A Sematic Web-Based Framework for Quality Assurance of Electronic Medical Records Data for Secondary Use

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1 A Sematic Web-Based Framework for Quality Assurance of Electronic Medical Records Data for Secondary Use Guoqian Jiang, Harold Solbrig, Christopher Chute Mayo Clinic W3C RDF Validation Workshop September 10, MFMER slide-1

2 Secondary use of EHR data The secondary use of electronic health records (EHR) sourced data is a broad domain. It includes patient safety and clinical quality metrics and development programs The entire categories of clinical and translational research are fundamentally dependent on effective secondary use of clinical information, including clinical trials, observational cohorts, outcomes research, comparative effectiveness, and best evidence discovery MFMER slide-2

3 The dimensions of data quality and methods of data quality assessment Source from: Weiskopf NG, Weng C. J Am Med Inform Assoc MFMER slide-3

4 Use of Data Standards A central part of good data practice that improves data quality Meaningful Use A national strategy in the US A roadmap for the advancement of health information exchange Using certified EHR technology to improve quality, safety, efficiency and reduce health disparities EHRIncentivePrograms/Meaningful_Use.html 2013 MFMER slide-4

5 Clinical Information Modeling Initiative (CIMI) an international collaboration effort, has been actively working on developing a common format for detailed specifications for the representation of health information content Main_Page 2013 MFMER slide-5

6 CIMI Information Model Ideas Source from: Dr. Stan Huff, CIMI 2013 MFMER slide-6

7 Standardized clinical information models for secondary use There is an emerging interest in the use of clinical information models in the context of secondary use of Electronic Medical Records (EMR) data The Office of the National Coordinator (ONC) s Strategic Health IT Advanced Research Projects Area 4 (SHARPn) project has adopted Intermountain Healthcare clinical element models (CEMs) for normalizing patient data extracted from EMR systems MFMER slide-7

8 SHARPn Project Organization (Secondary Use of EHR Data) 2013 MFMER slide-8

9 Clinical Element Models Developed by the Intermountain Healthcare A model for describing and representing detailed clinical information through defining a standard data structure Presently, over 4,000 CEMs, such as blood pressure measurement or specific laboratory tests, are defined. Authored in the Constrain Definition Language (CDL) Distributed in XML schema (XSD) 2013 MFMER slide-9

10 System Architecture SPARQL Inference Notation (SPIN) Framework Semantic Web Layer CEMs in OWL Instance Data in RDF Current Normalization Pipeline CEMs in XSD CEMs in CDL Instance Data in XML Patient Data in EMRs 2013 MFMER slide-10

11 2013 MFMER slide-11

12 CEMs in XSD -> OWL 2013 MFMER slide-12

13 Instance Data in XML -> RDF 2013 MFMER slide-13

14 Check constraints and perform data validation Define SPIN constraints 2013 MFMER slide-14

15 Check whether the units are identical cem:secondaryusenoteddrug 2013 MFMER slide-15

16 Check whether lowerlimit is greater than upperlimit cem:secondaryusenoteddrug 2013 MFMER slide-16

17 Constraint Violation Warning When (takendoselowerlimit.pq.unit.value TAB = takendoseupperlimit.pq.unit.value TAB ) and (takendoselowerlimit.pq.value 3 > takedoseupperlimit.pq.value 2 ) 2013 MFMER slide-17

18 Standardized Semantic Web Services We develop a CIMI-compliant semantic web representation and services for clinical information models Convert the CIMI reference model in the UML to OWL Generate domain templates from the BRIDG model (which is a domain analysis model in the domain of clinical research) 2013 MFMER slide-18

19 The Parts of the CIMI Reference Model Core Model Party Model with HL7 V3 RIM mappings Data Value Types Primitive Types 2013 MFMER slide-19

20 CIMI Reference Model - Core class CIMI Core Model LINK meaning :TEXT link 0..* source target LOCATABLE archetype_node_id :String name :String archetype_details 0..1 ARCHETYPED archetype_id :String rm_version :String = {readonly} 1 CORE_LOCATABLE participation 0..* PARTICIPATION function :CODED_TEXT details :ITEM [0..*] party 1..1 PARTY details :ITEM [0..*] COMPOSITION category :CODED_TEXT language :CODED_TEXT jurisdiction :CODED_TEXT 0..* content CONTENT_ITEM 0..* item SECTION ENTRY language :CODED_TEXT data 1..* 1..* ITEM item Name: CIMI Core Model Author: CIMI MTF Version: Created: 30/11/2012 8:32:29 PM Updated: 9/04/2013 1:29:40 PM CLUSTER structure_type :CODED_TEXT [0..1] ELEMENT null_flavor :CODED_TEXT [0..1] value :DATA_VALUE [0..1] 2013 MFMER slide-20

21 CIMI Reference Model Data Values 2013 MFMER slide-21

22 CIMI Reference Model in OWL MFMER slide-22

23 Domain Templates in CIMI-compliant Representation Using Semantic Web 2013 MFMER slide-23

24 2013 MFMER slide-24

25 Mindmap View BRIDG Associations BRIDG Attributes 2013 MFMER slide-25

26 cimi:entry cimi:cluster cimi:element 2013 MFMER slide-26

27 Discussion RDF validation mechanism against CIMI models Model level (CIMI models) Instance level (Patient data) Challenging issues Data types Value set binding XML Semantics Reuse technology XSD -> OWL XML -> RDF 2013 MFMER slide-27

28 XML Rules XSD/XML BRIDGing Technology SWRL/SPARQL Rules Object Constraint Language (OCL)? RDF/OWL UML 2013 MFMER slide-28

29 Questions & Discussion 2013 MFMER slide-29

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