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Koray Atalag Ph.D. Thesis 2007

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Koray Atalag Ph.D. Thesis 2007 ARCHETYPE BASED DOMAIN MODELING FOR HEALTH INFORMATION SYSTEMS A THESIS SUBMITTED TO THE GRADUATE SCHOOL OF INFORMATICS OF THE MIDDLE EAST TECHNICAL UNIVERSITY BY KORAY ATALA Ğ IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY IN THE DEPARTMENT OF INFORMATION SYSTEMS JULY 2007 Approval of the Graduate School of Informatics ___________________________ Assoc.Prof.Dr. Nazife Baykal Director I certify that this thesis satisfies all the requirements as a thesis for the degree of Doctor of Philosophy. ___________________________ Assoc.Prof.Dr. Yasemin Yardımcı Head of Department This is to certify that we have read this thesis and that in our opinion it is fully adequate, in scope and quality, as a thesis for the degree of Doctor of Philosophy. ___________________________ Prof.Dr. Semih Bilgen Supervisor Examining Committee Members Prof.Dr. Sedat Boyacıo ğlu (MESA Hospital) _____________________ Prof.Dr. Semih Bilgen (METU, EEE) _____________________ Assoc.Prof.Dr. Onur Demirörs (METU, II) _____________________ Assoc.Prof.Dr. Gürden Gür (Güven Hospital) _____________________ Assoc.Prof.Dr. Ü. Erkan Mumcuo ğlu (METU, II) _____________________ I hereby declare that all information in this document has been obtained and presented in accordance with academic rules and ethical conduct. I also declare that, as required by these rules and conduct, I have fully cited and referenced all material and results that are not original to this work. Name, Last Name : Koray Atala ğ Signature : _______________ iii ABSTRACT ARCHETYPE BASED DOMAIN MODELING FOR HEALTH INFORMATION SYSTEMS Atala ğ, Koray Ph.D., Department of Information Systems Supervisor: Prof.Dr. Semih Bilgen July 2007, 163 pages A major problem to be solved in health informatics is high quality, structured and timely data collection. Standard terminologies and uniform domain conceptual models are important steps to alleviate this problem which are also proposed to enable interoperability among systems. With the aim of contributing to the solution of this problem, this study proposes novel features for the Archetypes and multi-level modeling technique in health information and knowledge modeling. The study consists of the development of a research prototype for endoscopic data management, and based on that experience, the extension of Minimal Standard Terminology in Digestive Endoscopy (MST). A major contribution of the study consists of significant extensions to the modeling formalism. The proposed modeling approach may be used in the design and development of health information systems based on archetypes for structured data collection, validation and dynamic user interface creation. The thesis work is aimed to make considerable contribution to the emerging Electronic Health Records (EHR) standards and specifications. Keywords: Information systems, health information systems, domain modeling, archetypes, endoscopy. iv ÖZ SA ĞLIK ENFORMASYON S ĐSTEMLER Đ ĐÇĐN ARKET ĐP TABANLI ALAN MODELLEMES Đ Atala ğ, Koray Doktora, Bili şim Sistemleri Bölümü Tez Yöneticisi: Prof.Dr. Semih Bilgen Temmuz 2007, 163 sayfa Sa ğlık bili şiminin çözülmesi gereken önemli problemlerinden biri kaliteli, yapısal ve zamanında veri toplanmasıdır. Standart terminolojiler ve kavramsal alan modelleri bu problemi hafifletmek için önemli adımlardır ve aynı zamanda sistemler arasında birlikte çalı şabilirli ği sa ğlayabilecekleri öne sürülmektedir. Bu problemin çözümü amacıyla, bu çalı şma sa ğlıkta enformasyon ve bilgi modellemesi için Arketipler ve çok-seviyeli modelleme tekni ğine özgün katkılar önermektedir. Çalı şma endoskopide veri yönetimi için bir ara ştırma prototipi geli ştirilmesi ve edinilen tecrübeyle Gastrointestinal Endoskopide Minimal Standart Terminoloji’nin (MST) geli ştirilmesini içerir. Önerilen modelleme yakla şımı yapısal veri toplanması, do ğrulama ve dinamik kullanıcı arayüzleri geli ştirmek için arketip tabanlı sa ğlık enformasyon sistemleri tasarlanması ve geli ştirilmesinde kullanılabilir. Bu tez çalı şmasının yeni geli şmekte olan elektronik sa ğlık kayıtları (ESK) standart ve spesifikasyonlarına önemli katkılarda bulunması hedeflenmi ştir. Anahtar kelimeler: Enformasyon sistemleri, sa ğlık enformasyon sistemleri, alan modellemesi, arketipler, endoskopi. v To Atalağ Family ☺☺☺ especially my father, Mehmet and my daughter, Karya vi ACKNOWLEDGMENTS I would like to express my sincerest gratitude to my thesis supervisor, Dr. Semih Bilgen who helped this heavy ship (Ph.D. studies) out in the stormy waters (business life) and brought it back to the calm waters (academia). If he did not assure me that we could make it through the end in each and every meeting, I would not be writing these lines. I really appreciate