Hoot72Throw the Semantic Web at Today’s Health-Care

www.hoot72.org

Land of Silo’s

•Health Data in “islands”, “silo’s”

• Admissions/Pharmacy/Lab ... Systems

• Billing data does leave the premises!

•Clinical data scattered

•Research, portable records, management?

Possible?

A View for Everyone

Linked Health Data

Patient

Doctor

Manager

Researcher

Insurance

IT

One Enabler: Silo’s chat

Source: Neotool, V3 vs V2

“HL7 version 2 is a major breakthrough and market success. More than 93% hospitals in US are using this standard” - Health Level Horizon (HLH) Project

A “tweet” ...MSH|^~\&|REGADT|MCM|IFENG||199112311501||ADT^A04^ADT_A01|000001|P|2.4|||EVN|A04|199901101500|199901101400|01||199901101410PID|||191919^^GENHOS^MR~371-66-9256^^^USSSA^SS|253763|MASSIE^JAMES^A||19560129|M|||171 ZOBERLEIN^^ISHPEMING^MI^49849^""^||(900)485-5344|(900)485-5344||S^^HL70002|C^^HL70006|10199925^^^GENHOS^AN|371-66-9256||NK1|1|MASSIE^ELLEN|SPOUSE^^HL70063|171 ZOBERLEIN^^ISHPEMING^MI^49849^""^|(900)485-5344|(900)545-1234~(900)545-1200|EC1^FIRST EMERGENCY CONTACT^HL70131NK1|2|MASSIE^MARYLOU|MOTHER^^HL70063|300 ZOBERLEIN^^ISHPEMING^MI^49849^""^|(900)485-5344|(900)545-1234~(900)545-1200|EC2^SECOND EMERGENCY CONTACT^HL70131NK1|3NK1|4|||123 INDUSTRY WAY^^ISHPEMING^MI^49849^""^||(900)545-1200|EM^EMPLOYER^HL70131|19940605||PROGRAMMER|||ACME SOFTWARE COMPANYPV1||O|O/R||||0148^ADDISON,JAMES|0148^ADDISON,JAMES||AMB|||||||0148^ADDISON,JAMES|S|1400|A|||||||||||||||||||GENHOS|||||199501101410|PV2||||||||199901101400|||||||||||||||||||||||||199901101400ROL||AD|CP^^HL70443|0148^ADDISON,JAMESOBX||NM|3141-9^BODY WEIGHT^LN||62|kg|||||F

James was admitted ... his wife is his emergency contact ... here’s his weight ...

Focus on Information

MSH|^~\&||GA0000||VAERS PROCESSOR|20010331605||ORU^R01|20010422GA03|T|2.3.1|||AL|PID|||1234^^^^SR~1234-12^^^^LR~00725^^^^MR||Doe^John^Fitzgerald^JR^^^L||20001007|M||2106-3^White^HL70005|123 Peachtree St^APT 3B^Atlanta^GA^30210^^M^^GA067||(678) 555-1212^^PRN|ORC|CN|||||||||||1234567^Welby^Marcus^J^Jr^Dr.^MD^L|||||||||Peachtree Clinic|101 Main Street^^Atlanta^GA^38765^^O^^GA121|(404) 554-9097^^WPN|101 Main Street^^Atlanta^GA^38765^^O^^GA121|OBR|1|||^CDC VAERS-1 (FDA) Report|||20010316|OBX|1|CE|30955-9&30956-7^Vaccine type^LN|1|08^HepB-Adolescent/pediatric^CVX|OBX|2|CE|30955-9&30957-5^Manufacturer^LN|1|MSD^Merck^MVX|OBX|3|ST|30955-9&30959-1^Lot number^LN|1|MRK12345|OBX|4|CE|30955-9&30958-3^Route^LN|1|IM^Intramuscular^HL70162|OBX|5|CE|30955-9&31034-2^Site^LN|1|LA^Left arm^ HL70163|OBX|6|NM|30955-9&30960-9^Number of previous doses^LN|1|01I

•Messages just “trucks”

•People and Codes and Relationships

•Leave “what do you drive” behind

What if?

From obscure Soup to query-ready Graph

OR|20010331605||ORU^R01|20010422GA03|T|2.3.1|||AL|725^^^^MR||Doe^John^Fitzgerald^JR^^^L||20001007|M||2106-3^White^HL70005|123 Peachtree St^APT 3B^Atlanta^GA^30210^^M^^GA067||(678) 555-1212^^PRN||||||||||Peachtree Clinic|101 Main Street^^Atlanta^GA^38765^^O^^GA121|(404) 554-9097^^WPN|101 Main Street^^Atlanta^GA^38765^^O^^GA121|

Graph?

