Untangle the Web: Communicating Through the Web Services Using Semantics Asuman Dogac METU, Turkey Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 1/36
The Interoperability Problem in the Healthcare Domain Can be investigated in the following categories: – Interoperability of the healthcare messages exchanged (HL 7 v 3, HL 7 v 2, Proprietary messages…) – Interoperability of Electronic Healthcare Records (EHRs): HL 7 CDA, CEN EHRcom, open. EHR – Interoperability of Coded Terms (ICD 10, SNOMED, …) – Interoperability of Patient Identifiers, Healthcare Business Processes, Clinical Guide Lines, … Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 2
Exchanging Messages Interface Engine HL 7 -I 12 Patient Referral ^ 12345 john ^ smith 11011010 Network 12345 smith (e. g. , VAN) john Application 1: HIS Database and back end applications Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 Application 2: HIS Database and back end applications 3
Ability to Communicate: Bits Running on the Wires… Transport Protocols: TCP/IP, VAN Network Protocols: HTTP, EDI Transport Binding: Simple Object Access Protocol (SOAP) – Web Services and eb. XML messaging use SOAP – HL 7 approved Web Services and eb. XML as DSTU – IHE XDS uses eb. XML Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 4
SOAP is Important… Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 5
Why Use Web Services? Web services are application functions that can be programmatically invoked over the Internet Advantages of Web services: – They are supported by every major corporation – They have a flexible core language which is XML – Two universally accepted standards: Web Services Description Language (WSDL), and, Simple Object Access Protocol (SOAP) Web services exploit the ubiquity and access simplicity of the Internet Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 6
The Use of Web Services in the Healthcare Domain… IHE has developed Retrieve Information for Display (RID) Profile as a set of Web services The Netherlands Institute for ICT in Healthcare (NICTIZ) has implemented the Dutch national infrastructure for healthcare messaging by wrapping HL 7 v 3 messages as Web services Also, Health Level Seven (HL 7) has announced the approval of a Web Services Profile as Draft Standards for Trial Use (DSTUs) as Version 3 Transport Specifications within the HL 7 Messaging Standard in May 2004 Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 7
Communicating through Web Services HL 7 -I 12 <patient> <id> <name> </id> HL 7 -I 12 Referral Patient <patient> Web Service <id> </id> 12345 <name> john </name> <surname> </surname> 11011010 </patient> </surname> </patient> smith HTTP over TCP/IP 12345 smith john Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 8
Example: Deploying an Existing Application as Web Service “Retrieve. Critical. Healthcare. Data” functionality of Care 2 x: A public domain HIS used in many countries A Care 2 x SQL Query: SELECT * FROM care_encounter CE, WHERE CP. pid=patientpid Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 9
Example: Deploying an Existing Application as Web Service Prepare the WSDL file: – Determine operation, e. g. , Retrieve. Critical. Health. Care. Data – Specify Input and Output Parameters – Specify how it will be accessed, i. e. , transport binding like SOAP – Specify endpoint where the Web service will be deployed and invoked – Deploy it to a Web Container Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 10
Example: Exposing Care 2 x “RCHD” as a Web Service Implementation public void SQL Query retrieve. Critical. Healthcare. Data() { Select * From Select * care_encounter CE From care_encounter CE Where CE. pid=pid } WSDL Interface Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 11
Example: Invoking Care 2 x “RCHD” Web service Process Client Request Web Retrieve. Critical. H Container ealthcare. Data Return Output Message <RCHDOutput. Message> <result>Patient Encounter</result> </APOutput. Message> Prepare Output Message Asuman Dogac <RCHDInput. Message>. . . <local. Patient. ID>10000101 </local. Patient. ID> Building SQL Update Query Web Service Extracting and Formatting Information 10000101: int SELECT * FROM care_encounter CE WHERE CE. pid=10000101 Patient Encounters: Result HIMSS 2006, San Diego, Feb. 16, 2006 Care 2 x Data. Base 12
IHE Retrieve Information for Display (RID) Two Web services : – Retrieve Specific Information: Patient centric: patient ID Type of Request Date, Time, n. Most. Recent – Retrieve a Document Object Unique Instance Identifier (OID) Type of Request Content Type Expected Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 13
