MedeTel, Luxemburg, April 0507 2006

1
Med-e-Tel, Luxemburg, April 05-07 2006
Doc_at_Hand AN INNOVATIVE WEB PLATFORM FOR
INFORMATION AND KNOWLEDGE SHARING WITH ONTOLOGY
DRIVEN RETRIEVAL
Luca Sammartino, Nomos Sistema S.p.A.
2
Key project information

• Project name Doc_at_Hand
• Project type STREP
• Consortium composition8 partners, 5 countries (5
  IT Companies, 1 Academic, 2 Users)
• Project Coordination TXT e-Solutions (I)
• Project duration 36 months (1/1/2004 -
  31/12/2006)

3
Why Doc_at_Hand?
Healthcare professionals need help in

• Reducing the time spent in collecting information
  widely dispersed needed for their day-by-day
  activities
• Accessing heterogeneous amount of decentralised
  data also reducing associated costs
• Collect information remotely promptly through
  portable devices, such as tablet PC accordingly
  their mobility needs
• Increasing the quality of their decision making
  through prompt availability of relevant and
  complete data

4
Mission

• Our goals
• To facilitate the retrieval and the understanding
  of knowledge and information geographically
  dispersed (indexing, knowledge elicitation)
• To interrogate the System through Natural
  Language queries (query-answering extended
  browsing and navigation)
• To improve health professionals quality of
  services
• To support health professionals in their
  day-by-day complex problem solving and decision
  making activities.

5
Main features

• Transparent access to heterogeneous and
  geographically dispersed databases owned by
  separate, but cooperating organizations
• Proactive search for relevant information, using
• push technologies complementing traditional
  pull approach
• domain ontology
• Collection of related knowledge and information
• Presentation through an intuitive user interface
  highly customized on user profile and current
  activities
• Information accessible by different terminals
  Desktop, Laptop, Tablet PCs

6
Expected benefits

• Improved access and sharing of up-to-date
  patients data and clinical documentation.
• Improved overall quality in care delivery
• More information for a better informed decision
  making
• Reduction in patient admission times, avoiding
  duplicated procedures

• Doc_at_Hand Platform is mostly application
  independent
• Adaptable to different organization types
• Easily extendible to different applications/domain
  s
• Non-intrusive integration with existing systems

IT Perspective
7
Platform Architecture
8
Technologies

• Opensource tools
• If available, opensource solutions like MySQL,
  Tomcat, Lucene preferred instead of commercial
  ones
• Platform independent
• Modules developed with Java and Microsoft .Net
  for system portability
• Web Services
• Web-based distributed architecture using WS
• HL7 protocol
• Data extraction from Legacy Systems using HL7
  messages
• XML
• Information and modules data exchange represented
  in XML standard

9
Doc_at_Hand interface
10
Doc_at_Hand core The Semantic Subsystem

• Description
• It is composed by a set of tools strictly
  interoperating each others in order to basically
  provide two features
• information/knowledge retrieval (clinical
  records, guidelines, clinical cases)
• information management (document submission,
  content parsing, knowledge mark-up, concept
  extraction, document indexing )
• Key modules
• Natural language Parser
• Top, Middle and Domain Level Ontologies
• XML based Search Engine
• Main Benefits
• Ontology-based search
• Multi-lingual concept recognition
• Better recall hits results that would not have
  been found by using token-based searches
• Better precision avoids results that are not
  relevant (through matching the token provided)

11
Semantic Subsystem Example (1/2)
Clinical Record Woman 43 years with menstruation.
Non toxic habits Consults for an increased
feeling of fatigue in the past three months. No
suspicious family history. No other digestive
symptoms. No medication. Slightly distended,
soft, non-tender abdomen with active bowel
sounds. Pallor of skin and mucosa. Preliminary
Diagnose Iron deficiency.
Clinical Record (after parsing) Woman 43 years
with menstruation. Non toxic habits Consults for
an increased feeling of fatigue in the past three
months. No suspicious family history. No other
digestive symptoms. No medication. Slightly
distended, soft, non-tender abdomen with active
bowel sounds. Pallor of skin and mucosa.
Preliminary Diagnose Iron deficiency.
Concepts feeling of fatigue pallor of skin iron
deficiency
12
Early referral colon cancer example (2/2)
Concepts feeling of fatigue pallor of skin iron
deficiency anemia colon cancer

• Benefits
• Generated automatically
• More precise (additional tokens)

• Benefits
• Extracts correlated information
• Finds relevant documents even though they do not
  contain the original tokens

13
Data communication security

• EHR is first split in two distinct packages
  personal data e clinical data
• Unique Id has been assigned to EHR and added to
  each packages header information
• Each package is encrypted and submitted
  separately via https
• Doc_at_Hand receives both distinct packages and
  recombines the original EHR such data will then
  be managed entirely in memory. Packages are sent
  separately

Personal data
Pronl aa
Clnal dt
encryption
EHR
Clinical data
Data transfer (https)
Remote Hospital Information System (HIS)
Doc_at_Hand Platform
EHR
Recombined EHR
Data request
Not persistent
14
HCPB case
Primary Care
Early diagnosis and referral of colon cancer
Doc_at_Hand
Hospital
Management Centre

• Evidence Based Guidelines
• Distributed patients clinical data
• Access to updated clinical knowledge

Patients home
15
GST case
Hospital
Primary Care
Patient allocation to clinical trials
Doc_at_Hand
Primary Care

• National policy encouraging enrollment in trials
• Matching trial requirements to patients profile

Hospital
Hospital
16
ASP model offering

• Evaluate the potential of an ASP offering for
  Doc_at_Hand to
• Extend Improve Doc_at_Hand visibility Web
  interactive demo
• Extend the potential market to new countries and
  segments
• Provide a light client for portable devices with
  key features

17
Project life cycle
18
Conclusion
Thank you Any questions?
Luca Sammartino sammartino_at_nomos.it
Doc_at_Hand website http//www.doc-at-hand.org/