Timothy W Cook | UFF - Universidade Federal Fluminense (original) (raw)

Books by Timothy W Cook

Research paper thumbnail of Crossing the Data Quality Chasm Using Shareable, Structured, Semantic Models

SocietyByte, 2019

Data is being collected everywhere. From the large enterprise to the mom and pop shop on the corn... more Data is being collected everywhere. From the large enterprise to the mom and pop shop on
the corner. From hospitals to all levels of government. We are storing data that we often have
no idea why we are keeping or what use it will be in the future. However, there are some
questions to ask:
● Are some of the data points you are collecting incomplete?
● Are most of your work hours devoted to massaging data?
● Do reports from your business come from tables in databases that no one seems to
understand?
●
Does data from one department look similar to data from another; but no one is sure if or
how it is connected?
If you answered yes to any of those questions, you have a data quality problem.

Research paper thumbnail of “Open Source”

“Open Source”, Cook T.W., Book Chapter in “Computerization And Going Paperless in Canadian Primar... more “Open Source”, Cook T.W., Book Chapter in “Computerization And Going Paperless in Canadian
Primary Care” (2005) Shaw, N.T. Radcliffe Medical Press ; ISBN: 1857756231

Papers by Timothy W Cook

Research paper thumbnail of Open source and international health informatics: placebo or panacea?

Journal of Innovation in Health Informatics, 2002

... Nilesh Jain DSc MBCS Primary Health Care Specialist Group of the British Computer Society, UK... more ... Nilesh Jain DSc MBCS Primary Health Care Specialist Group of the British Computer Society, UK Mike Bainbridge BMedSci BM BS MRCGP Chair of the Primary Health Care Specialist Group of the British Computer Society, UK ABSTRACT ...

Research paper thumbnail of Modelagem Multinível de Conceitos Clínicos para Apoio à Decisão ao Diagnóstico de Demência, Doença de Alzheimer e Transtorno Cognitivo Leve

This paper describes the clinical concepts modeling for a decision support system applied to clin... more This paper describes the clinical concepts modeling for a decision
support system applied to clinical diagnosis of Dementia, Alzheimer’s Disease
and Mild Cognitive Impairment. The decision model is based on a Bayesian
network, where each clinical concept is represented by a node on causal
diagram. The semantic interoperability issue is addressed using a multilevel
approach described by MLHIM (Multilevel Healthcare Information Model).
Specifications are presented and the results are discussed, focusing on the
usage of multilevel information principles to support data models designed for
clinical decision support systems.

Research paper thumbnail of Use of XML Schema Definition for the Development of Semantically Interoperable Healthcare Applications

Foundations of Health Information Engineering and Systems Lecture Notes in Computer Science Volume 8315, 2014, pp 125-145

Multilevel modeling has been proven in software as a viable solution for semantic interoperabilit... more Multilevel modeling has been proven in software as a viable solution for semantic interoperability, without imposing any specific programming languages or persistence models. The Multilevel Healthcare Information Modeling (MLHIM) specifications have adopted the XML Schema Definition 1.1 as the basis for its reference implementation, since XML technologies are consistent across all platforms and operating systems, with tools available for all mainstream programming languages. In MLHIM, the healthcare knowledge representation is defined by the Domain Model, expressed as Concept Constraint Definitions (CCDs), which provide the semantic interpretation of the objects persisted according to the generic Reference Model classes. This paper reports the implementation of the MLHIM Reference Model in XML Schema Definition language version 1.1 as well as a set of examples of CCDs generated from the National Cancer Institute – Common Data Elements (NCI CDE) repository. The set of CCDs was the base for the simulation of semantically coherent data instances, according to independent XML validators, persisted on an eXistDB database. This paper shows the feasibility of adopting XML technologies for the achievement of semantic interoperability in real healthcare scenarios, by providing application developers with a significant amount of industry experience and a wide array of tools through XML technologies.

Research paper thumbnail of ENGENHARIA DO CONHECIMENTO DE SISTEMAS DE INFORMAÇÃO EM SAÚDE COM BASE EM MODELOS MULTINÍVEL MINIMALISTAS

A manutenção em longo prazo dos registros eletrônicos de saúde dentro de seu contexto original de... more A manutenção em longo prazo dos registros eletrônicos de saúde dentro de seu contexto original de informação é uma exigência ética que conflita com a necessidade constante de migração das informações para novos sistemas, quando eles são desenvolvidos e melhorados. As especificidades de cada estabelecimento de saúde em particular excluem a viabilidade de um registro de saúde monolítico, e garantir a interoperabilidade entre os sistemas é o principal desafio enfrentado pelos pesquisadores da área de informática em saúde. Diferentes abordagens de modelagem multinível têm sido desenvolvidas para lidar com essa complexidade. No entanto, as especificações originais de modelagem multinível são direcionadas para o desenvolvimento de prontuários eletrônicos de base hospitalar, o que dificulta sua adoção para o desenvolvimento de aplicativos mais simples, com propósitos específicos, para uso em situações de saúde extra-hospitalares. Este artigo apresenta a engenharia do conhecimento de um modelo multinível minimalista que pode ser implementado por desenvolvedores para todo o espectro mais amplo de aplicações na área de saúde. Ao utilizar padrões da indústria de tecnologia da informação, esta abordagem permite uma maior adoção de tecnologias interoperáveis em saúde. Palavras-chave: Registros Eletrônicos de Saúde, Gestão do Conhecimento, Design de Programas Computacionais.

