrained archetype – Heart rate ENTRY ̶Add semantic and value domain bindings ̶Confirm subsumption validation oCompile template – Discharge summary (with heart rate) ̶Fill slot with heart rate archetype, and oModel search ̶Search models using semantic bindings Demonstration of LMD Tooling
- 25. oBuilt on theseasoned Eclipse tooling platform with wide industry adoption –Composed of bundles running within an OSGi (Eclipse) container –Bundles can be deployed depending the product definition (possible for both client and server side) –Help and branding information are in separate bundles oUtilizes the services provided by the Snow Owl terminology platform oCore domain objects are modeled via standard EMOF as opposed to be hard-coded Platform Software Architecture
- 26. Platform Software Architecture com.xyz Modularity & extensibility OSGi container org.eclipse Confidential com.b2international com.b2international Branding com.b2international Exposed extension point Exposed service Snow Owl sg.com.mohh.lmd org.eclipse LMD sg.com.mohh.lmd sg.com.mohh.lmd
- 27. Platform Standards Stack LIM Ontologies SNOMED CT, ICD-10 EMOF (EMF) OSGi (Eclipse), JDBC REST, SOAP Runtime API access Healthcare semantics Healthcare standard agnostic modeling Runtime platform Scalability, modularity Confidential
- 28. o2012 April –LMD Project kick-off oV0.4: 2012 November 3 – current release oExisting MOHH LIM artefacts import oModelling artefacts browsing, searching and editing capabilities (archetype, constrained archetype, template, template hierarchy) oValidation framework oTerminology binding oSchema and instance generation oV0.9: 2013 June 3 - Final release oInstance conformance & compliance oMapping support oLogical query language support oPublication oADL Support Project Timeline