IHE Retrieve Information for Display Persistent Document Types of Requests • Summary of All Reports • Summary of Laboratory Reports • Summary of Radiology Reports • Summary of Cardiology. Info for Display Retrieve Specific Reports Retrieve Document for • Summary of Surgery Reports. Display • Summary of Intensive Care Reports • Summary of Emergency Reports • Summary of Discharge Reports IHE-RID WSDL • List of Allergies <? xml version="1. 0" encoding="utf 8"? > <definitions xmlns: http="http: //schemas. xmlsoap. org/wsdl/http/" xmlns: s="http: //www. w 3. org/2001/XMLSchema" • List of Medications xmlns: s 0="http: //rsna. org/ihe/IHERetrieve. For. Display" target. Namespace="http: //rsna. org/ihe/IHERetrieve. For. Display" xmlns="http: //schemas. xmlsoap. org/wsdl/"> <types> <s: schema element. Form. Default="qualified" target. Namespace="http: //rsna. org/ihe/IHERetrieve. For. Display"> <s: simple. Type name="summary. Request. Type"> <s: restriction base="s: string"> <s: enumeration value="SUMMARY" /> <s: enumeration value="SUMMARY-RADIOLOGY" /> ………… Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 14
Functional Interoperability Ability of two or more applications to exchange information Achieved by fixing – Network protocols such as Internet or Value Added Networks; – The application protocols and transport bindings such as HTTP, FTP, SMTP and SOAP – The message format like HL 7 v 3 What if applications use different message standards? Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 15
Interoperability of Message Standards Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 16
Semantic Interoperability Ability for information shared by systems to be understood through formally defined domain concepts Annotating the information to be shared through ontologies and performing semantic mediation Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 17
How do we achieve semantic interoperability through Web services? Annotating Web service functionality through ontologies Annotating Web service messages through ontologies At the message schema level: Mapping disjoint but overlapping ontologies one into other At the message instance level: Using the mapping definition produced for automated mapping of message instances one into other Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 18
What is an Ontology? The word ontology comes from the Greek ontos (being) and logos (word) An ontology describes objects and concepts as classes These classes are arranged in a hierarchy, and then class attributes and relationships are described with properties Asuman Dogac Class properties Subclass properties HIMSS 2006, San Diego, Feb. 16, 2006 19
Why use an ontology? An Ontology provides: – A common vocabulary: An ontology describes consensual knowledge, that is, it describes meaning which has been accepted by a group not by a single individual – Ability to define relationships among classes, properties and instances – Automated Processing Querying Reasoning Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 20
An Example Web Service Functionality Ontology Health. Care. Services Patient Referral Patient Administration Observation. Reporting Scheduling Patient Care Observation. Reporting. Of. Clinial. Trials Response. For. Clinical. Observation Properties of the Generic Service Class Asuman Dogac Clinical. Observation. Reporting Request. For. Clinical. Observation Retrieve. Critical. Health. Data service. Quality HIMSS 2006, San Diego, Feb. 16, 2006 location 21
Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 22
Semantic Mediation ! Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 23
A Motivating Scenario Mr. John Smith is hospitalized with a cardiac episode at the Care 2 x Hospital Previously, Mr. Smith had a “Coronary artery bypass” operation at the Istanbul Hospital The doctor at the Care 2 x Hospital wishes to retrieve Mr. Smith’s “Critical Health Data” from Istanbul Hospital uses HL 7 v 2. 3 EDI messages and has exposed the critical healthcare data of its patients to the authorized users through semantically enriched Web services Care 2 x hospital, on the other hand, uses HL 7 v 3 XML messages. Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 24
First Problem: How to Handle Patient Identifiers? It is not feasible to maintain a master patient index for any two healthcare organization in the world that wish to communicate We have devised a mechanism to match the patient identifiers based on commonly available patient demographics described in: – Eichelberg, M. , Aden, T. , Thoben, W. , "A Distributed Patient Identification Protocol based on Control Numbers with Semantic Annotation", Int'l Journal on Semantic Web & Information Systems, Vol. 1, No. 4, October 2005. Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 25
HL 7 v 2. 3 EDI Message Sent by Istanbul Hospital MSH|^~&|Care 2 x. Hospital||20041 125181150||RRI^I 12|MSG 0000 3|P|2. 3 PRD|RTPID|||1213||Smit h^John||19600309|M|||Massach usetts ^Avenue^Kennedy^Street^04^L A^California|US| 2228214|||M||402941703 DG 1|1|| 27679008| Pulmonary Hypertension with extreme obesity |PR 1|1||700. 740| Right Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 26