Research paper thumbnail of Open source and international health informatics: placebo or panacea?

… in Primary Care, 2001

The authors explore the history of open source software and how the future of this paradigm can a... more The authors explore the history of open source software and how the future of this paradigm can affect global changes to healthcare informatics. They identify four key requirements: 1 to establish an international health informatics open source (IHI-OS) community 2 to develop a kernel that is broad enough but also provides sufficient detail to be usable across international boundaries and across medical disciplines 3 to develop a business case for international health informatics open source 4 to develop international standards.

Research paper thumbnail of Modelagem dos Conceitos Clínicos e Psicológicos de Demências para o Diagnóstico Auxiliado por Computador

zeus.dimap.ufrn.br

A informação em saúde apresenta importantes complexidades espacial, temporal e de domínio, o que ... more A informação em saúde apresenta importantes complexidades espacial, temporal e de domínio, o que traz desafios à criação de sistemas de diagnóstico auxiliado por computador. Este artigo apresenta a estratégia de modelagem do conhecimento clínico e psicológico para um sistema de diagnóstico sindrômico de demências auxiliado por computador, baseado em modelagem multinível de sistemas de saúde. Para a modelagem do conhecimento, foram identificados os conceitos envolvidos na síndrome demencial, e foram elaborados arquétipos, de acordo com as especificações openEHR. Espera-se, com o desenvolvimento deste projeto, um melhor apoio às ações de detecção precoce de demências nos serviços de atenção básica.

Research paper thumbnail of Migração de um Sistema de Emergência Pré-Hospitalar de Cardiologia para a Modelagem Multinível

lbd.dcc.ufmg.br

Health information presents significant spatial-temporal and domain complexities, which challenge... more Health information presents significant spatial-temporal and domain complexities, which challenges the creation of citizen-centered, longitudinal, interoperable, and semantically coherent healthcare information systems. This paper presents the migration strategy of a prehospital cardiology emergency system from a relational data model to multilevel modeling. The graphic user interfaces of the original system have been preserved and matched to correspondent openEHR archetypes, and the archetype specializations needed for such matching were modeled. We expect, with the results presented in this paper, the achievement of a semantic interoperability for deployments of this system at the points of care.

Research paper thumbnail of Modeling healthcare authorization and claim submissions using the openEHR dual-model approach

BMC medical informatics and decision …, 2011

The TISS standard is a set of mandatory forms and electronic messages for healthcare authorizatio... more The TISS standard is a set of mandatory forms and electronic messages for healthcare authorization and claim submissions among healthcare plans and providers in Brazil. It is not based on formal models as the new generation of health informatics standards suggests. The objective of this paper is to model the TISS in terms of the openEHR archetype-based approach and integrate it into a patient-centered EHR architecture. Methods: Three approaches were adopted to model TISS. In the first approach, a set of archetypes was designed using ENTRY subclasses. In the second one, a set of archetypes was designed using exclusively ADMIN_ENTRY and CLUSTERs as their root classes. In the third approach, the openEHR ADMIN_ENTRY is extended with classes designed for authorization and claim submissions, and an ISM_TRANSITION attribute is added to the COMPOSITION class. Another set of archetypes was designed based on this model. For all three approaches, templates were designed to represent the TISS forms. Results: The archetypes based on the openEHR RM (Reference Model) can represent all TISS data structures. The extended model adds subclasses and an attribute to the COMPOSITION class to represent information on authorization and claim submissions. The archetypes based on all three approaches have similar structures, although rooted in different classes. The extended openEHR RM model is more semantically aligned with the concepts involved in a claim submission, but may disrupt interoperability with other systems and the current tools must be adapted to deal with it. Conclusions: Modeling the TISS standard by means of the openEHR approach makes it aligned with ISO recommendations and provides a solid foundation on which the TISS can evolve. Although there are few administrative archetypes available, the openEHR RM is expressive enough to represent the TISS standard. This paper focuses on the TISS but its results may be extended to other billing processes. A complete communication architecture to simulate the exchange of TISS data between systems according to the openEHR approach still needs to be designed and implemented.

