Healthc Inform Res.  2014 Jul;20(3):163-172. 10.4258/hir.2014.20.3.163.

Detailed Clinical Models: Representing Knowledge, Data and Semantics in Healthcare Information Technology

• Goossen WT

• KMID: 2284579
• DOI: http://doi.org/10.4258/hir.2014.20.3.163

Abstract

OBJECTIVES
This paper will present an overview of the developmental effort in harmonizing clinical knowledge modeling using the Detailed Clinical Models (DCMs), and will explain how it can contribute to the preservation of Electronic Health Records (EHR) data.
METHODS
Clinical knowledge modeling is vital for the management and preservation of EHR and data. Such modeling provides common data elements and terminology binding with the intention of capturing and managing clinical information over time and location independent from technology. Any EHR data exchange without an agreed clinical knowledge modeling will potentially result in loss of information.
RESULTS
Many attempts exist from the past to model clinical knowledge for the benefits of semantic interoperability using standardized data representation and common terminologies. The objective of each project is similar with respect to consistent representation of clinical data, using standardized terminologies, and an overall logical approach. However, the conceptual, logical, and the technical expressions are quite different in one clinical knowledge modeling approach versus another. There currently are synergies under the Clinical Information Modeling Initiative (CIMI) in order to create a harmonized reference model for clinical knowledge models.
CONCLUSIONS
The goal for the CIMI is to create a reference model and formalisms based on for instance the DCM (ISO/TS 13972), among other work. A global repository of DCMs may potentially be established in the future.

Keyword

Electronic Health Records; Knowledge; Semantics; Artificial Intelligence; Medical Informatics

MeSH Terms

Artificial Intelligence
Delivery of Health Care*
Electronic Health Records
Intention
Logic
Medical Informatics
Semantics*

Figure

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  Figure 1 Two level modeling in Detailed Clinical Models (DCMs).

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  Figure 2 A three-dimensional architectural approach in Detailed Clinical Models (DCMs).

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  Figure 3 Example of Detailed Clinical Models used for registration and reporting.

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  Figure 4 Glasgow Coma Scale archetype fragment.

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  Figure 5 Glasgow Coma Scale represented in Health Level 7 version 3 Reference Information Model classes.

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  Figure 6 Glasgow Coma Scale in Health Level 7 version 3 eXtensible Markup Language (XML) formalism (derived from the classes in Figure 5).

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  Figure 7 Detailed Clinical Models (DCMs) in Unified Modeling Language of the Glasgow Coma Scale (2014 revised but unpublished version).

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  Figure 8 Glasgow Coma Scale fragments presented in Fast Healthcare Interoperability Resources eXtensible Markup Language (XML).

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