Cory: working with Ken on MDMI, and OMG
Daniel Stone: Working at Mayo with Dr Jiang
Dahzi: Working at Johns Hopkins on FHIRCat project and terminology ser4vices
EricP: Works W3C, lots of RDF geekery with Sem web and healthcare.
harold: Prof at Johns Hopkins, working on FHIR
Ken Lord: Working for MDIS, project lead for MDMI project (model driven message interop), and OMG standard, working on enhancement with Cory Davide Sottoro, Elisa Kendall, Robert Lario
Sajad Hussein: Ontario hospitals, RDF, V2 to FHIR use cases, and FHIR to I2B2.
Slides from Ken Lord: https://lists.w3.org/Archives/Public/www-archive/2020Jan/att-0000/Yosemite_OMG_MDMI_2.pdf
ken: RDF and OWL experts are other members of the team -- Cory and Elisa.
(slide 3)
ken: It's all about
transformation from source message to target message
... Not a research project.
... Partners Research was transforming CCDA data to I2B2.
(slide 4)
ken: Starts w an interop model -
metamodel. Deconstruct a file into its semantic elements. Then
uses syntax components to reconstruct the target message.
... The semantic component describes the semantics in that
specific format. Structure is captured in the model, such as
containership.
... The mapping is an isosemantic relationship between a
semantic element in the model for the format, with a central
respository, that contains the equivalent semantic concepts.
Relationship betweeen a data element in a format with
adictionary in this repisotory. About 4000 right now.
... A business concept has a meaning: how that thing has been
placed into a context. Like a triple.
Q: Central repository?
(slide 5)
ken: input message A is
transformed using Map A and Map B to message B.
... Maps are created independently.
(slide 6)
scribe: SEER is a repository, but
really a dictionary of concepts at the same granularity level.
No structure. The only structure is that there is as flat as
possible a datatype. Simplest one is patient ID or patient
name.
... If we get into clinical data, medication administered code,
which indicates what was administered. Or Med administered
dosage, which is different. Small atomic concepts,
unambiguous.
... The SEER does not contain synonyms, though it can have
multiple names.
... We've been doing this for 8-9 years, and applying it to
healthcare for 6 years.
... The problem: the meaning is described by unstructured text,
and this makes them ambiguous.
... Our group is trying to extend the MDMI standard to provide
a formalism for each MDMI business element.
... We don't want to reinvent anything. A principle of interop
is you can't invent it, you have to work with what
exists.
... Want to leverage existing healthcare ontologies and
terminologies.
(slide 7)
ken: Selected an OWL tech stack.
Had issues with 11179, with linkage. Want to link to existing
semantic foundations.
... Want to link to reference models. Primary model we're
working with: ANF, which just went to ballot.
... ANF is an information model, but it's built on a semantic
foundation of the SOLR concept, to harmonize the underlying
terminologies and ontologies.
harold: Use of SOLR is interesting because of the SNOMED component. Also want to undertand what the 11179 issues were.
david: Process for coming up with these formalisms?
ken: OMG issues an RFP, out of
the healthcare domain task force. That was for an enhancement
of MDMI 2.0.
... OMG creates open standards, and various proposal teams come
together to work on it. Proposal team has submitted a proposal,
and we've submitted a proposal. Trying to make it as open as
possible.
... once the standard has been approved, it becomes open. But
if people want to become a part of the team, they are
welcome.
david: Do you have to come up with these formalisms?
ken: yes
(slide 8)
ken: We've currently scoped it initially to deal with clinical info exchange. This is informative, not normative.
cory: To clarify formalisms: they
are being defined in the std, and they define how these
business elements in the MDMI model reference ontologies. Not
standardizing those ontologies.. Not making any assertions
about how to model healthcare.
... We're doing the modeling in a profile of UML, and then
generate OWL from that.
... OWL that we're using is quite restricted -- basically RDFS
plus property type restrictions and property chains. Chains are
important because in flattening the concepts we're typically
taking a path through the model and making it single defined
element.
... Also important to restrict properties in a context.
... Mostly subclasses and subproperties other than that.
eric: "redefines" = onproperty all values from?
cory: Yes.
... Not intending to do inference.
... Layers are color coded. Orange things are mid-upper level
scaffolding to put in place basic categories.
... one important one: separation of concerns between speech
act of a message from what the message is describing.
... As part of that we get that the statement is abouit
something and things have participants.
... Blue layer is a stand-in for where a ref ont would
go.
