Active Semantic Electronic Medical Records

TitleActive Semantic Electronic Medical Records
Publication TypeBook Chapter
Year of Publication2008
AuthorsNicole Oldham, K. Gallegher, Amit Sheth, P. Yadav, S. Agrawal, Jon Lathem, H. Wingate
KeywordsActive Semantic Document, Clinical Ontology, Semantic Annotation of Patient Records, Semantic Electronic Medical Record, Semantic Web Clinical Application, Semantic Web Health Application

The most cumbersome aspect of health care is the extensive documentation which is legally required for each patient. For these reasons, physicians and their assistants spend about 30% of their time documenting encounters. Paper charts are slowly being phased out due to inconvenience, inability to mine data, costs and safety concerns. Many practices are now investing in electronic medical records (EMR) systems which allow them to have all patient data at their fingertips. Although current adoption by medical groups (based on a 2005 survey (AHRQ 2005)) is still below 15% with even less adoption rate for smaller practices, the trend is clearly towards increasing adoption. This trend will accelerate as regulatory pressures such as 'Pay-4- Performance' become mandatory thus enhancing the ROI sophisticated systems can achieve. This paper focuses on the first known development and deployment24 of a comprehensive EMR system that utilizes semantic Web and Web service/process technologies. It is based on substantial collaboration between practicing physicians (Dr. Agrawal is a cardiologists and a fellow of the American Cardiology Association, Dr. Wingate is an emergency room physician) at the Athens Heart Center and the LSDIS lab at UGA. More specifically, we leverage the concept and technology of Active Semantic Documents (ASDs) developed at the LSDIS lab. ASDs get their semantic feature by automatic semantic annotation of documents with respect to one or more ontologies. These documents are termed active since they support automatic and dynamic validation and decision making on the content of the document by applying contextually relevant rules to components of the documents. This is accomplished by executing rules on semantic annotations and relationships that span across ontologies. Specifically, Active Semantic Electronic Medical Record (ASEMR) is an application of ASDs in health care which aims to reduce medical errors, improve physician efficiency, improve patient safety and satisfaction in medical practice, improve quality of billing records leading be better payment, and make it easier to capture and analyze health outcome measures. In ASMER, rules specified in conjunction with ontologies play a key role. Examples of the rules include prevention of drug interaction (i.e., not allowing a patient to be prescribed two severely interacting drugs, or alerting the doctor and requiring his/her to make specific exceptions when low or moderate degree of interactions are acceptable) or ensuring the procedure performed has supporting diagnoses. ASDs display the semantic (for entities defined in the ontologies) and lexical (for terms and phrases that are part of specialist lexicon, specific items related to the clinics, and other relevant parts of speech) annotations in document displaced in a browser, show results of rule execution, and provide the ability to modify semantic and lexical components of its content in an ontology-supported and otherwise constrained manner such as through lists, bags of terms, specialized reference sources, or a thesaurus or lexical reference system such as WordNet. This feature allows for better and more efficient patient care and because of the ability of ASDs to offer suggestions when rules are broken or exceptions made. ASEMR is currently in daily and routine use by the Athens Heart Center (AHC) and eight other sites in Georgia. ASEMRs have been implemented as an enhancement of AHC's Panacea electronic medical management system. Panacea is a web-based, end to end medical records and management system, and hence it is used with respect to each patent seen at AHC. This has enhanced the collaborative environment and has provided insights into the components of electronic medical records and the kinds of data available in these systems. The preliminary version was implemented during Summer 2005 and tested in early fall. The current version was deployed and has been fully functional since January 2006. Parts of ASMER we will focus on in this paper are:

  • the development of populated ontologies in the healthcare (specifically cardiology) domain
  • the development of an annotation tool that utilizes the developed ontologies for annotation of patient records
  • the development of decision support algorithms that support rule and ontology based checking/validation and evaluation.
Full Text

A. Sheth, S Agrawal, J. Lathem, N. Oldham, H Wingate, P. Yadav, and K. Gallegher, 'Active Semantic Electronic Medical Records,'in The Semantic Web: Real World Applications from Industry, Jorge Cardoso, Martin Hepp, and Miltiadis Lytras (Eds.), Springer, 2008, pp. 123-140. ISBN-13: 978-9-387-48530-0
pages: pp. 123-140
publisher: Springer
year: 2008
hasEditor: Jorge Cardoso
related resource url: and
hasBookTitle: The Semantic Web: Real World Applications from Industry

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