Research paper thumbnail of Sistemas de informação em saúde: a importância do software livre e da modelagem multinível

J Bras TelesSaúde, 2012

Resumo A informação em saúde apresenta complexidades significativas em termos espaço-temporais e ... more Resumo A informação em saúde apresenta complexidades significativas em termos espaço-temporais e de domínio, o que traz desafios para o desenvolvimento de sistemas de informação em saúde centrados no paciente, interoperáveis e semanticamente coerentes. Este artigo de revisão sustenta a ideia de que a abordagem de modelagem multinível é essencial para garantir a interoperabilidade a nível semântico, mas uma verdadeira interoperabilidade só é obtida com a adoção de padrões abertos, e implementações de código aberto são necessárias para promover a concorrência com base na qualidade do software. As especificações Multilevel Healthcare Information Modeling (MLHIM) são apresentadas, como uma referência para a modelagem multinível totalmente baseada em software livre, e são sugeridas boas práticas para o desenvolvimento de aplicativos para a área de saúde baseados em modelagem multinível e software livre.

Research paper thumbnail of ENGENHARIA DO CONHECIMENTO DE SISTEMAS DE INFORMAÇÃO EM SAÚDE COM BASE EM MODELOS MULTINÍVEL MINIMALISTAS

J Bras Tele, 2013

A manutenção em longo prazo dos registros eletrônicos de saúde dentro de seu contexto original de... more A manutenção em longo prazo dos registros eletrônicos de saúde dentro de seu contexto original de informação é uma exigência ética que conflita com a necessidade constante de migração das informações para novos sistemas, quando eles são desenvolvidos e melhorados. As especificidades de cada estabelecimento de saúde em particular excluem a viabilidade de um registro de saúde monolítico, e garantir a interoperabilidade entre os sistemas é o principal desafio enfrentado pelos pesquisadores da área de informática em saúde. Diferentes abordagens de modelagem multinível têm sido desenvolvidas para lidar com essa complexidade. No entanto, as especificações originais de modelagem multinível são direcionadas para o desenvolvimento de prontuários eletrônicos de base hospitalar, o que dificulta sua adoção para o desenvolvimento de aplicativos mais simples, com propósitos específicos, para uso em situações de saúde extra-hospitalares. Este artigo apresenta a engenharia do conhecimento de um modelo multinível minimalista que pode ser implementado por desenvolvedores para todo o espectro mais amplo de aplicações na área de saúde. Ao utilizar padrões da indústria de tecnologia da informação, esta abordagem permite uma maior adoção de tecnologias interoperáveis em saúde. Palavras-chave: Registros Eletrônicos de Saúde, Gestão do Conhecimento, Design de Programas Computacionais.

Research paper thumbnail of HARMONIZAÇÃO DE TERMINOLOGIAS DE ENFERMAGEM MEDIADA POR MODELAGEM MULTINÍVEL: UM ESTUDO DE CASO

sbis.org.br

Resumo: Terminologias são frequentemente utilizadas na padronização de sistemas de informação de ... more Resumo: Terminologias são frequentemente utilizadas na padronização de sistemas de informação de enfermagem, para a obtenção de interoperabilidade semântica entre os registros. Entretanto, esta abordagem não tem sido suficiente para o alcance desta meta. Este trabalho apresenta um caso de harmonização de terminologias de enfermagem seguida pela representação de conceitos clínicos de acordo com os princípios de modelagem multinível. O modelo Fehring de diagnóstico da diminuição do débito cardíaco baseado na terminologia da North American Nursing Diagnosis Association (NANDA) foi mapeado a termos da Classificação Internacional para a Prática de Enfermagem (CIPE). Os conceitos mapeados foram modelados como arquétipos e Concept Constraint Definitions (CCDs), de acordo, respectivamente, com as especificações openEHR e MLHIM. O mapeamento entre as terminologias resultou incompleto; porém, todos os conceitos do modelo Fehring foram modelados em arquétipos e CCDs. Este trabalho demonstrou a capacidade da modelagem multinível de harmonizar terminologias de enfermagem que não são totalmente compatíveis Palavras-chave: Terminologia como Assunto, Registros Eletrônicos de Saúde, Informática em Enfermagem.

Research paper thumbnail of Multiculturalism and semantic interoperability in electronic health records: a W3C standard-based implementation

Research paper thumbnail of Constraint Definition Generator: an Open Source Tool for Multilevel Modeling of Healthcare Information Systems

sbis.org.br

Resumo: As especificações de modelagem multinível foram concebidas para enfrentar os desafios rel... more Resumo: As especificações de modelagem multinível foram concebidas para enfrentar os desafios relacionados à natureza distribuída e diversificada dos sistemas de informação de saúde. As especificações Multilevel Healthcare Information Modeling (MLHIM) definem um modelo multinível minimalista compatível com o padrão W3C XML capaz de garantir interoperabilidade semântica entre diferentes aplicações da área de saúde, incluindo sistemas legados. As ferramentas de modelagem de conhecimento são essenciais para permitir a implementação de aplicativos baseados em modelagem multinível para serviços de saúde reais, mas existem poucas iniciativas neste sentido. Nós desenvolvemos o Constraint Definition Generator, um aplicativo Python baseado em software livre que cria os arquivos XSD dos Concept Constraint Definition (CCDs) necessários para a modelagem de conhecimento nas especificações MLHIM. Aspectos teóricos dos CCDs e do processo de implementação do CDG são apresentados Palavras-chave: Registros Eletrônicos de Saúde, Modelos Estruturais, Software. Abstract: Multilevel modeling specifications were conceived to face the challenges related to the distributed and diverse nature of healthcare information systems. The Multilevel Healthcare Information Modeling (MLHIM) specifications define a W3C XML-compliant minimalist multilevel model that has the ability to ensure semantic interoperability among different health applications, including legacy systems. Knowledge modeling tools are essential for allowing the implementation of multilevel modeling-based applications in real healthcare settings, but there are few initiatives in this direction. We developed the Constraint Definition Generator, an open source Python application that creates the Concept Constraint Definition (CCDs) XSD files required for knowledge modeling in the MLHIM specifications. Theoretical aspects of CCDs and the CDG implementation process are presented

