David Moner

VeraTech for Health

This study describes the process of building an OMOP CDM repository from an OpenEHR Clinical Data Repository ( at Hospital Universitario 12 de Octubre (H12O) and Primary Care ( in Madrid Region, Spain, within the INFOBANCO platform This OMOP CDM repository has supported the participation in several international data driven consortiums, such as EHD...

Due to the heterogeneity of Electronic Health Record (EHR) standards, the decision-making teams, who are not experts in health information, express confusion for selecting and applying these resources in their data platforms. For this reason, a group of experts has analyzed strengths and weaknesses about design, modeling capabilities, flexibility a...

Clinical Information Models (CIMs) expressed as archetypes play an essential role in the design and development of current Electronic Health Record (EHR) information structures. Although there exist many experiences about using archetypes in the literature, a comprehensive and formal methodology for archetype modeling does not exist. Having a model...

We present the results of a pilot project of the Spanish Ministry of Health, Social Services and Equality, envisaged to the development of a national integrated data repository of maternal-child care information. Based on health information standards and data quality assessment procedures, the developed repository is aimed to a reliable data reuse...

The reuse of data captured during health care delivery is essential to satisfy the demands of clinical research and clinical decision support systems. A main barrier for the reuse is the existence of legacy formats of data and the high granularity of it when stored in an electronic health record (EHR) system. Thus, we need mechanisms to standardize...

Messaging standards, and specifically HL7 v2, are heavily used for the communication and interoperability of Health Information Systems. HL7 FHIR was created as an evolution of the messaging standards to achieve semantic interoperability. FHIR is somehow similar to other approaches like the dual model methodology as both are based on the precise mo...

Clinical information models are increasingly used to describe the contents of Electronic Health Records. Implementation guides are a common specification mechanism used to define such models. They contain, among other reference materials, all the constraints and rules that clinical information must obey. However, these implementation guides typical...

Objective This systematic review aims to identify and compare the existing processes and methodologies that have been published in the literature for defining clinical information models (CIMs) that support the semantic interoperability of electronic health record (EHR) systems. Material and Methods Following the preferred reporting items for syste...

This paper describes the design and implementation of a clinical-oriented tool for the definition of HL7 CDA templates based on the archetype methodology proposed by CEN/ISO 13606 and openEHR. The use of archetypes together with HL7 CDA brings along new possibilities for clinical model definitions based on CDA. It allows taking profit of the formal...

In this work we present the Concept Oriented Repository (ROC), a system developed for the management of clinical information models, also known as detailed clinical models (DCM). It has been developed to be used in the Electronic Health Record project of the Valencia regional health agency (AVS). The system uses DCMs as a way to define clinical mod...

The secondary use of electronic healthcare records (EHRs) often requires the identification of patient cohorts. In this context, an important problem is the heterogeneity of clinical data sources, which can be overcome with the combined use of standardized information models, virtual health records, and semantic technologies, since each of them con...

La necesidad de interoperabilidad en los sistemas públicos de salud como soporte a la continuidad asistencial está plenamente establecida desde hace ya algún tiempo y el uso de la normalización se ha situado como la principal estrategia para conseguirla. Este texto pretende ser un manual práctico para dotar a los profesionales de la salud tanto tec...

Normalization of data is a prerequisite to achieve semantic interoperability in any domain. This is even more important in the healthcare sector due to the special sensitivity of medical data: data exchange must be done in a meaningful way, avoiding any possibility of misunderstanding or misinterpretation. In this chapter, we present the LinkEHR sy...

While HL7 CDA is a widely adopted standard for the documentation of clinical information, the archetype approach proposed by CEN/ISO 13606 and openEHR is gaining recognition as a means of describing domain models and medical knowledge. This paper describes our efforts in combining both standards. Using archetypes as an alternative for defining CDA...

Possibly the most important requirement to support co-operative work among health professionals and institutions is the ability of sharing EHRs in a meaningful way, and it is widely acknowledged that standardization of data and concepts is a prerequisite to achieve semantic interoperability in any domain. Different international organizations are w...

This paper describes a solution developed for medicines reconciliation at the Hospital de Fuenlabrada in Madrid. It is based on the use of a CEN/ISO 13606 based patient summary that is shared between primary care and the hospital center. The 13606 norm and archetypes were used to achieve the semantic interoperability of the clinical information tog...

Clinical guidelines contain recommendations based on the best empirical evidence available at the moment. There is a wide consensus about the benefits of guidelines and about the fact that they should be deployed through clinical information systems, making them available during consultation time. However, one of the main obstacles to this integrat...

In this Project, a Patient Summary was implemented collecting information from three disparate heterogeneous sources: the Primary Care Electronic Health Record (EHR), the Hospital EHR and the data available in the Pharmacy Department software application. Knowing alerts, including allergies, and current treatments or certain conditions could be vit...

The comparison of the patient's current medication list with the medication being ordered when admitted to Hospital, identifying omissions, duplications, dosing errors, and potential interactions, constitutes the core process of medicines reconciliation. Access to the medication the patient is taking at home could be unfeasible as this information...

In this paper, we present the ResearchEHR project. It focuses on the usability of Electronic Health Record (EHR) sources and EHR standards for building advanced clinical systems. The aim is to support healthcare professional, institutions and authorities by providing a set of generic methods and tools for the capture, standardization, integration,...

