PhD Thesis online: Detailed clinical models and their relation with Electronic Health Records

Nadim Anani Nadim.Anani at
Thu Jan 28 05:22:35 EST 2016

Dear Diego,

Congratulations and Thank you!!!! Very impressive work (that is visible without reading every detail, which I have not had the time for yet)!!!!


-----Original Message-----
From: openEHR-technical [mailto:openehr-technical-bounces at] On Behalf Of Diego Boscá
Sent: den 27 januari 2016 21:41
To: For openEHR clinical discussions; For openEHR technical discussions; For openEHR implementation discussions
Subject: PhD Thesis online: Detailed clinical models and their relation with Electronic Health Records

Hello all,

My thesis "Detailed clinical models and their relation with Electronic Health Records" is now available online. Until the university publishes it on the public repository, here is a link to it.

The slides are also available just in case anyone wants a quick summary

I also attach the abstract below

Best Regards

Diego Boscá

Healthcare domain produces and consumes big quantities of people’s health data. Although data exchange is the norm rather than the exception, being able to access to all patient data is still far from achieved. Current developments such as personal health records will introduce even more data and complexity to the Electronic Health Records (EHR).
Achieving semantic
interoperability is one of the biggest challenges to overcome in order to benefit from all the information contained in the distributed EHR. This requires that the semantics of the information can be understood by all involved parties. It has been established that three layers are needed to achieve semantic interoperability: Reference models, clinical models (archetypes), and clinical terminologies.

As seen in the literature, information models (reference models and clinical models) are lacking methodologies and tools to improve EHR systems and to develop new systems that can be semantically interoperable. The purpose of this thesis is to provide methodologies and tools for advancing the use of archetypes in three different scenarios:

- Archetype definition over specifications with no dual model architecture native support. Any EHR architecture that directly or indirectly has the notion of detailed clinical models (such as HL7 CDA templates) can be potentially used as a reference model for archetype definition. This allows transforming single-model architectures (which contain only a reference model) into dual-model architectures (reference model with archetypes). A set of methodologies and tools has been developed to support the definition of archetypes from multiple reference models.

- Data transformation. A complete methodology and tools are proposed to deal with the transformation of legacy data into XML documents compliant with the archetype and the underlying reference model. If the reference model is a standard then the transformation is a standardization process. The methodologies and tools allow both the transformation of legacy data and the transformation of data between different EHR standards.

- Automatic generation of implementation guides and reference materials from archetypes. A methodology for the automatic generation of a set of reference materials is provided. These materials are useful for the development and use of EHR systems. These reference materials include data validators, example instances, implementation guides, human-readable formal rules, sample forms, mindmaps, etc.
These reference materials can be combined and organized in different ways to adapt to different types of users (clinical or information technology staff). This way, users can include the detailed clinical model in their organization workflow and cooperate in the model definition.

These methodologies and tools put clinical models as a key part of the system. The set of presented methodologies and tools ease the achievement of semantic interoperability by providing means for the semantic description, normalization, and validation of existing and new systems.

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