Research paper thumbnail of Implementing a specification for exceptional data in multilevel modeling of healthcare applications

Research paper thumbnail of Knowledge engineering of healthcare applications based on minimalist multilevel models

e-Health Networking, Applications and …, 2012

Research paper thumbnail of Modeling of nursing knowledge for multilevel information systems

Research paper thumbnail of Migration of a pre-hospital cardiology emergency system from data model to multilevel modeling

Research paper thumbnail of Health informatics: the relevance of open source and multilevel modeling

Open Source Systems: Grounding Research, 2011

Research paper thumbnail of Crossing the Data Quality Chasm Using Shareable, Structured, Semantic Models

SocietyByte, 2019

Data is being collected everywhere. From the large enterprise to the mom and pop shop on the corn... more Data is being collected everywhere. From the large enterprise to the mom and pop shop on
the corner. From hospitals to all levels of government. We are storing data that we often have
no idea why we are keeping or what use it will be in the future. However, there are some
questions to ask:
● Are some of the data points you are collecting incomplete?
● Are most of your work hours devoted to massaging data?
● Do reports from your business come from tables in databases that no one seems to
understand?
●
Does data from one department look similar to data from another; but no one is sure if or
how it is connected?
If you answered yes to any of those questions, you have a data quality problem.

Research paper thumbnail of “Open Source”

“Open Source”, Cook T.W., Book Chapter in “Computerization And Going Paperless in Canadian Primar... more “Open Source”, Cook T.W., Book Chapter in “Computerization And Going Paperless in Canadian
Primary Care” (2005) Shaw, N.T. Radcliffe Medical Press ; ISBN: 1857756231

Research paper thumbnail of Open source and international health informatics: placebo or panacea?

Journal of Innovation in Health Informatics, 2002

... Nilesh Jain DSc MBCS Primary Health Care Specialist Group of the British Computer Society, UK... more ... Nilesh Jain DSc MBCS Primary Health Care Specialist Group of the British Computer Society, UK Mike Bainbridge BMedSci BM BS MRCGP Chair of the Primary Health Care Specialist Group of the British Computer Society, UK ABSTRACT ...

Research paper thumbnail of Modelagem Multinível de Conceitos Clínicos para Apoio à Decisão ao Diagnóstico de Demência, Doença de Alzheimer e Transtorno Cognitivo Leve

This paper describes the clinical concepts modeling for a decision support system applied to clin... more This paper describes the clinical concepts modeling for a decision
support system applied to clinical diagnosis of Dementia, Alzheimer’s Disease
and Mild Cognitive Impairment. The decision model is based on a Bayesian
network, where each clinical concept is represented by a node on causal
diagram. The semantic interoperability issue is addressed using a multilevel
approach described by MLHIM (Multilevel Healthcare Information Model).
Specifications are presented and the results are discussed, focusing on the
usage of multilevel information principles to support data models designed for
clinical decision support systems.

Research paper thumbnail of Use of XML Schema Definition for the Development of Semantically Interoperable Healthcare Applications

Foundations of Health Information Engineering and Systems Lecture Notes in Computer Science Volume 8315, 2014, pp 125-145

Multilevel modeling has been proven in software as a viable solution for semantic interoperabilit... more Multilevel modeling has been proven in software as a viable solution for semantic interoperability, without imposing any specific programming languages or persistence models. The Multilevel Healthcare Information Modeling (MLHIM) specifications have adopted the XML Schema Definition 1.1 as the basis for its reference implementation, since XML technologies are consistent across all platforms and operating systems, with tools available for all mainstream programming languages. In MLHIM, the healthcare knowledge representation is defined by the Domain Model, expressed as Concept Constraint Definitions (CCDs), which provide the semantic interpretation of the objects persisted according to the generic Reference Model classes. This paper reports the implementation of the MLHIM Reference Model in XML Schema Definition language version 1.1 as well as a set of examples of CCDs generated from the National Cancer Institute – Common Data Elements (NCI CDE) repository. The set of CCDs was the base for the simulation of semantically coherent data instances, according to independent XML validators, persisted on an eXistDB database. This paper shows the feasibility of adopting XML technologies for the achievement of semantic interoperability in real healthcare scenarios, by providing application developers with a significant amount of industry experience and a wide array of tools through XML technologies.

