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Artemis Project

Artemis Project. A Semantic Web Service-based P2P Infrastructure for the Interoperability of Medical Information Systems (IST-1-002103-STP). Artemis Architecture. The Artemis project addresses the interoperability problem in the healthcare domain

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Artemis Project

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  1. Artemis Project A Semantic Web Service-based P2P Infrastructure for the Interoperability of Medical Information Systems (IST-1-002103-STP) EUROREC Satellite Conference on Ontology

  2. Artemis Architecture • The Artemis project addresses the interoperability problem in the healthcare domain • The Syntactic interoperability is handled through Web services • Semantic Interoperability is addressed by semantically annotating the Web services EUROREC Satellite Conference on Ontology, Brussels

  3. Semantic Mediation: OntologyMapping • To annotate Web services we propose • Service Functionality Ontologies • Service Message Ontologies • It is not realistic to expect all the healthcare institutes to use the same ontology • The differences between disparate Service Functionality and Service Message Ontologies are resolved through Ontology Mapping EUROREC Satellite Conference on Ontology, Brussels

  4. Healthcare Informatics Semantics • Semantics is domain knowledge! • Medicine is one of the few domains to have extensive domain knowledge defined through standards • These standards offer significant value in developing ontologies to express the semantics of Web services EUROREC Satellite Conference on Ontology, Brussels

  5. What kind of Semantics? • Service Functionality Semantics: • HL7 has categorized the events in healthcare domain by considering service functionality which reflects the business logic in this domain • This classification can be used as a basis for defining the service action semantics through a Service Functionality Ontology • Service Message Semantics: • Electronic healthcare record (EHR) based standards like HL7 CDA (Clinical Document Architecture), GOM (GEHR Object Model), and CEN TC251's ENV 13606 define meaningful components of EHR so that when transferred, the receiving party can understand the record content better • The meaningful components defined by these standards can be used in developing service message ontologies EUROREC Satellite Conference on Ontology, Brussels

  6. HL7 and Web Services • The primary goal of HL7 is to provide standards for the exchange of data among healthcare computer applications • An event in the healthcare world, called the trigger event, causes exchange of messages between a pair of applications • When an event occurs in an HL7 compliant system, an HL7 message is prepared by collecting the necessary data from the underlying systems and it is passed to the requestor, usually as an EDI message • Mapping HL7’s message based events directly into Web services may result in several inefficiencies EUROREC Satellite Conference on Ontology, Brussels

  7. HL7 and Web Services • The input and output messages defined for HL7 events are usually very complex containing innumerous segments of different types and optionality • Furthermore, all the semantics about the business logic and the document structure are hard coded in the message • This implies that, the party invoking the Web service must be HL7 compliant to make any sense of the content of the output parameter(s) returned by the service • Furthermore, the information contained in an HL7 message may be coming from different systems either proprietary or complying to different standards • Hence, in Web services terminology, HL7 events correspond to Composite services, whereas more elementary services are needed EUROREC Satellite Conference on Ontology, Brussels

  8. HL7 and Web Services • Since HL7 has already been through an effort of categorizing the events in healthcare domain considering service functionality, it can be used as a basis for a service functionality ontology EUROREC Satellite Conference on Ontology, Brussels

  9. Properties of the Generic Service Class An Example Service FunctionalityOntology HealthCareServices PatientAdministration PatientCare PatientReferral Scheduling ObservationReporting PatientReferralRequest PatientInfoRequest CancelPatientReferral InsuranceInformation ClinicalInformation DemographicData GetClinicalInformation serviceQuality location EUROREC Satellite Conference on Ontology, Brussels

  10. Service Messages • A Web service in the healthcare domain usually accesses or updates a part of an electronic healthcare record, that is, parts of the EHR constitute the service parameters • An electronic healthcare record may get very complex with data coming from diverse systems such as lab tests, diagnosis, prescription of drugs which may be in different formats • Electronic healthcare record (EHR) based standards like HL7 CDA, GOM and CEN's ENV 13606 aim to facilitate the interoperability between Medical Information Systems • These standards provide conceptual building blocks or meaningful components • We propose to use these standards as a basis for Service Message Ontology EUROREC Satellite Conference on Ontology, Brussels