Since the approval of the CEN EN13606 norm for the electronic health record communication, a growing interest around the application of this specification has emerged. The main objective of the norm is to serve as a mechanism to achieve the semantic interoperability of clinical data. This will require an effort to use common terminologies, to norma...

To build a semantically interoperable Electronic Health Record is one of the most challenging research fields in health informatics. In order to reach this objective, EHR standards that formally describe health data structures have to be used. CEN EN13606 is one of the most promising approaches. It covers the technical needs for semantic interopera...

To develop a powerful archetype editing framework capable of handling multiple reference models and oriented towards the semantic description and standardization of legacy data. The main prerequisite for implementing tools providing enhanced support for archetypes is the clear specification of archetype semantics. We propose a formalization of the...

The construction of a Virtual Federated Electronic Health Record (VFEHR) requires using standards, tools and an adequate technological infrastructure. We have developed LinkEHR as a framework platform for the standardization, integration and sharing of health information among distributed and heterogeneous Health Information Systems. To perform thi...

Objetivo: Analizar el papel de los arquetipos y las terminologías en la representación de estructuras de datos clínicos. Metodología: Para el dominio de la úlcera por decúbito se identificaron los conjuntos de datos en los formularios en uso de la HCE. Sobre esta especificación se editaron arquetipos, especializando arquetipos de referencia que cor...

RESUMEN Objetivo: Evaluar la utilidad de los Arquetipos ISO/CEN 13606 y openEHR en la representación de modelos clínicos detallados. Metodología: como editores de arquetipos se utilizaron LinkERH para ISO/CEN 13606 y los editores de Ocean Informatics y LiU para openEHR. Como caso de uso se representaron los conjuntos de datos identificados en los m...

Archetypes facilitate the sharing of clinical knowledge and therefore are a basic tool for achieving interoperability between healthcare information systems. In this paper, a Semantic Web System for Managing Archetypes is presented. This system allows for the semantic annotation of archetypes, as well for performing semantic searches. The current s...

We present the mapping and data transformation capabilities of LinkEHR-Ed, a visual tool to construct formal definitions of medical concepts in the form of archetypes which can be defined on the basis on multiple electronic health record architecture such as ISO 13606. With LinkEHR-Ed, users can enrich archetypes with mapping information which capt...

The International Organization for Standardization (ISO) has recently approved a new standard for the communication and semantic interoperability of electronic health record extracts. This standard is based on a dual model architecture, where a simple and generic reference model is defined for the representation of data and an archetype model is us...

Motivation Healthcare is a very data-intensive sector, producing and consuming a great amount of biomedical information. In healthcare organizations, especially hospitals, the big amount of data gets increasingly obscure due to their decentralized organization which has allowed different departments to meet specific or local requirements. This has...

In this paper we describe Pangea-LE, a message-oriented lightweight data integration engine that allows homogeneous and concurrent access to clinical information from disperse and heterogeneous data sources. The engine extracts the information and passes it to the requesting client applications in a flexible XML format. The XML response message can...

Standardization of data is a prerequisite to achieve semantic interoperability in any domain. This is even more important in the healthcare sector where the need for exchanging health related data among professional and institutions is not an exception but the rule. Currently, there are several international organizations working on the definition...

One of the basic needs for any healthcare professional is to be able to access clinical information of patients in an understandable and normalized way. The lifelong clinical information of any person supported by electronic means configures his Electronic Health Record (EHR). There are currently different standards for representing EHRs. Each stan...

One of the basic needs for any healthcare professional is to be able to access to clinical information of patients in an understandable and normalized way. The lifelong clinical information of any person supported by electronic means configures his/her Electronic Health Record (EHR). This information is usually distributed among several independent...

There are currently different standards for representing electronic healthcare records (EHR). Each standard defines its own information models, so that, in order to promote the interoperability among standard-compliant information systems, the different information models must be semantically integrated. In this work, we present an ontological appr...

Pangea-LE is a message oriented light-weight integration engine, allowing concurrent access to clinical information from disperse and heterogeneous data sources. The engine extracts the information and serves it to the requester client applications in a flexible XML format. This XML response message can be formatted on demand by the appropriate XSL...

Resumen Una de las necesidades básicas de cualquier profesional sanitario es tener acceso al registro de todos los datos clínicos disponibles de sus pacientes. Cuando esta información está en soporte informático (Historia Clínica Electrónica o HCE) normalmente está distribuida por diversos sistemas autónomos y heterogéneos cuya interopeabilidad es...

During last years great efforts have been made on Healthcare systems computerization. Those efforts are a great leap on both quantitative and qualitative patient care. However, nearly all of current developed systems are still being built ad-hoc for each organization. This makes the communication between organizations a time and money consuming tas...

The demographic information management of the patients in an information system is usually considered a secondary problem. This causes that the demographic information is scattered around the organization or stored along with the clinical information. With the standardization of the clinical information becoming a popular topic, the standardization...

Privacy of personal health information is the target of many efforts of Health Information Systems administrators. But every person has the right to gain access and control his own information security rules. In this work we propose a framework for the definition of access policies oriented to its use by the legal owners of data: the patients. At t...

A semantically interoperable Electronic Health Record (EHR) is one of the most challenging research fields of health informatics. EHR standards that formally describe health data structures are a prerequisite for sharing medical records. CEN EN13606 is one of the most promising approaches to solve this problem since it covers the technical needs fo...