Research paper thumbnail of ENGENHARIA DO CONHECIMENTO DE SISTEMAS DE INFORMAÇÃO EM SAÚDE COM BASE EM MODELOS MULTINÍVEL MINIMALISTAS

A manutenção em longo prazo dos registros eletrônicos de saúde dentro de seu contexto original de... more A manutenção em longo prazo dos registros eletrônicos de saúde dentro de seu contexto original de informação é uma exigência ética que conflita com a necessidade constante de migração das informações para novos sistemas, quando eles são desenvolvidos e melhorados. As especificidades de cada estabelecimento de saúde em particular excluem a viabilidade de um registro de saúde monolítico, e garantir a interoperabilidade entre os sistemas é o principal desafio enfrentado pelos pesquisadores da área de informática em saúde. Diferentes abordagens de modelagem multinível têm sido desenvolvidas para lidar com essa complexidade. No entanto, as especificações originais de modelagem multinível são direcionadas para o desenvolvimento de prontuários eletrônicos de base hospitalar, o que dificulta sua adoção para o desenvolvimento de aplicativos mais simples, com propósitos específicos, para uso em situações de saúde extra-hospitalares. Este artigo apresenta a engenharia do conhecimento de um modelo multinível minimalista que pode ser implementado por desenvolvedores para todo o espectro mais amplo de aplicações na área de saúde. Ao utilizar padrões da indústria de tecnologia da informação, esta abordagem permite uma maior adoção de tecnologias interoperáveis em saúde. Palavras-chave: Registros Eletrônicos de Saúde, Gestão do Conhecimento, Design de Programas Computacionais.

Research paper thumbnail of Open source and international health informatics: placebo or panacea?

… in Primary Care, 2001

The authors explore the history of open source software and how the future of this paradigm can a... more The authors explore the history of open source software and how the future of this paradigm can affect global changes to healthcare informatics. They identify four key requirements: 1 to establish an international health informatics open source (IHI-OS) community 2 to develop a kernel that is broad enough but also provides sufficient detail to be usable across international boundaries and across medical disciplines 3 to develop a business case for international health informatics open source 4 to develop international standards.

Research paper thumbnail of Modelagem dos Conceitos Clínicos e Psicológicos de Demências para o Diagnóstico Auxiliado por Computador

zeus.dimap.ufrn.br

A informação em saúde apresenta importantes complexidades espacial, temporal e de domínio, o que ... more A informação em saúde apresenta importantes complexidades espacial, temporal e de domínio, o que traz desafios à criação de sistemas de diagnóstico auxiliado por computador. Este artigo apresenta a estratégia de modelagem do conhecimento clínico e psicológico para um sistema de diagnóstico sindrômico de demências auxiliado por computador, baseado em modelagem multinível de sistemas de saúde. Para a modelagem do conhecimento, foram identificados os conceitos envolvidos na síndrome demencial, e foram elaborados arquétipos, de acordo com as especificações openEHR. Espera-se, com o desenvolvimento deste projeto, um melhor apoio às ações de detecção precoce de demências nos serviços de atenção básica.

Research paper thumbnail of Migração de um Sistema de Emergência Pré-Hospitalar de Cardiologia para a Modelagem Multinível

lbd.dcc.ufmg.br

Health information presents significant spatial-temporal and domain complexities, which challenge... more Health information presents significant spatial-temporal and domain complexities, which challenges the creation of citizen-centered, longitudinal, interoperable, and semantically coherent healthcare information systems. This paper presents the migration strategy of a prehospital cardiology emergency system from a relational data model to multilevel modeling. The graphic user interfaces of the original system have been preserved and matched to correspondent openEHR archetypes, and the archetype specializations needed for such matching were modeled. We expect, with the results presented in this paper, the achievement of a semantic interoperability for deployments of this system at the points of care.

Research paper thumbnail of Modeling healthcare authorization and claim submissions using the openEHR dual-model approach

BMC medical informatics and decision …, 2011

The TISS standard is a set of mandatory forms and electronic messages for healthcare authorizatio... more The TISS standard is a set of mandatory forms and electronic messages for healthcare authorization and claim submissions among healthcare plans and providers in Brazil. It is not based on formal models as the new generation of health informatics standards suggests. The objective of this paper is to model the TISS in terms of the openEHR archetype-based approach and integrate it into a patient-centered EHR architecture. Methods: Three approaches were adopted to model TISS. In the first approach, a set of archetypes was designed using ENTRY subclasses. In the second one, a set of archetypes was designed using exclusively ADMIN_ENTRY and CLUSTERs as their root classes. In the third approach, the openEHR ADMIN_ENTRY is extended with classes designed for authorization and claim submissions, and an ISM_TRANSITION attribute is added to the COMPOSITION class. Another set of archetypes was designed based on this model. For all three approaches, templates were designed to represent the TISS forms. Results: The archetypes based on the openEHR RM (Reference Model) can represent all TISS data structures. The extended model adds subclasses and an attribute to the COMPOSITION class to represent information on authorization and claim submissions. The archetypes based on all three approaches have similar structures, although rooted in different classes. The extended openEHR RM model is more semantically aligned with the concepts involved in a claim submission, but may disrupt interoperability with other systems and the current tools must be adapted to deal with it. Conclusions: Modeling the TISS standard by means of the openEHR approach makes it aligned with ISO recommendations and provides a solid foundation on which the TISS can evolve. Although there are few administrative archetypes available, the openEHR RM is expressive enough to represent the TISS standard. This paper focuses on the TISS but its results may be extended to other billing processes. A complete communication architecture to simulate the exchange of TISS data between systems according to the openEHR approach still needs to be designed and implemented.

