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ThinkMind // eTELEMED 2019, The Eleventh International Conference on eHealth, Telemedicine, and Social Medicine // View article etelemed_2019_4_20_40065


The Patient Summary Case: Challenges in Archetypes Terminology Binding Using SNOMED-CT Compositional Grammar

Authors:
Luis Marco Ruiz
Rune Pedersen

Keywords: openEHR, SNOMED-CT, archetype, terminology binding, biomedical ontology

Abstract:
Abstract— In order to cover the requirements of interoperability in the Norwegian context, we studied the adequacy of expressing the clinical semantics contained in archetypes as terminology expressions using SNOMED-CT´s compositional grammar. As a result, we identified important challenges categorized as technical, expressivity, human, and models mismatch related. Technical challenges include the binding of archetype elements to sections of the SNOMED-CT expressions that are semantically equivalent, lack of tooling for performing guided binding based on pre-defined semantic patterns, and lack of guidance about the infrastructure to use ontology-based terminologies. Expressivity challenges include variations in the precision of the semantics expressed by the archetype and the SNOMED-CT models, challenges expressing temporal semantics in SNOMED-CT, and lack of mechanisms for specifying expressions whose values are only known at runtime. Human challenges include lack of guidance to discern what to leave represented at archetype level and what to project as a terminology expression depending on the expressivity requirements, and the need for more clarity about which hierarchies and attributes to use when several options are available for expressing the same concept. Model mismatch issues were related to the issue of grounding (referencing) the sections of one model to the other and clarify the role of the context model and in which situations it makes sense to annotate archetypes using its verbose expressions. The challenges detected show a pressing need for the collaboration between the openEHR community and SNOMED International for providing better guidelines about terminology binding, better tooling for facilitating the binding process, and developing mechanisms that allow for extending SNOMED-CT with other biomedical ontologies in order to increase the coverage of archetypes semantics for scenarios with high expressivity requirements such as data reuse ones.

Pages: 49 to 55

Copyright: Copyright (c) IARIA, 2019

Publication date: February 24, 2019

Published in: conference

ISSN: 2308-4359

ISBN: 978-1-61208-688-0

Location: Athens, Greece

Dates: from February 24, 2019 to February 28, 2019

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