Department of Computer Science and Mathematics, Universitat Rovira i Virgili, Av Països Catalans 26, 43007 Tarragona, Catalonia, Spain.
Int J Med Inform. 2010 May;79(5):370-87. doi: 10.1016/j.ijmedinf.2010.01.012. Epub 2010 Feb 24.
Information Technologies and Knowledge-based Systems can significantly improve the management of complex distributed health systems, where supporting multidisciplinarity is crucial and communication and synchronization between the different professionals and tasks becomes essential. This work proposes the use of the ontological paradigm to describe the organizational knowledge of such complex healthcare institutions as a basis to support their management. The ontology engineering process is detailed, as well as the way to maintain the ontology updated in front of changes. The paper also analyzes how such an ontology can be exploited in a real healthcare application and the role of the ontology in the customization of the system. The particular case of senior Home Care assistance is addressed, as this is a highly distributed field as well as a strategic goal in an ageing Europe.
The proposed ontology design is based on a Home Care medical model defined by an European consortium of Home Care professionals, framed in the scope of the K4Care European project (FP6). Due to the complexity of the model and the knowledge gap existing between the - textual - medical model and the strict formalization of an ontology, an ontology engineering methodology (On-To-Knowledge) has been followed.
After applying the On-To-Knowledge steps, the following results were obtained: the feasibility study concluded that the ontological paradigm and the expressiveness of modern ontology languages were enough to describe the required medical knowledge; after the kick-off and refinement stages, a complete and non-ambiguous definition of the Home Care model, including its main components and interrelations, was obtained; the formalization stage expressed HC medical entities in the form of ontological classes, which are interrelated by means of hierarchies, properties and semantically rich class restrictions; the evaluation, carried out by exploiting the ontology into a knowledge-driven e-health application running on a real scenario, showed that the ontology design and its exploitation brought several benefits with regards to flexibility, adaptability and work efficiency from the end-user point of view; for the maintenance stage, two software tools are presented, aimed to address the incorporation and modification of healthcare units and the personalization of ontological profiles.
The paper shows that the ontological paradigm and the expressiveness of modern ontology languages can be exploited not only to represent terminology in a non-ambiguous way, but also to formalize the interrelations and organizational structures involved in a real and distributed healthcare environment. This kind of ontologies facilitates the adaptation in front of changes in the healthcare organization or Care Units, supports the creation of profile-based interaction models in a transparent and seamless way, and increases the reusability and generality of the developed software components. As a conclusion of the exploitation of the developed ontology in a real medical scenario, we can say that an ontology formalizing organizational interrelations is a key component for building effective distributed knowledge-driven e-health systems.
信息技术和知识型系统可以显著改善复杂分布式卫生系统的管理,其中支持多学科性至关重要,不同专业人员和任务之间的沟通和同步变得至关重要。本工作提出使用本体论范例来描述复杂医疗保健机构的组织知识,以此作为支持其管理的基础。详细描述了本体工程过程,以及在面对变化时保持本体更新的方法。本文还分析了这种本体论如何在实际医疗保健应用中得到利用,以及本体在系统定制中的作用。特别提到了高级家庭护理援助的情况,因为这是一个高度分散的领域,也是欧洲老龄化战略目标。
所提出的本体设计基于由欧洲家庭护理专业人员组成的联盟定义的家庭护理医疗模型,该模型框架在 K4Care 欧洲项目(FP6)的范围内。由于模型的复杂性以及-文本-医疗模型和本体严格形式化之间存在的知识差距,因此采用了本体工程方法(On-To-Knowledge)。
在应用 On-To-Knowledge 步骤后,得到了以下结果:可行性研究得出结论,本体论范式和现代本体语言的表达能力足以描述所需的医学知识;在启动和细化阶段之后,获得了家庭护理模型的完整且无歧义的定义,包括其主要组件和相互关系;形式化阶段以本体类的形式表示 HC 医疗实体,这些类通过层次结构、属性和语义丰富的类限制相互关联;通过在实际场景中运行的基于知识的电子健康应用程序利用本体进行评估表明,从最终用户的角度来看,本体设计及其利用带来了灵活性、适应性和工作效率方面的好处;对于维护阶段,提出了两个软件工具,旨在解决医疗单位的纳入和修改以及本体配置文件的个性化问题。
本文表明,本体论范式和现代本体语言的表达能力不仅可用于以非歧义的方式表示术语,还可用于形式化实际分布式医疗保健环境中涉及的相互关系和组织结构。这种本体论有助于在医疗保健组织或护理单元发生变化时进行适应,以透明和无缝的方式支持基于配置文件的交互模型的创建,并提高开发软件组件的可重用性和通用性。作为在实际医疗场景中开发的本体的利用的结论,我们可以说,形式化组织关系的本体是构建有效分布式知识驱动型电子健康系统的关键组成部分。