Research paper thumbnail of Sistemas de informação em saúde: a importância do software livre e da modelagem multinível

J Bras TelesSaúde, 2012

Resumo A informação em saúde apresenta complexidades significativas em termos espaço-temporais e ... more Resumo A informação em saúde apresenta complexidades significativas em termos espaço-temporais e de domínio, o que traz desafios para o desenvolvimento de sistemas de informação em saúde centrados no paciente, interoperáveis e semanticamente coerentes. Este artigo de revisão sustenta a ideia de que a abordagem de modelagem multinível é essencial para garantir a interoperabilidade a nível semântico, mas uma verdadeira interoperabilidade só é obtida com a adoção de padrões abertos, e implementações de código aberto são necessárias para promover a concorrência com base na qualidade do software. As especificações Multilevel Healthcare Information Modeling (MLHIM) são apresentadas, como uma referência para a modelagem multinível totalmente baseada em software livre, e são sugeridas boas práticas para o desenvolvimento de aplicativos para a área de saúde baseados em modelagem multinível e software livre.

Research paper thumbnail of ENGENHARIA DO CONHECIMENTO DE SISTEMAS DE INFORMAÇÃO EM SAÚDE COM BASE EM MODELOS MULTINÍVEL MINIMALISTAS

J Bras Tele, 2013

A manutenção em longo prazo dos registros eletrônicos de saúde dentro de seu contexto original de... more A manutenção em longo prazo dos registros eletrônicos de saúde dentro de seu contexto original de informação é uma exigência ética que conflita com a necessidade constante de migração das informações para novos sistemas, quando eles são desenvolvidos e melhorados. As especificidades de cada estabelecimento de saúde em particular excluem a viabilidade de um registro de saúde monolítico, e garantir a interoperabilidade entre os sistemas é o principal desafio enfrentado pelos pesquisadores da área de informática em saúde. Diferentes abordagens de modelagem multinível têm sido desenvolvidas para lidar com essa complexidade. No entanto, as especificações originais de modelagem multinível são direcionadas para o desenvolvimento de prontuários eletrônicos de base hospitalar, o que dificulta sua adoção para o desenvolvimento de aplicativos mais simples, com propósitos específicos, para uso em situações de saúde extra-hospitalares. Este artigo apresenta a engenharia do conhecimento de um modelo multinível minimalista que pode ser implementado por desenvolvedores para todo o espectro mais amplo de aplicações na área de saúde. Ao utilizar padrões da indústria de tecnologia da informação, esta abordagem permite uma maior adoção de tecnologias interoperáveis em saúde. Palavras-chave: Registros Eletrônicos de Saúde, Gestão do Conhecimento, Design de Programas Computacionais.

Research paper thumbnail of HARMONIZAÇÃO DE TERMINOLOGIAS DE ENFERMAGEM MEDIADA POR MODELAGEM MULTINÍVEL: UM ESTUDO DE CASO

sbis.org.br

Resumo: Terminologias são frequentemente utilizadas na padronização de sistemas de informação de ... more Resumo: Terminologias são frequentemente utilizadas na padronização de sistemas de informação de enfermagem, para a obtenção de interoperabilidade semântica entre os registros. Entretanto, esta abordagem não tem sido suficiente para o alcance desta meta. Este trabalho apresenta um caso de harmonização de terminologias de enfermagem seguida pela representação de conceitos clínicos de acordo com os princípios de modelagem multinível. O modelo Fehring de diagnóstico da diminuição do débito cardíaco baseado na terminologia da North American Nursing Diagnosis Association (NANDA) foi mapeado a termos da Classificação Internacional para a Prática de Enfermagem (CIPE). Os conceitos mapeados foram modelados como arquétipos e Concept Constraint Definitions (CCDs), de acordo, respectivamente, com as especificações openEHR e MLHIM. O mapeamento entre as terminologias resultou incompleto; porém, todos os conceitos do modelo Fehring foram modelados em arquétipos e CCDs. Este trabalho demonstrou a capacidade da modelagem multinível de harmonizar terminologias de enfermagem que não são totalmente compatíveis Palavras-chave: Terminologia como Assunto, Registros Eletrônicos de Saúde, Informática em Enfermagem.

