A Technological Framework for EHR Interoperability: Experiences from Italy

Ciampi, Mario; Sicuranza, Mario; Esposito, Angelo; Guarasci, Roberto; Pietro, Giuseppe De

doi:10.1007/978-3-319-62704-5_6

Cited by 2 publications

(1 citation statement)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, toward this aim, strategies for collecting the outputs and making them available in patients' data (or electronic health records) need to be investigated. In this regard, scientific literature offers some interesting approaches grounded in the Italian health care system that could be considered to make the COPD DSS interoperable with existing tools [68][69][70]. As the COPD DSS leverages ontologies to represent its data, this technology can be used to achieve semantic interoperability of the information [68], moving a step toward the longitudinal collection of health data about patients [70] while ensuring data protection according to the national and European laws [69].…”

Section: Future Workmentioning

confidence: 99%

An Ontology-Based Decision Support System for Tailored Clinical Nutrition Recommendations for Patients With Chronic Obstructive Pulmonary Disease: Development and Acceptability Study

Spoladore,

Colombo,

Fumagalli

et al. 2024

JMIR Med Inform

View full text Add to dashboard Cite

Background Chronic obstructive pulmonary disease (COPD) is a chronic condition among the main causes of morbidity and mortality worldwide, representing a burden on health care systems. Scientific literature highlights that nutrition is pivotal in respiratory inflammatory processes connected to COPD, including exacerbations. Patients with COPD have an increased risk of developing nutrition-related comorbidities, such as diabetes, cardiovascular diseases, and malnutrition. Moreover, these patients often manifest sarcopenia and cachexia. Therefore, an adequate nutritional assessment and therapy are essential to help individuals with COPD in managing the progress of the disease. However, the role of nutrition in pulmonary rehabilitation (PR) programs is often underestimated due to a lack of resources and dedicated services, mostly because pneumologists may lack the specialized training for such a discipline. Objective This work proposes a novel knowledge-based decision support system to support pneumologists in considering nutritional aspects in PR. The system provides clinicians with patient-tailored dietary recommendations leveraging expert knowledge. Methods The expert knowledge—acquired from experts and clinical literature—was formalized in domain ontologies and rules, which were developed leveraging the support of Italian clinicians with expertise in the rehabilitation of patients with COPD. Thus, by following an agile ontology engineering methodology, the relevant formal ontologies were developed to act as a backbone for an application targeted at pneumologists. The recommendations provided by the decision support system were validated by a group of nutrition experts, whereas the acceptability of such an application in the context of PR was evaluated by pneumologists. Results A total of 7 dieticians (mean age 46.60, SD 13.35 years) were interviewed to assess their level of agreement with the decision support system’s recommendations by evaluating 5 patients’ health conditions. The preliminary results indicate that the system performed more than adequately (with an overall average score of 4.23, SD 0.52 out of 5 points), providing meaningful and safe recommendations in compliance with clinical practice. With regard to the acceptability of the system by lung specialists (mean age 44.71, SD 11.94 years), the usefulness and relevance of the proposed solution were extremely positive—the scores on each of the perceived usefulness subscales of the technology acceptance model 3 were 4.86 (SD 0.38) out of 5 points, whereas the score on the intention to use subscale was 4.14 (SD 0.38) out of 5 points. Conclusions Although designed for the Italian clinical context, the proposed system can be adapted for any other national clinical context by modifying the domain ontologies, thus providing a multidisciplinary approach to the management of patients with COPD.

show abstract