•Format for Web of Data, not Documents

•RDF (Things) vs HTML (Documents)

•Web: link anywhere by URI (http://...)

•every Thing gets an address

•Semi-Structured: query through links

•SPARQL: SQL-like

Enter Hoot72

• Hoot (w3c’s OWL), 72 (HL7 v2)

• A Mapping: message to graph assertions

• Open Source Reference Implementation

• Painless Deployment

• Sssh - listens quietly

• doesn’t disturb the existing

Two plus Two

Hoot72 Mapper

HL7 Message

s

HL7 Message Definitions

Hoot72 Ontology

Clinical Data Graph

Observation (OBX)PID|||1234^^^^SR~1234-12^^^^LR~00725^^^^MR||Doe^John^Fitzgerald^JR^^^L|...OBX|4|CE|30949-2^Vaccination adverse event outcome^LN|1|H^required hospitalization^NIP005|

LN 30949-2

CodingSystem Code

H NIP005

CodingSystemCode

observation observationValue

Doe

John Fitzgerald

personName

familyName

givenName

middleName

contextPatient

type

Identifiers and Time not shown

Now Just Ask ...

All Patients with adverse outcome from vaccine ...

SELECT DISTINCT ?givenName ?familyName WHERE { ?patient hoot72:personName [ hoot72:givenName ?givenName ; hoot72:familyName ?familyName ] . [ hoot72:tcontext ?patient ; ?codePredicate [ hoot72:nameOfCodingSystem "LN" ; hoot72:simpleIdentifier "30949-2" ] ] }

So?

•A Clinical Care Warehouse

•I warehouse already! Just another silo

•Quick, easy way to Integrated View

•I have my own ways

•Standard format (RDF), query (SPARQL)

•Another? I like SQL/XML etc

•Difference: born to link, semantically!

Link Out, Anywhere

•First HTML browser disappointed some

•“Nicer” links in CD-ROM encyclopedias

•Power: link any Document = “world-wide”

•No site, an island; every document, a URI

•Web of Data: link any Thing

•No store, an island; every thing, a URI

Link Local Codes

LN 13317-3

CodingSystem Code

Local 182253

CodingSystem

Code

MRSA Culture

Text

Hoot72 Graph LOINC Code

SameAs

•Local Lab “same-as” Lab Standard (LOINC)

•Run standard, off-the-shelf queries

Link Categories

•Question: Patients taking “Weight Loss Drugs”

•Hoot72 Graph: very particular

• Patient drugs as NDC codes: DESOXYN TABLETS (00074337701) ...

•Too big a gap?

•Not for “the Ontologies” ...

The Ontologies?• Ontology: “an implementable model of the

entities that need to be understood in common in order for some group of software systems and their users to function and communicate at the level required for a set of tasks” -- Alan Rector

• Define Concepts: hierarchies, equivalence ...

• The “middleware” of the Semantic Web

• Growing every day: in Colleges, Corporations, ...

• OWL (WOL) - Web Ontology Language

RxNorm picks Joe

Name

RxNorm:6816

Methamphetamine

Methamphetamine

StanDrug: C0025611

Name

ObeseMay Treat

NDC: 00074337701

Desoxyn 5MG Tablet

Name

SameAs

Ingredient

Patient Joe

Medication

NDC: 00074337701

SameAs

RxNorm

Stanford Drug Ontology

Hoot72 Graph

* Dotted: composite of links to save space

** w3c HCLS Example

Ontologies are Standing by

Only As good as your Links

•Link out: to Ontologies (drugs, conditions)

•avoid re-invention

•Run powerful queries

•leverage the definitions of others

•Run off-the-shelf queries

•avoid re-invention

•Who’s your “link man”?

Link an Individual• “The ultimate aim in public health infrastructure

is to allow two organizations to exchange patient and other health information seamlessly.” -- Kun, Ray Merrell, Kwankam

•URIs: www.ucla.com/patient/36600

•Portable health records

•sameas: “Alex Ben” in X, “Alex J. Ben” in Y

•Security concerns - de-identify sometimes

•Clearing houses ala Google Health? True “meaningful use”?

The Urgency of Now

•Health-care needs functioning IT

•the now-financed EHR push

•Semantic Web ready and waiting

•standards, ontologies, tools

•ideal for health-care

•The slow pace of alternatives

•no traction (HL7 v3 etc.)

Interested?

•Hear more?

•Your messages graphed?

•Participate?

Go to: http://www.hoot72.org and Contact!