Bio-medical Ontologies Maintenance and Change Management

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