  11. Good Electronic Healthcare Record (GEHR) • Transaction level • Navigation level • Content (e.g. observation, subjective, instruction) level • Data types (e.g. quantity, multimedia) level • Clinical models are expressed outside the GOM in the form of archetypes EUROREC Satellite Conference on Ontology, Brussels

  12. CEN (European Committee for Standardization) TC 251 ENV 13606 • Folder: High-level subdivisions of the entire EHR for a patient • Composition: A set of record entries relating to one time and place of care delivery; grouped contributions to an aspect of health care activity; composed reports and overviews of clinical progress • Headed Section: Sub-divisions used to group entries with a common theme or derived through a common healthcare process. • Cluster: Low-level aggregations of elementary entries (Record Items) to represent a compound clinical concept EUROREC Satellite Conference on Ontology, Brussels

  13. Concept Property An example Service Message Ontology DD02: Problem DTC12: CarePlan DF03: AllergyState DTH03: Ongoing Problems DTH08: Present Interpretations DD01: Diagnosis DTC08: Diagnostic Test Results DS00: Patient EUROREC Satellite Conference on Ontology, Brussels

  14. Semantic Mediation • In Artemis architecture, the healthcare institutes can develop their own ontologies • However these ontologies are based on standards developed by the healthcare standardization bodies like CEN TC251, ISO TC215, GEHR or HL7 • The ontology mappings are achieved through semantic mediation EUROREC Satellite Conference on Ontology, Brussels

  15. Mapping Message Ontologies EUROREC Satellite Conference on Ontology, Brussels

  16. DS00 Concept Bridge name Surname patientId sex PID Date patientName id dateOfBirth sex maritialStatus address accountNumber day month year Property Bridge birthDate hasContact Contact Concept Bridge address phoneNo Property Bridge Semantic Mediation throughMAFRA Tool CEN ENV 13606 HL7 EUROREC Satellite Conference on Ontology, Brussels

  17. UDDI Business Entities and Related HacettepeHospital UDDI tModels ObservationReportingServices . . . PatientReferralServices getClinicalInfo CategoryBag reference Relating the Web services with the semantic defined through an ontology - UDDI Medical Services PatientCare PatientReferral Observation Reporting GetClinicalInfo PatientReferralReq EUROREC Satellite Conference on Ontology, Brussels

  18. subclassOf subclassOf subclassOf subclassOf ebXML associations Associating semantics to Web services in ebXML HealthCareServices PatientCare PatientAdministration ObservationReporting PatientInfoRequest PatientReferralRequest Standards Conformed serviceQuality ebXML Classification Hierarchy ebXML ClassificationNodes ebXMLslots EUROREC Satellite Conference on Ontology, Brussels

  19. WebService (seviceQuality) PatientAdministration PatientReferral (stdConformed) How to Define a Classification Hierarchy in ebXML? <rim:ClassificationScheme id = ‘WebService‘ isInternal='true' nodeType='UniqueCode' > <rim:Name> <rim:LocalizedString value = ‘WebService'/> </rim:Name> <rim:Description> <rim:LocalizedString value = 'This is a sample WebServicescheme'/> </rim:Description> <Slot name = ‘serviceQuality' slotType= 'StringList’/> </rim:ClassificationScheme> <rim:ClassificationNode id = ‘PatientReferral‘ parent= ‘WebService'> <rim:Name> <rim:LocalizedString value = ‘PatientReferral' /> </rim:Name> <rim:Description> <rim:LocalizedString value = ''/> </rim:Description> <Slot name = ‘stdConformed' slotType= 'StringList’/> </rim:ClassificationNode> … EUROREC Satellite Conference on Ontology, Brussels

