Call for semantic health interoperability

“A leading UK academic has called for a new push on the development of semantic electronic health records based on ‘clinical archetypes’ as the only viable route to deliver fully interoperable electronic health care records, writes Jon Hoeksma in Slovenia.
Dr Dipak Kalra of University College London said clinical archetypes, or “clinical shapes” need to be used in tandem with the advanced clinical standards terminology of SNOMED CT to develop fully interoperable EHRs. He described archetypes as a tool “for building clinical consensus in a consistent ways”.”
Article
e-Health Europe, 6 May 2008

Semantic interoperability of EHR systems

Dipak Kalra a & Bernd Blobel b
a CHIME – Centre for Health Informatics and Multiprofessional Education, University College London, United Kingdom
b eHealth Competence Center, University of Regensburg Medical Center, Regensburg, Germany

Abstract.

This paper describes the challenges that are being tackled and those that remain to be addressed if we are to enable electronic health record information to be shared seamlessly and meaningfully. This goal is known as semantic interoperability, and is needed if computational services are to be able to interpret safely clinical data that has been integrated from diverse sources. Based on sustainable architectural approaches, the paper describes the clinical case for consistently expressed clinical meaning within electronic health records, in particular where computers rather than humans need to be able to process EHR data safely. It outlines the main kinds of information and knowledge artefact that are used to represent meaning within EHRs, and considers for each its role and limitations. The problems that arise with trying to use terminology consistently with EHR reference models is explored, together with the implications for designing EHR archetypes. Examples are given of situations where a diversity of options exists for how to represent compound (multi-part) clinical expressions. Recommendations are made for the kinds of change that are needed both in record structures and in terminology systems to minimise this diversity and thereby aid semantic interoperability.