Successful integration of EN/ISO 13606 standardized extracts from a patient mobile app into an electronic health record (Preprint)

Abstract

<sec> <title>BACKGROUND</title> There is an increasing need to integrate patient-generated health data into health information systems. The use of health information standards based on the dual model allows the achievement of semantic interoperability among systems. This article is framed within ASCAPE, a project that aims to employ Artificial Intelligence / Machine Learning mechanisms to support cancer patients’ health status and quality of life. </sec> <sec> <title>OBJECTIVE</title> To design and implement a methodology based on the dual model paradigm to communicate clinical information between a patient mobile app (Xemio) and an institutional ontology-based clinical repository (OntoCR) without loss of meaning. </sec> <sec> <title>METHODS</title> First, the variables to be communicated were defined and represented in both systems. Then, EN/ISO 13606 archetypes were created, and local concepts were modeled conforming to the standard in OntoCR and in Xemio. Extracts were sent to an API in OntoCR, which maps each element in the normalized XML files to its corresponding location in the ontology. In this way, instantiated data of patients are stored in the clinical repository. </sec> <sec> <title>RESULTS</title> Between December 22, 2020 and April 4, 2022, 1,100 extracts of 47 patients were successfully communicated (234 of secondary effects and 866 of daily activity). Furthermore, the creation of EN/ISO 13606-standardized archetypes allows the reuse of clinical information regarding daily activity and secondary effects, while with the creation of ontologies we extended the knowledge representation of our clinical repository. </sec> <sec> <title>CONCLUSIONS</title> Health information interoperability is one of the requirements for continuity of healthcare. The dual model allows the separation of knowledge and information in health information systems. EN/ISO 13606 was chosen for this project because of the operational mechanisms it offers for data exchange. To the extent of our knowledge, this is the first experience reported in the literature of effective communication of EN/ISO 13606 electronic health record (EHR) extracts between a patient mobile application and an institutional clinical repository. </sec>

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