  20. classificationNode classsifiedObject PatientReferral serviceQuality stdConformed Relating the services with the semantic defined through an ontology - ebXML ServiceToIndustryClassification: Classification MyService RegistryEntry Service Classification Hieararchy EUROREC Satellite Conference on Ontology, Brussels

  21. “SubmitObjectRequest” which declares the semantic of “MyService” and relates it with the “PatientReferral” Service <?xml version = '1.0' encoding = 'UTF-8'?> <SubmitObjectsRequest> <rim:LeafRegistryObjectList> <Service id="MyService"> <Name> <LocalizedString lang="en_US" value = “MyService"/> </Name> <Classification classificationNode=“PatientReferral“ ClassifiedObject= "MyService" /> <Slot name = ‘stdConformed'> <ValueList> <Value>HL7</Value> </ValueList> </Slot> EUROREC Satellite Conference on Ontology, Brussels

  22. An Example “SubmitObjectRequest” (Cont’d) <ServiceBinding accessURI="http://www.sun.com/ebxmlrr/registry/nameSpaceI ndexer"> <SpecificationLink specificationObject="wsdl"> </SpecificationLink> </ServiceBinding> </Service> <ExtrinsicObject id="wsdl" mimeType="text/xml"> </ExtrinsicObject> </rim:LeafRegistryObjectList> </SubmitObjectsRequest> EUROREC Satellite Conference on Ontology, Brussels

  23. We need more: Archetypes for semantic Interoperability • Using archetypes is a promising approach in providing semantic interoperability among healthcare systems • Annotating the messages of services with archetypes • To realize archetype based interoperability the healthcare systems need to • Discover the existing archetypes based on their semantics • Annotate their archetypes with ontologies • Compose templates from archetypes and retrieve corresponding data from the underlying medical information systems EUROREC Satellite Conference on Ontology, Brussels

  24. Exploiting ebXML Registry Semantic Constructs for handling Archetype Metadata • ebXML Registry semantic constructs can be used for • Storing Archetype Metadata • Storing Archetypes • Associating archetypes with metadata • Retrieving archetypes by using their semantics EUROREC Satellite Conference on Ontology, Brussels

  25. Education fitsSlotsOf Purpose Archetype relatedClinicalDomain hasPurpose Clinical ClininalDomain Referral hasLinkTo isAPartOf Research relatedClinicalDomain ClinicalDocument hasLinkTo DocumentTemplate CodingScheme isDocumentedIn Plan ICD10 MedDRA Location Procedure Assessment LOINC Clinic SNOMED Hospital ClinicalInformation DiagnosticTests Office Semantically annotating the archetypes • An example Archetype Metadata Ontology EUROREC Satellite Conference on Ontology, Brussels

  26. Representing Archetype Metadata as ebXML Classification Scheme • OWL classes can be represented through “ClassicationNodes” • RDF properties that are used in OWL can be treated as “Associations” • “OWL ObjectProperty", “DataTypeProperty” and “TransitiveProperty” are defined by introduc ing new association types such as “objectProperty” EUROREC Satellite Conference on Ontology, Brussels

  27. Representing Archetype Metadata as ebXML Classification Scheme • OWL class hierarchies • It is not possible to represent multiple inheritance in ebXML • Define a new association type “subClassOf” • Use the predefined “EquivalentTo” association to express • “owl:equivalentClass”, “owl:equivalentProperty” and “owl:sameAs“ • A. Dogac, Y. Kabak, G. Laleci, C. Mattocks, F. Najmi, J. Pollock, “Enhancing ebXML Registries to Make them OWL Aware”, Submitted to the Distributed and Parallel Databases Journal, Kluwer Academic Publishers. • http://www.srdc.metu.edu.tr/webpage/-publications/2004/ DAPD ebXML-OWL.pdf EUROREC Satellite Conference on Ontology, Brussels