... These are examples to explain the bottom level, which are
business elements (concepts) of MDMI
... Want to determine that they are unique.
... So the only logic is to look at how they're derived from
more general concepts, using those restrictions and property
chains.
... That green wire is what would be specific to MDMI. Want to
determine the uniqueness of that concept.
... That's the only purpose of that ref ont.
eric: How does that work in practice? Example: When someone quits smoking, that's written in the EMR and it gets exchanged. Would that be a special item in the ref model?
cory: Something like "patient quit smoking <date>"
ken: it probably would have an
end date, associated with the act of smoking.
... Even though it might be represented very differently in the
info model.
... Very fine grained, but want to keep it at the level of
information exchange.
... Green is what we want. Orange is what we need to get it
through OMG and be robust. Blue is where we'd like to make sure
there's an understanding of what those things mean, to do
mappings between them.
harold: Curious about Observation here. Is this guided by the SNOMED work on Observables?
ken: I think so, but it's driven by Keith and Davide. We want their input.
cory: Challenge is finding
abstractions that work well across other ways it has been
done.
... This entire model is non-normative. Upper structure might
move forward in some other effort. Want to understand
generically whjat works acrross multiple approaches.
david: FHIR has 5-Ws ontology
harold: Yes, but it's a model of data, not the the information. This is a general model of how one gets a data model with what it is about.
cory: Lot of work I do is in
finance, with FIBO model. Generic parts of this should be able
to work with any ref model.
... It can be hard with a broken model, but with a reasonably
vconstructed model it works.
harold: Many models blur the
model of the data from what it is about. SNOMED for a long time
did not distinguish between a def of appendicitis vs a finding
of appendicitis, so could not ask how many documented
appendicitis were diagnosed.
... Half the purpose of the doc is human doc.
cory: Distinguishing situation
from definition. Also differentiation between roles of person
as patient or doctor, so a doctor can operate on
himself/herself.
... Trying to get a start in a non-normative way.
david: what would you like to see happen?
ken: Want to provide this group with what we're doing, on a regular schedule. Get comments. Especially need to be certain that what we describe is understood by a machine in a level of precision that people need.
harold: FHIR/RDF that we're doing
is to define a third exchange format besides XML and JSON.
FOcus now is to use JSON-LD 1.1 to combine JSON with RDF.
... FHIR now has 7 metamodels.
... Also want to seamlessly connect things into FHIR space. Out
of scope: for a while we called the definition the FHIR
ontology.
... We're modeling documents about patients. FHIR is beginning
to add semantics. 5 Ws ont is the beginning of that.
eric: First step is to recognize the same entities between different resources. How that's documented is almost orthogonal.
harold: They're beginning to put
links to concept codes in FHIR, though I'm not sure they're
getting the right ones.
... Such as, about appendicitis vs a finding of
appendicitis.
ken: How can we help that effort?
harold: First step is to look closer at the model to see what semantics are being added to FHIR. Also want to see what's going on w semantic elements repository.
ken: We've already mapped to
FHIR. We have a FHIR map.
... Every attribute in a FHIR resource, to the business
elements. We can exchange CCDA docs with FHIR.
harold: That sounds exciting, because we have official URIs for everything in the model. Might be really useful to put those together.
cory: Are you looking it FHIR as being a semantic ref, or would it ref something else?
harold: FHIR is a data model.
Semantics are largely tacit. History is from people figuring
out the enterprise or info model they needed.
... FHIR describes a pt record, but formal def is a block of
text. We have no idea if we get a record from a different
space, whether it refs the same thing or not. Can a pt be an
animal, for example?
... The only way to find out is to read the text and hope that
someone wrote it down.
ADJOURNED
This is scribe.perl Revision: 1.154 of Date: 2018/09/25 16:35:56 Check for newer version at http://dev.w3.org/cvsweb/~checkout~/2002/scribe/ Guessing input format: Irssi_ISO8601_Log_Text_Format (score 1.00) Present: David_Booth EricP Harold_Solbrig Dazhi Daniel_Stone Cory Ken_Lord Sajad_Hussein No ScribeNick specified. Guessing ScribeNick: dbooth Inferring Scribes: dbooth WARNING: No date found! Assuming today. (Hint: Specify the W3C IRC log URL, and the date will be determined from that.) Or specify the date like this: <dbooth> Date: 12 Sep 2002 People with action items: WARNING: IRC log location not specified! (You can ignore this warning if you do not want the generated minutes to contain a link to the original IRC log.)[End of scribe.perl diagnostic output]