Presented at CDISC 2009 in Baltimore, it explores what the Semantic Web can bring to Healthcare. Can it be deployed right now? With ease? CDISC sets standards for the exchange of clinical trial data. Once deployed, they remove much of the redundancy and paper processing that characterizes a typical trial today. Its membership includes government regulators like the US FDA, all the major drug companies and their IT vendors.

1. Hoot72
Health-Care, meet the Semantic Web
CDISC 2009
www.hoot72.org

2. Hoot72.org
• “Demonstrate the power the
Semantic Web brings to Health-Care
and how easy it is to deploy today.”
• Incubate: open source, docs
• Not Green Field - 40+ years of
Health IT

3. : Just Another Format?
• Technology: Web Stack++
• Reuse: HTTP, URIs, not HTML
• + RDF, OWL, SPARQL
• Get Link docs -> Query Link data
• One more reuse: Link ANYWHERE
• Begone CD-ROM: no islands
• WW: new adds on, reuse, open

4. A Linkable Patient
type
Patient
about
personName
observation observationValue
familyName
givenName Doe
CodingSystem Code
middleName
Code CodingSystem
John Fitzgerald
LN 30949-2 005 NIP
Identifiers and Time not shown
URI: http://www.facilityx.com/cdrs/112123449

5. 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:about ?patient ;
?assert [ hoot72:nameOfCodingSystem "LN" ;
hoot72:simpleIdentifier "30949-2" ] ]
}

6. Move out and up
• Question: Patients taking “Weight Loss Drugs”
• Patient Web: very particular
• Patient drugs as NDC codes: DESOXYN
TABLETS (00074337701) ...
• Too big a gap?

7. Ontologies Link!
Obese StanDrug: C0025611 Methamphetamine
May Treat
Name Name
SameAs
Stanford Drug
Ontology Methamphetamine RxNorm:6816
Ingredient
NDC: 00074337701
Patient Joe
SameAs
Hoot72 Name
Patient Medication
Graph Desoxyn 5MG Tablet
NDC: 00074337701
RxNorm
* Dotted: composite of links to save space
** w3c HCLS Example

8. The Ontologies?
• “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
• “Shared Knowledge” for Machines
• Links, hierarchies, equivalence ...
• The “middleware” of the Semantic Web
• OWL (WOL) - Web Ontology Language

9. More Every Day ...
URIs for SDTM “Finding” ...

10. Not just “Standards”
SameAs
CodingSystem CodingSystem Code
Text
Code
Local 182253 MRSA Culture LN 13317-3
Local Code LOINC Code
• Enable standard, off-the-shelf queries
• Definition is incremental

11. CDISC: it’s the content
• Roadmap: “The separation of content
standards from the means of
transporting that content”
• Terms: to OWL and Endpoints
• “BRIDGing” in OWL
• Trials as querable Graphs (vs docs)

12. Many Users, Contributors
Patient Researcher
Linked Health Data
Doctor Informatics
Insurance Manager
One Semantic Web for Health-Care

13. But ... “Patient Gap”
• “Trapped”, “Silo’ed”
• Ontologies Left Waiting
• EMRs Hold Back

14. Approach: Mine

15. Enabler: the Silo’s chat
“HL7 version 2 is a major
breakthrough and market 2.2
success. More than 93% 2.1
3.0 2.3
hospitals in US are using this 2.5
2.4
standard” - Health Level
Horizon (HLH) Project
2.3.1
2.1 2.2 2.3 2.3.1 2.4
2.5 3.0
Source: Neotool, V3 vs V2

16. HL7 “tweet” ...
MSH|^~&|REGADT|MCM|IFENG||199112311501||ADT^A04^ADT_A01|000001|P|2.4|||
EVN|A04|199901101500|199901101400|01||199901101410
PID|||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^HL70131
NK1|2|MASSIE^MARYLOU|MOTHER^^HL70063|300
ZOBERLEIN^^ISHPEMING^MI^49849^""^
|(900)485-5344|(900)545-1234~(900)545-1200|EC2^SECOND EMERGENCY
CONTACT^HL70131
NK1|3
NK1|4|||123 INDUSTRY WAY^^ISHPEMING^MI^49849^""^||(900)545-1200|
EM^EMPLOYER^HL70131|19940605||PROGRAMMER|||ACME SOFTWARE COMPANY
PV1||O|O/R||||0148^ADDISON,JAMES|0148^ADDISON,JAMES||AMB|||||||
0148^ADDISON,JAMES|S|1400|A|||||||||||||||||||GENHOS|||||199501101410|
PV2||||||||199901101400|||||||||||||||||||||||||199901101400
ROL||AD|CP^^HL70443|0148^ADDISON,JAMES
OBX||NM|3141-9^BODY WEIGHT^LN||62|kg|||||F
James was admitted ... his wife is his emergency contact ... hereʼs his weight ...

17. What if?
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|
Unload to a query-happy Graph

18. Observation
PID|||1234^^^^SR~1234-12^^^^LR~00725^^^^MR||Doe^John^Fitzgerald^JR^^^L|
...
OBX|4|CE|30949-2^Vaccination adverse event outcome^LN|1|005^required
hospitalization^NIP|
type
Patient
about
personName
observation observationValue
familyName
givenName Doe
CodingSystem Code
middleName
Code CodingSystem
John Fitzgerald
LN 30949-2 005 NIP Identifiers and Time not shown

19. Hoot72 HL7 Mapper
HL7 Message Definitions
HL7 Hoot72
Messages Mapper
Clinical Data Repostory
Hoot72 Ontology

20. Which Represents ...
CDR/S EMR
Research HL7...
URL
SPARQL
Personal
Ontology
Report Represent Produce

21. Reality: from Vets
• Concrete EMR - VistA
• VA: Largest U.S. Care Provider
• 128 VistAs, federated, 14+ Million in MPI - ICNs
• Available under FOIA
• The Proof
• Mapper Subscribes for HL7 (30/120 packs)
• Maintains a CDR/S for VistA (1 or more)

22. Austin already calls
DOD/CDC
HL7...
MPI/HDR VistA
HealthEVet
Report Represent Produce

23. Our Austin
• Interfaces under/not doc’ed
• first document (a graph!), example code
• open = clear (vs standard) documents
• Demographics, Patient Identity, >1 EMR
• ADT/VQQ messages (1->40)
• Now Vitals, Adverse Reaction ...

24. Approach: Wrap

25. Every EMR, an EndPoint
• EMR links to the cloud, natively
• Mini-Austin: MPI only (old VA Approach)
• Lucky: MUMPS repositories
• Network-Format ala Semantic Web
• VistA’s FileMan (no scale to test)
• If only you could SPARQL them ...

26. FMQL: SPARQL-like
SELECT ?name ?diagnosis ?age ?history FILE
"PATIENT" WHERE {?r "NAME" ?name ;
"DIAGNOSIS" ?d . ?d "DIAGNOSIS" ?diagnosis ;
"AGE AT ONSET" ?age ; "HISTORY" ?history }
• Specification in progress
• Initial goal: limited Patient, meta data dumps

27. Summary
• Semantic Web growing in Health-Care
• But a “Patient Gap”
• Different ways to bridge
• CDISC can drive it forward
• More: http://www.hoot72.org