Purpose. To develop a powerful archetype editing framework capable of handling multiple reference models and oriented towards the semantic description and standardization of legacy data.Methods. The main prerequisite for implementing tools providing enhanced support for archetypes is the clear specification of archetype semantics. We propose a formalization of the definition section of archetypes based on types over tree-structured data. It covers the specialization of archetypes, the relationship between reference models and archetypes and conformance of data instances to archetypes.Results. LinkEHR-Ed a visual archetype editor based on the former formalization with advanced processing capabilities that supports multiple reference models, the editing and semantic validation of archetypes, the specification of mappings to data sources, and the automatic generation of data transformation scripts.Conclusions. LinkEHR-Ed is a useful tool for building, processing and validating archetypes based on any reference model.
In this paper we describe Pangea-LE, a message-oriented lightweight data integration engine that allows homogeneous and concurrent access to clinical information from disperse and heterogeneous data sources. The engine extracts the information and passes it to the requesting client applications in a flexible XML format. The XML response message can be formatted on demand by appropriate XSL (Extensible Stylesheet Language) transformations in order to meet the needs of client applications. We also present a real deployment in a hospital where Pangea-LE collects and generates an XML view of all the available patient clinical information. The information is presented to healthcare professionals in an EHR (Electronic Health Record) viewer Web application with patient search and EHR browsing capabilities. Implantation in a real setting has been a success due to the non-invasive nature of Pangea-LE which respects the existing information systems.3
The International Organization for Standardization (ISO) has recently approved a new standard for the communication and semantic interoperability of electronic health record extracts. This standard is based on a dual model architecture, where a simple and generic reference model is defined for the representation of data and an archetype model is used for the representation of complex domain concepts of the electronic health record. By using this standard and a tool called LinkEHR-Ed, we have defined different types of hospital discharge reports in the form of archetypes and then we have normalized automatically discharge reports instances in a real environment following those archetype definitions. This work proves that it is possible to standardize legacy data automatically and enrich them with a semantic information layer by using archetypes as an integration and standardization mechanism.
One of the basic needs for any healthcare professional is to be able to access to clinical information of patients in an understandable and normalized way. The lifelong clinical information of any person supported by electronic means configures his/her Electronic Health Record (EHR). This information is usually distributed among several independent and heterogeneous systems that may be syntactically or semantically incompatible. The Dual Model architecture has appeared as a new proposal for maintaining a homogeneous representation of the EHR with a clear separation between information and knowledge. Information is represented by a Reference Model which describes common data structures with minimal semantics. Knowledge is specified by archetypes, which are formal representations of clinical concepts built upon a particular Reference Model. This kind of architecture is originally thought for implantation of new clinical information systems, but archetypes can be also used for integrating data of existing and not normalized systems, adding at the same time a semantic meaning to the integrated data. In this paper we explain the possible use of a Dual Model approach for semantic integration and standardization of heterogeneous clinical data sources and present LinkEHR-Ed, a tool for developing archetypes as elements for integration purposes. LinkEHR-Ed has been designed to be easily used by the two main participants of the creation process of archetypes for clinical data integration: the Health domain expert and the Information Technologies domain expert.
We present the mapping and data transformation capabilities of LinkEHR-Ed, a visual tool to construct formal definitions of medical concepts in the form of archetypes which can be defined on the basis on multiple electronic health record architecture such as ISO 13606. With LinkEHR-Ed, users can enrich archetypes with mapping information which captures the relationship between relational or XML data sources and archetype structures. This mapping information is then analyzed and compiled into an XQuery expression that transforms source instances into an XML document. The target document satisfies the constraints imposed by the archetype and at the same time is compliant with the underlying electronic health record architecture.
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