  28. Education fitsSlotsOf Purpose ebXML Registry Archetype relatedClinicalDomain hasPurpose Clinical ClininalDomain Referral hasLinkTo isAPartOf Research relatedClinicalDomain Classification Hierarchy ClinicalDocument hasLinkTo DocumentTemplate CodingScheme Archetype isDocumentedIn Plan Clinical Domain Coding Scheme ICD10 MedDRA Location Archetype Metadata Ontology Procedure Assessment LOINC Clinic Organ System SNOMED SNOMED Radiology Hospital ClinicalInformation DiagnosticTests Office Central Nervous System Complete Blood Count Representing Archetype Metadata as ebXML Classification Scheme EUROREC Satellite Conference on Ontology, Brussels

  29. Representing Archetypes in ebXML Registry • An “archetype” is represented in the Registry as a “Registry Information Model (RIM) Extrinsic Object” • “Extrinsic Objects” point to the Repository items where their contents are stored • OWL definition of an archetype is created from its ADL (Archetype Definition Language) definition and is stored in the Repository EUROREC Satellite Conference on Ontology, Brussels

  30. URI Archetype OWL Definition Archetype OWL Definition Archetype OWL Definition Archetype Haemotology Observation Brain CT Clinical Domain Coding Scheme Complete Blood Count URI Organ System SNOMED Radiology URI Central Nervous System Complete Blood Count Representing Archetypes in ebXML Registry ebXML Repository ebXML Registry Extrinsic Objects Classification Hierarchy EUROREC Satellite Conference on Ontology, Brussels

  31. URI Archetype OWL Definition Archetype OWL Definition Archetype OWL Definition Archetype Brain CT Haemotology Observation Clinical Domain Coding Scheme Complete Blood Count URI Organ System SNOMED Radiology URI Central Nervous System Complete Blood Count Associating archetypes with metadata ebXML Repository ebXML Registry Extrinsic Objects Classification Hierarchy EUROREC Satellite Conference on Ontology, Brussels

  32. ebXML Repository URI Archetype OWL Definition Archetype OWL Definition Archetype OWL Definition Archetype Haemotology Observation Brain CT Clinical Domain Coding Scheme Complete Blood Count URI Organ System SNOMED Radiology URI filterQuery Central Nervous System Complete Blood Count getContentQuery ebXML Registry Classification Hierarchy Extrinsic Objects Query Interface EUROREC Satellite Conference on Ontology, Brussels

  33. An Example query • A user can find all templates and archetypes that make reference to the SNOMED Complete Blood Count term EUROREC Satellite Conference on Ontology, Brussels

  34. Filter Query < FilterQuery > < ExtrinsicObjectQuery > < ClassifiedByBranch > < ClassicationNodeQuery > < NameBranch > < LocalizedStringFilter > < Clause > < SimpleClause leftArgument = \value" > < StringClause stringPredicate = \Equal" > CompleteBloodCount < /StringClause > < /SimpleClause > < /Clause > < /LocalizedStringFilter > < /NameBranch > < /ClassicationNodeQuery > < /ClassiedByBranch > < /ExtrinsicObjectQuery > < /FilterQuery > Result ExtrinsicObjects IDs classied with the “CompleteBloodCount" ClassicationNode EUROREC Satellite Conference on Ontology, Brussels

  35. URI Archetype OWL Definition Archetype OWL Definition Archetype OWL Definition Archetype Brain CT Haemotology Observation Clinical Domain Coding Scheme Complete Blood Count URI Organ System SNOMED Radiology URI Central Nervous System Complete Blood Count Retrieving Archetype Definitions ebXML Repository ebXML Registry Classification Hierarchy Extrinsic Objects <GetContentRequest> <rim:ObjectRefList> <rim:ObjectRef id="urn:uuid:368661c9-b733-4c14-96a3 -eabbdf36ff5b"/> </rim:ObjectRefList> </GetContentRequest> EUROREC Satellite Conference on Ontology, Brussels

