WWW/Internet - Portal do Software Público Brasileiro

ISBN: 978-972-8939-25-0 © 2010 IADISwithout losing the possibility of retrieving captured information. Until now these benefits stay in thebackground as most approaches tend to fit these models into legacy systems instead of rethinking legacydevelopments.These standards should be used to facilitate the EBM information support for health care participants(HCP) during their daily practice. The models enable a vast range of interactive IT support for HCP by usingthe benefits of semantic interoperability. We are going to show how this works through introducing anontology driven application model (ODAM). Furthermore we will use this approach to show an interactive ITsupport for EBM and electronic documentation.2. METHODS AND STANDARDS2.1 ISO 13606 – EHR Communication StandardISO 13606 facilitates structuring, communicating and interpreting medical information. The ISO defines anEHR for integrated care as: “a repository of information regarding the health status of a subject of care incomputer processable form, stored and transmitted securely, and accessible by multiple authorized users. Ithas a standardized or commonly agreed logical information model which is independent of EHR systems. Itsprimary purpose is the support of continuing, efficient and quality integrated health care and it containsinformation which is retrospective, concurrent, and prospective” (International Organization forStandardization 2005). Communication is not only supported inside and between EHR systems but also withother applications and components such as middleware services, moving towards an architecture-centricapproach with alerting and decision-support services, agent components including work flow managementsystems (Blobel, Engel et al. 2006).ISO 13606 is based on the GEHR/openEHR dual model approach. That is the idea of an archetype modelthat constrains and references a generic reference model (Beale 2001). In other words an instance of thearchetype model - which is basically a meta-model provided following UML and XML - can be seen asdescription of how to use the reference model, through constraining and referencing it. ISO 13606 comprisesof five parts:Part 1 - specifies the Reference Model, which is a generic information model for communicating anddefining virtually any patient information. Furthermore it specifies the communication of a part or all of theelectronic health record (EHR) of a single identified subject of care between EHR systems, or between EHRsystems and a centralized EHR data repository (ISO 2008).Part 2 - specifies the Archetype Model, which is also a generic information model and language tospecify archetypes for communicating domain concepts. Archetypes describe constraints and structures for a(medical) information domain using the Reference Model for data definitions. This means an informationarchitecture required for interoperable communications between systems and services that need or provideEHR data. Part 2 is not intended to specify the internal architecture or database design of such systems.Archetype Definition Language (ADL), is a formal language for expressing archetypes, and can becategorised as a knowledge description language. It provides a formal, abstract syntax for describingconstraints on any domain entity whose data is described by the Reference Model.Part 3 - specifies the Reference Archetypes and Terms Lists, which describes how other EHR standardscould comply with ISO 13606.Part 4 - specifies the Security Features.Part 5 - specifies the Interface Model which describes how an interoperable communication can takeplace.2.2 Web Ontology LanguageThe semiotic triangle describes how linguistic symbols are related to objects they reference. The relationbetween a symbol and a reference is established through a concept that describes the object abstractly.Formalizing these relations was the aim for developing an ontology language (Sowa 2000).The World Wide Web Consortium (W3C) developed the basic standards of Resource DescriptionFramework (Schema) (RDF(S)) and the Web Ontology Language (OWL) (W3C). RDF(S) and OWL are334