a peer to peer agent coordination framework for ihe based cross-community health record exchange
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A Peer to Peer Agent Coordination Framework for IHE
based Cross-Community Health Record Exchange
Institute of Applied Sciences of Western Switzerland
V. Urovi, A. Olivieri, S. Bromuri, N. Fornara and M. Schumacher
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Applied Intelligent Systems Lab AISLab – aislab.hevs.ch
eHealth Topics: InteroperabilityMonitoring of chronic diseasesMulti-parametric data analysisDiagnosis help for General Practitioners
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Research Question
• How to enable the dynamic exchange of electronic health records (EHR) of patients beyond the health organisation level?
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We answer it by• Extending the existing IHE profiles with a solution for
dynamically discovering and connecting with other health institutions;
• Using semantic description of data to facilitate the interpretation and sharing of data between the different health institutions;
• Connecting health communities in a scalable solution that uses a P2P based model;
• Automatizing the collection of EHRs by using a coordination model between communities that is based on a multi-agent platform.
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IHE – Integrating the Healthcare Enterprise http://www.ihe.net
• Non profit organization composed of healthcare industry professionals
• Combines standards into specifications (named Profiles) targeted at solving specific medical use-cases
• The Swiss strategy recommends the use of Integrating the Healthcare Enterprise (IHE) and its profiles to make medical information systems interoperable
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IHE Exchange Profiles• XDS - Cross Enterprise Document Sharing
• Enables health organisations to share patient-relevant documents by storing and retrieving them from a central registry;
• XCA -Cross-Community Access
• Defines how medical data held by other communities can be queried and retrieved;
• XCPD - Cross-Community Patient Discovery
• Locates communities that hold patient's relevant health data and translate patient's identifiers across communities holding the same patient's data.
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Example: the XDS profile
Document Source
Document Repository
Document Registry
Document Consumer
Provide&Register Document Set
Retrieve Document
Query Document Actor
Register Document Set
Transaction
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Limitations of these IHE profiles• XDS does not resolve document sharing among
different health communities;
• XCA requires communities to have pre-established agreements and knowledge of one another;
• XCPD does not automatise the discovery of communities and it still requires communities to have pre-established agreements for exchanging the documents.
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To address IHE limitations
• We define an IHE and agent-based coordination model that supports communities to dynamically connect to one another.
• We also specify an ontology that may be used to define the knowledge base of every community.
• To model and implement this semantic coordination layer, we use the coordination framework TUCSON.
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Semantic Tuple Centers in TuCSoN• TuCSoN is an agent coordination infrastructure where:
• Agents interact performing in/out/rd operations on semantic tuple centers.
• Tuples are read and retrieved associatively using tuple templates.
• Semantic tuple centers are modeled using OWL Web Ontology Language
• Semantic tuple centers:
• Are hosted in distributed nodes
• Can perform out/in/rd towards other tuple centres.
• The behavior of tuple centers is programmable in the ReSpecT language:
reaction(action, guard, react).Where: action= in/out/rd a Semantic Tupleguard= internal/external action and pre/post reactreact= logics+in/out/rd of Semantic Tuple
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The ArchitectureLegend
Publish/Subscribe/Notify/Search operations
Tuple Center
Agent
Community/Node
Node
a) Logic Architecture of a Community
b) The P2P structure between CommunitiesSearch Agent
PolicyTuple Center
Log Agent Update Agent
COMMUNITY/Node
Node
Node
Node
Node
NodeNode
P2P NETWORK
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Policy Tuple Centre Coordination • Every community maintains a semantic
knowledge of patients and their EHRs and
• Can share patient related data in the P2P;
• Can search data in the P2P;
• Can directly query and subscribe to updates happening in the knowledge bases of other communities;
• Can propagate updates on patient’s EHRs.
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Semantic Knowledge Base
CommunityCommunity
DocumentDocument
PatientPatient
identifiernameaddress
identifierdate
identifiername
addressfatherchildren
status
author
hasHomeCommunity
RoleRole
identifier
name
activities
PolicyPolicy
identifier
name
categorydescription
ServiceService
ActorActor profession
name
contact
address
identifier
speciality
assumes
member
complies
follows
provideshas
cares
subscribe
identifiername
link
description
∐relates
attachment
DatatypeProperty
ClassObjectProperty
∐
home
Union
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• Health communities can search patient data in other communities by:
• querying the P2P network about the community that holds the data of a patient and
• sending a request query to that community
Searching EHR data
• Subscriptions and update propagations are treated similarly
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Results
Patient Search Community Search
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Conclusions• We proposed a distributed coordination framework
to dynamically exchange EHR
• The proposed coordination mechanisms that go beyond the current IHE solutions
• In future works we will focus on defining:
• Security mechanisms for P2P based health record exchange.
• A sophisticated publish-subscribe model based on complex event patterns
• Complex reasoning and deductions over semantic data
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Thank youAny Questions?
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Implementation
UserAgent
Data BaseCommunityComponent
LegendSystemAgent
Jena LibraryQuery Lang.Reasoner
Logic Connection
Certification Authority
OpenXDS
TuCSoN
PTC
OWL
SPARQL
Pellet
Jena
DomainAuthority
P2P NETWORK
PostgreSQL
Community
OpenXDS
TuCSoN
PTC
OWL
SPARQL
Pellet
Jena PostgreSQL
Community
Certifying body
Peer
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