Bio-medical Ontologies Maintenance and Change Management

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Design of an Online Physician-Mediated Personal Health Record System Jake Y. Chen 1,2,3,* , Shailaja Taduri 2 , and Frank Lloyd 3,4 1 Indiana University School of Informatics, Indianapolis, IN 46202 jakechen@iupui.edu 2 Department of Computer and Information Science, Purdue University School of Science, Indianapolis, IN 46202 3 Indiana Center for Systems Biology and Personalized Medicine, Indianapolis, IN 46202 4 The Center for Surgical Sciences and Trauma, Methodist Hospital, Indianapolis, IN 46206 Abstract. Electronic Medical Record (EMR) has been adopted by most hospitals in the United States to keep track of patient medical information today. However, HIPAA (Health Insurance Portability and Accountability Act) regulations, technical information system design challenges, and social-economic factors—all contributed to significant barriers to granting patients access to his own EMR maintained by hospitals with the personal health records (PHR) maintained by patients. In this chapter, we describe a new Personal Health Office Framework (PhoF), which is designed to enable patients effectively manage their own PHR integrated with a portion of their EMR with the guidance of health-care providers. PhoF is characterized with a unique online physician-approval process, which can allow a computer agent to retrieve specific information securely on a particular patient maintained with the approving physician’s hospital EMR. The mediated access to medical treatment information enables a physician to administer patient self-education and self-care for online patients and therefore may help reduce medical errors and health care cost. A prototype system with web user interface is described and several case studies are presented to show the how the concept works in practice. Keywords: electronic medical records, personal health records, computer agents, physician-mediation. 1 Introduction Providing the most cost-effective care and quality of service to patients with continued information technology innovation is a major theme in the United States health care industry today. In many hospitals and clinics throughout the country, digital transcription of physician’s notes, electronic medical records, and automated patient scheduling systems are becoming commonplace. Each time a patient visits his/her health care provider, an electronic record of the visit can now be made, compiled into, and maintained as part of the provider’s medical information system * Corresponding author. A.S. Sidhu et al. (Eds.): Biomedical Data and Applications, SCI 224, pp. 265–279. springerlink.com © Springer-Verlag Berlin Heidelberg 2009
266 J.Y. Chen, S. Taduri, and F. Lloyd (IS). This type of centralized medical information system serves as an emerging central platform for managing and planning quality health care by hospital administrators, physicians, nurses, and other medical researchers. It also serves as a legal recording system by which the patient’s insurance company verifies medical billing. The system replaces the traditional paper-based system as an effective platform of choice, known to help reduce medical errors, reduce billing errors, and increase efficiency. Along this trend, there has been a similar drive to provide access and selfmanagement of individual electronic medical records to patients and healthconscious consumers in the United States [1]. There are two types of electronic records in the markets today available to patients. The first type, Electronic Medical Records (EMR), contains a patient’s hospital-related health care record in digital format stored in hospital/clinic’s information systems. EMR, while managed electronically by health-care providers, include data from hospitals, pathology labs, clinics, and insurance companies. The effective implementation of EMR systems have been shown to improve health care efficiency and safety while reducing costs [2]. As a good example of the latest EMR software systems, Medicware (www.medicware.com) aims to promote patient care and improve treatment efficiency by enabling providers to manage their patient’s complete clinical experience, which includes office visits, medical examination results, health maintenance, referrals, medications and prescriptions. The second type, Personal Health Record (PHR), contains a personal’s health log created and maintained by individuals. A good PHR record should provide complete and accurate summary of health and medical history of an individual including primary care providers, health insurance, allergies, current medications, illness and hospitalizations, surgical history, laboratory test results, as well as personal health information such as medication, allergies, diet, weight, mental status, and exercising status. For example, the American Health Information and Management Association (AMIMA) has been educating patients on the need to make use of PHR to improve health management. Electronic version of a PHR can be internet-based or PC-based software, portable yet connected to backend information systems. Various industry partners such as CapMed, ihealthRecord, Dr.iNet, Medic Alert has just begun to offer PHR solutions to the customers as standalone software and data entry systems, which consumers can interact with. In spite of the progress in digitizing medical and health information for individuals concerned with their own health or disease issues, the choices available for patients to access and control their medical and health information are still extremely limited. On one hand, even in hospitals where information systems are available for hospital staffs and physicians, majority of them still offer paperbased records. This is partly because EMR systems were developed primarily to help hospital workers gain integrated view of disparate data sources such as laboratory systems, pharmacy systems, and physician notes. It’s challenging to develop user interfaces to make such system easy to understand by non-medical users [3]. Moreover, privacy and confidentiality are perceived to be a significant problem, even though a protected electronic medical record generally offers much better security than a paper-based record [4]. All EMR systems specifically developed for physicians have to be compliant with the HIPAA (Health Insurance Portability and Accountability Act) legal rules and regulations in the United States. On
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Amandeep S. Sidhu and Tharam S. Dil
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Amandeep S. Sidhu and Tharam S. Dil
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Preface The molecular biology commu
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Preface VII biomedical systems, and
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X Contents Mining Clinical, Immunol
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2 A.S. Sidhu, M. Bellgard, and T.S.
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Towards Bioinformatics Resourceomes
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2 The New Waves Towards Bioinformat
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2.4 Semantic Web Towards Bioinforma
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A Summary of Genomic Databases: Ove
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Appendix A Summary of Genomic Datab
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Protein Data Integration Problem Am
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Protein Data Integration Problem 57
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Fig. 3. Class Hierarchy of Protein
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Bio-medical Ontologies Maintenance
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TextToOnto (Maedche and Volz 2001)
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Extraction of Constraints from Biol
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Classifying Patterns in Bioinformat
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Author Index Apiletti, Daniele 169
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Bio-medical Ontologies Maintenance and Change Management

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