his warm and excellent guiding, and especially for his ability to find an appropriate time slot for me in his busy schedule. It is still a wonder for me how he could read and edit my tens of pages of thesis material in just a matter of hours and always provide me with written feedback. Thank you again… Thanks to Dr. Onur Demirörs for helping me to establish a solid understanding of software engineering discipline and to Dr. Erkan Mumcuo ğlu for supporting my studies. I also would like to thank Dr. Sedat Boyacıo ğlu for getting me involved with gastrointestinal endoscopy domain and providing me with valuable knowledge. I am also grateful to Dr. Gürden Gür for his generous support during development of the research prototype. I still appreciate their continuing support, especially for participating to my thesis progress meetings and also for accepting to appear in the thesis jury. Uninterrupted support and close collaboration of Thomas Beale and Dr. Sam Heard from openEHR have broadened my vision in this field and provided me with the knowledge and tools for conducting my research. I highly appreciate and feel deeply indebted to them. I also acknowledge Philippe Ameline for sharing me with his technical knowledge on endoscopy and also supporting me with his genuine friendship. Thanks to Dr. Louis Korman who always provided me with excellent insight and practical knowledge on both MST and informatics. vii TABLE OF CONTENTS ABSTRACT…………………………………………………… …….…………….. ..iv ÖZ……………………………………………………………………………….…….v DEDICATION……………………………………………………………….……….vi ACKNOWLEDGEMENTS………………...………………………………...…….. .vii TABLE OF CONTENTS……………..…………………………….……..……….. .viii LIST OF TABLES………………………………………………….….………….….xi LIST OF FIGURES……………………………………...…………..….…………...xii LIST OF BOXES……………………..………………………………..…………...xiii LIST OF ACRONYMS AND ABBREVIATIONS……………………………..….xiv CHAPTER 1 INTRODUCTION .....................................................................................................1 1.1 Description of the Research Domain...........................................................3 1.2 Objective and Goals of the Study................................................................4 1.3 Research Methodology and Validation Approach.......................................5 1.4 Organization of the Thesis...........................................................................8 2 LITERATURE REVIEW ..........................................................................................9 2.1 INFORMATION SYSTEMS and SOFTWARE.........................................9 2.2 Healthcare problems and e-Health ............................................................11 2.2.1 General Problems of Healthcare ...........................................................11 2.2.2 Trends in Healthcare .............................................................................14 2.2.3 Benefits and Promises of ICT in Healthcare.........................................16 2.2.4 Types and Evolution of Healthcare ICT ...............................................18 2.2.5 Other key concepts................................................................................21 viii 2.2.6 Key enabling technology for next generation medicine: EHR..............23 2.2.7 Standards in Health Informatics............................................................31 2.3 Domain Modeling: Reference Models and Archetypes ............................40 2.3.1 The Need for Modeling in Healthcare ..................................................40 2.3.2 Domain Modeling in HIS......................................................................41 2.3.3 Common Domain Modeling Formalisms for HIS/EHR .......................43 2.4 Archetype based Multi-level Domain Modeling for HIS/EHR.................47 2.4.1 What’s in the Levels?............................................................................47 2.4.2 Reference (Information) Models (RM).................................................48 2.4.3 Archetypes and Templates ....................................................................48 2.4.4 Service Models (SM) ............................................................................49 2.4.5 Terminology and Ontologies: ...............................................................49 2.4.6 ADL/AOM & TDL/TOM .....................................................................49 2.4.7 Developing Archetypes and Templates: Tools .....................................50 2.4.8 Relationship of Modeling with Terminologies and Ontologies............51 2.4.9 Interoperability & Governance Issues...................................................52 2.4.10 Advantages and Promises of Archetypes..............................................53 2.4.11 Challenges with Archetypes and Multi-level Modeling .......................54
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