Research paper thumbnail of Multiculturalism and semantic interoperability in electronic health records: a W3C standard-based implementation

Research paper thumbnail of Constraint Definition Generator: an Open Source Tool for Multilevel Modeling of Healthcare Information Systems

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Resumo: As especificações de modelagem multinível foram concebidas para enfrentar os desafios rel... more Resumo: As especificações de modelagem multinível foram concebidas para enfrentar os desafios relacionados à natureza distribuída e diversificada dos sistemas de informação de saúde. As especificações Multilevel Healthcare Information Modeling (MLHIM) definem um modelo multinível minimalista compatível com o padrão W3C XML capaz de garantir interoperabilidade semântica entre diferentes aplicações da área de saúde, incluindo sistemas legados. As ferramentas de modelagem de conhecimento são essenciais para permitir a implementação de aplicativos baseados em modelagem multinível para serviços de saúde reais, mas existem poucas iniciativas neste sentido. Nós desenvolvemos o Constraint Definition Generator, um aplicativo Python baseado em software livre que cria os arquivos XSD dos Concept Constraint Definition (CCDs) necessários para a modelagem de conhecimento nas especificações MLHIM. Aspectos teóricos dos CCDs e do processo de implementação do CDG são apresentados Palavras-chave: Registros Eletrônicos de Saúde, Modelos Estruturais, Software. Abstract: Multilevel modeling specifications were conceived to face the challenges related to the distributed and diverse nature of healthcare information systems. The Multilevel Healthcare Information Modeling (MLHIM) specifications define a W3C XML-compliant minimalist multilevel model that has the ability to ensure semantic interoperability among different health applications, including legacy systems. Knowledge modeling tools are essential for allowing the implementation of multilevel modeling-based applications in real healthcare settings, but there are few initiatives in this direction. We developed the Constraint Definition Generator, an open source Python application that creates the Concept Constraint Definition (CCDs) XSD files required for knowledge modeling in the MLHIM specifications. Theoretical aspects of CCDs and the CDG implementation process are presented

Research paper thumbnail of Implementing a specification for exceptional data in multilevel modeling of healthcare applications

Research paper thumbnail of Knowledge engineering of healthcare applications based on minimalist multilevel models

e-Health Networking, Applications and …, 2012

Research paper thumbnail of Modeling of nursing knowledge for multilevel information systems

Research paper thumbnail of Migration of a pre-hospital cardiology emergency system from data model to multilevel modeling

Research paper thumbnail of Health informatics: the relevance of open source and multilevel modeling

Open Source Systems: Grounding Research, 2011

Research paper thumbnail of Where the Context Lies

A discussion on semantic interoperability in health information systems.

Research paper thumbnail of Contextual Persistence in Complex Information Systems: An analysis of storing and retrieving information in an electronic health record.

This thesis is the result of a qualitative research study undertaken in order to determine a well... more This thesis is the result of a qualitative research study undertaken in order to
determine a well defined theory for choosing the correct data storage model for
healthcare data as used in electronic health records. The researcher views an
electronic health record application from the point of view of the patient as a primary
care patient. This perspective is analogous to the current system in place with paper
records in many Western countries. The primary care (family physician) maintains a
record that is the point of consolidation of all of the patient's healthcare issues. It
will contain information such as hospital discharge summaries, immunizations,
reports from other healthcare/medical specialists and other care providers. The
family physician and / or the patient is the single point where all of this information
will ever come together. The results of this study indicate that while any type of
storage philosophy may be deployed for electronic health records, there are certainly
trade-offs as far as performance both in the short term and the long term. The key
issues revealed are the long term (many years) of contextual integrity that must be
maintained and the application and database maintenance costs of various approaches
over time.

Research paper thumbnail of Innovation in Healthcare IT Standards: The Path to Big Data Interchange

Research paper thumbnail of Use of XML Schema Definition for the Development of Semantically Interoperable Healthcare Applications

Multilevel modeling has been proven in software as a viable solution for semantic interoperabilit... more Multilevel modeling has been proven in software as a viable solution for semantic interoperability, without imposing any specific programming languages or persistence models. The Multilevel Healthcare Information Modeling (MLHIM) specifications have adopted the XML Schema Definition 1.1 as the basis for its reference implementation, since XML technologies are consistent across all platforms and operating systems, with tools available for all mainstream programming languages. In MLHIM, the healthcare knowledge representation is defined by the Domain Model, expressed as Concept Constraint Definitions (CCDs), which provide the semantic interpretation of the objects persisted according to the generic Reference Model classes. This paper reports the implementation of the MLHIM Reference Model in XML Schema Definition language version 1.1 as well as a set of examples of CCDs generated from the National Cancer Institute – Common Data Elements (NCI CDE) repository. The set of CCDs was the base for the simulation of semantically coherent data instances, according to independent XML validators, persisted on an eXistDB database. This paper shows the feasibility of adopting XML technologies for the achievement of semantic interoperability in real healthcare scenarios, by providing application developers with a significant amount of industry experience and a wide array of tools through XML technologies.

Research paper thumbnail of Implementing openEHR

Implementing the openEHR specifications ( http://www.openehr.org ) within a Python web framework.