Semantic Mediation of Web Service Messages Healthcare Institute A HL 7 v 2. 3 Message Normalization Schema Map (XSD) C-Normalization Engine HL 7 v 2. 3 Ontology RDF OWL Wrapper Ontology Mapper HL 7 v 2. 3 Ontology Mapping Definition Healthcare Institute B OWL Wrapper OWL RDF C-Normalization Engine Asuman Dogac HL 7 v 3 Ontology HL 7 v 3 Normalization Message Ontology Map Schema (XSD) HIMSS 2006, San Diego, Feb. 16, 2006 27
Additional Tools Used for creating HL 7 v 3 Message Schemas HL 7 Rose. Tree Tool is used to create HL 7 v 3 messages Rose. Tree allows the user to graphically build a HMD (Hierarchical Message Definition) from the HL 7 v 3 Reference Information Model In order to translate the HMD to XSD, HL 7 v 3 Schema Generator Tool is used Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 28
Healthcare Institute A HL 7 v 2. 3 Message HL 7 v 2. 3 Normalization Schema Ontology Map (XSD) Semantic Mediation EDI 2 XML Converter XML HL 7 v 2. 3 Message (EDI) HL 7 v 2. 3 Message (OWL) D-Normalization Engine RDF OWL Wrapper Ontology Mapper HL 7 v 2. 3 Message (OWL) Mapping Definition OWL Wrapper RDF D-Normalization Engine Asuman Dogac HL 7 v 3 Message (OWL) Healthcare Institute B HL 7 v 3 Message (OWL) HIMSS 2006, San Diego, Feb. 16, 2006 HL 7 v 3 Message (XML) HL 7 v 3 Normalization HL 7 v 3 Message Map Ontology Schema (XSD) 29
Additional Tools Used for Instance Transformation EDI to XML Conversion in HL 7: HL 7 Application Programming Interface (HAPI) Assembler/Disassembler Tool is used to transform the HL 7 v 2 EDI messages into their XML representations Data Normalization Engine of the Harmonize project is used to transform XML Message instances to OWL instances Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 30
OWL Mapping Tool Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 31
An Example Mapping through OWLmt Similar. To Person PID Similar. To XAD Addr Name PID. 5. Name PDI Role class. Code XON Similar. To Organization_Name Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 32
An Example Mapping through OWLmt DG 1 Similar. To DG 1. 4 DG 1. 3 Message Pulmonary outbound. Relationship. Diagnosis Hypertension with extreme Data. Property. Transform Act. Diagnosis obesity CE act. Diagnosis. Description CE. 1 27679008 Primary Pulmonary Hypertension act. Diagnosis. Code Data. Property. Transform Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 I 27. 2 33
HL 7 v 3 Message Received by the Care 2 x Hospital <Message xmlns="http: //corttex. com/MSCorttex. xsd"> <control. Act> <outbound. Relationship. Diagnosis> <act. Diagnosis. Code>I 27. 2</act. Diagnosis. Code> <act. Diagnosis. Description> Primary Pulmonary Hypertension</act. Diagnosis. Description> </act. Diagnosis> </outbound. Relationship. Diagnosis> <outbound. Relationship. Operation> <act. Operation> <operation. Code>93501</operation. Code> <operation. Description> Right Hearth Catheterization</operation. Description> </act. Operation> </outbound. Relationship. Operation> </control. Act> </Message> Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 34
Important Note We are considering only the messages exchanged through a limited set of welldefined Web services! Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 35
Reasoning: An Example… Similarity SNOMED: 27679007 -Pulmonary Hypertension ICD 10: I 27 - Primary Pulmonary Hypertension rdf: sub. Class. Of SNOMED 27679008 -Pulmonary Hypertension with extreme obesity instance. Of DG 1 -code: 27679008 Ontology Level Inferred Info “instance. Of” DG 1 -code: 27679008 Instance Level Mapping act. Diagnosis. Code: I 27. 2 (rdf: sub. Class. Of cls 1 cls 2)(rdf: type ind 1 cls 1) (rdf: type ind 1 cls 2) Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 36
Conclusions… Web service based access and Semantic Mediation among healthcare institutes is becoming a reality The technologies described have been implemented within the scope of the IST-2103 Artemis project funded by the European Commission http: //www. srdc. metu. edu. tr/webpage/projects/artemis/ Please come to booth 6147 to see a live demo of the technologies described! Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 37
Conclusions… Currently, Artemis infrastructure is used to semantically mediate among different healthcare information systems of the end users of the project, namely, – TEPE Technologies’ Corttex Hospital Information System (HIS), – SEBT Paris system as well as – the Care 2 x HIS The source code of the OWL mapping tool described is publicly available at Source. Forge, http: //sourceforge. net/projects/owlmt We are starting the RIDE Project supported by the European Commission which aims to develop a Roadmap for Interoperability of e. Health Systems for EU member states Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 38
Thank you very much for your attention… Questions? Asuman Dogac HIMSS 2006, San Diego, Feb. 16, 2006 39/36
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