  36. Continuing.. • There may be other archetypes classified with • MedDRA - Full Blood Count • Read Codes Full Blood Count • These may have been defined to be equivalent to SNOMED Complete Blood Count Term • Through ebXML “EquivalentTo“ association EUROREC Satellite Conference on Ontology, Brussels

  37. A Stored Procedure to find Equivalent Class Instances… CREATE PROCEDURE findEquivalentInstances($className) BEGIN SELECT N.value FROM ExtrinsicObject EO, Name_ N WHERE EO.id IN ( SELECT classifiedObject FROM Classification WHERE classificationNode IN ( SELECT id FROM ClassificationNode WHERE id IN ( SELECT parent FROM name_ WHERE value LIKE $className ) UNION SELECT A.targetObject FROM Association A, Name_ N, ClassificationNode C WHERE A.associationType LIKE 'EquivalentTo' AND C.id = N.parent AND N.value LIKE $className AND A.sourceObject = C.id ) ) AND EO.id=N.parent END; • GUI sends this stored procedure • It becomes possible to automatically obtain the archetype instances that are classified with SNOMED • As well as those instances classified with • MEdDRA “Full Blood Count" term • Read Codes “Full Blood Count” term EUROREC Satellite Conference on Ontology, Brussels

  38. HealthCareServices Concept Bridge DS00 PatientAdministration PatientCare PatientReferral Scheduling ObservationReporting name Surname patientId PID Date id date Property Bridge day PatientReferralRequest PatientInfoRequest CancelPatientReferral Contact InsuranceInformation Concept Bridge ClinicalInformation DemographicData address GetClinicalInformation Property Bridge An Overview of a Mediator Mediator Components Ontology Server Semantic Mediator - Functional Ontology CEN/HL7/Gehr Encapsulation Legacy System VWS Semantic Mapping via Bridges - Clinical Concept Ontology Web Service Enactment ebXML UDDI SuperPeer Services Hospital B tModel KlinikBilgiServisi Client Interface BindingTemp EUROREC Satellite Conference on Ontology, Brussels

  39. Summary: Artemis Architecture • GUI based tools for deploying existing healthcare applications as Web services • Service functionality ontologies • Service message ontologies • We are working on archetype based service message ontologies • Semantic mediator • Semantically enriched Web service registries • Semantically enriched P2P Infrastructure for scalability and resource discovery EUROREC Satellite Conference on Ontology, Brussels

  40. Artemis Project: References • http://www.srdc.metu.edu.tr/artemis/ • Dogac, A., Laleci, G., Kirbas S., Kabak Y., Sinir S., Yildiz A. Gurcan, Y., "Artemis: Deploying Semantically Enriched Web Services in the Healthcare Domain", Information Systems Journal (Elsevier), accepted for publication http://www.srdc.metu.edu.tr/webpage/publications/ • Dogac, A., Laleci, G.B., Kabak, Y., Unal, S., Beale, T., Heard, S., Elkin, P., Najmi, F., Mattocks, C., Webber, D., “Exploiting ebXML Registry Semantic Constructs for Handling Archetype Metadata in Healthcare Informatics”, submitted for publication. • http://www.srdc.metu.edu.tr/webpage/publications/ EUROREC Satellite Conference on Ontology, Brussels

  41. Finally… • If you Google with “web service semantics healthcare”, Artemis project ranks the first  • If you Google with “web service semantics”, out of 371.000 docs : • [PPT]Semantics of Web Serviceswww.srdc.metu.edu.tr/~asuman/ grenoble/_DogacSematicWS_FV.ppt • [PPT]A Semantic-Based WebService Composition Facility for ebXML ...www.srdc.metu.edu.tr/~asuman/Dogac_ICE_ebXML.ppt EUROREC Satellite Conference on Ontology, Brussels

  42. Thank you for your attention! Questions? EUROREC Satellite Conference on Ontology, Brussels

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