Research paper thumbnail of openEHR Workshop

Overview of the openEHR specifications. http://www.openehr.org

Research paper thumbnail of Health Informatics Workshop

Two week workshop of presentations on health informatics and the openEHR specifications with hand... more Two week workshop of presentations on health informatics and the openEHR specifications with hands on laboratory experience with the Open Source Health Information Platform (OSHIP) https://launchpad.net/oship/

Research paper thumbnail of Interoperability with Health Information Systems

Issues in semantic interoperability between health information systems.

Research paper thumbnail of Vocabulary Management in openEHR Archetypes

Vocabulary Management in openEHR Archetypes (2007) WHO Global Health Data Standards Workshop, Nai... more Vocabulary Management in openEHR Archetypes (2007) WHO Global Health Data Standards
Workshop, Nairobi, Kenya

Research paper thumbnail of “Economic Sustainability of Open Source in Healthcare Applications”

“Economic Sustainability of Open Source in Healthcare Applications” (2005) Invited Presentation, ... more “Economic Sustainability of Open Source in Healthcare Applications” (2005) Invited Presentation,
University of British Columbia and Children and Women’s Hospital Business Development Group,
Vancouver, BC Canada

Research paper thumbnail of “Does Free and Open Source Software Really Mean Free for General Practice Computerization?”

“Does Free and Open Source Software Really Mean Free for General Practice Computerization?” (2004... more “Does Free and Open Source Software Really Mean Free for General Practice Computerization?”
(2004) Refereed Presentation, World Organization of Family Doctors (WONCA), Orlando, FL USA

Research paper thumbnail of “Using an Open Source EMR”

“Using an Open Source EMR” (2004) CPD Accredited Tutorial, American College of Physicians, New Or... more “Using an Open Source EMR” (2004) CPD Accredited Tutorial, American College of Physicians,
New Orleans, LA USA

Research paper thumbnail of “Open Source Application Success in Healthcare”

“Open Source Application Success in Healthcare” (2004) Panel Moderator, 11th World Congress on Me... more “Open Source Application Success in Healthcare” (2004) Panel Moderator, 11th World Congress on
Medical Informatics (MEDINFO), San Francisco, CA USA

Research paper thumbnail of “Using Scripting Languages for Rapid, Web-based EMR Development”

“Using Scripting Languages for Rapid, Web-based EMR Development”, (1999) Invited Presentation, Mi... more “Using Scripting Languages for Rapid, Web-based EMR Development”, (1999) Invited Presentation,
Minoru Development Corporation Open Source Retreat, Toronto, ON, Canada

Research paper thumbnail of “Introduction to an Open Source EMR”

“Introduction to an Open Source EMR” (2004) Refereed Presentation, American College of Physicians... more “Introduction to an Open Source EMR” (2004) Refereed Presentation, American College of
Physicians, New Orleans, LA USA

Research paper thumbnail of “Open Source Software in Healthcare”

“Open Source Software in Healthcare” (2001) Panel Member, American Medical Informatics Assn., Was... more “Open Source Software in Healthcare” (2001) Panel Member, American Medical Informatics Assn.,
Washington, D.C. USA

Research paper thumbnail of “Using RFID to Track Patients and Equipment in a Primary Care Clinic”

“Using RFID to Track Patients and Equipment in a Primary Care Clinic” (2002) Invited Presentation... more “Using RFID to Track Patients and Equipment in a Primary Care Clinic” (2002) Invited
Presentation, Bedrock Clinical Investors Conference, Houston, TX USA

Research paper thumbnail of “The Dangers of Relational Database Vocabularies in Long Term EMR Usage”

“The Dangers of Relational Database Vocabularies in Long Term EMR Usage” (2002) Invited Presentat... more “The Dangers of Relational Database Vocabularies in Long Term EMR Usage” (2002) Invited
Presentation, Fresno III Open Source Retreat, Fresno, CA USA

Research paper thumbnail of “Integrating Relational Data Vocabulary in an Object Database EMR”

“Integrating Relational Data Vocabulary in an Object Database EMR” (2001) Invited Presentation, F... more “Integrating Relational Data Vocabulary in an Object Database EMR” (2001) Invited Presentation,
Fresno II Open Source Retreat, Fresno, CA USA

Research paper thumbnail of “Web-based EMR Demonstration”

“Web-based EMR Demonstration” (2000) Tutorial, American Medical Informatics Assn., Los Angles, CA... more “Web-based EMR Demonstration” (2000) Tutorial, American Medical Informatics Assn., Los
Angles, CA USA

Research paper thumbnail of “Using Web Protocols to Exchange Health Record Data”

“Using Web Protocols to Exchange Health Record Data” (2000) Invited Presentation, Fresno I Open S... more “Using Web Protocols to Exchange Health Record Data” (2000) Invited Presentation, Fresno I Open
Source Retreat, Fresno, CA USA

Research paper thumbnail of “Using Object Databases in Healthcare Applications”

“Using Object Databases in Healthcare Applications” (2000) Invited Presentation, Fresno I Open So... more “Using Object Databases in Healthcare Applications” (2000) Invited Presentation, Fresno I Open
Source Retreat, Fresno, CA USA