A Peer to Peer Agent Coordination Framework for IHE based Cross-Community Health Record Exchange

A Peer to Peer Agent Coordination Framework for IHE

based Cross-Community Health Record Exchange

Institute of Applied Sciences of Western Switzerland

V. Urovi, A. Olivieri, S. Bromuri, N. Fornara and M. Schumacher

vendredi, 5 avril 13

Applied Intelligent Systems Lab AISLab – aislab.hevs.ch

eHealth Topics: InteroperabilityMonitoring of chronic diseasesMulti-parametric data analysisDiagnosis help for General Practitioners


Research Question

• How to enable the dynamic exchange of electronic health records (EHR) of patients beyond the health organisation level?


We answer it by• Extending the existing IHE profiles with a solution for

dynamically discovering and connecting with other health institutions;

• Using semantic description of data to facilitate the interpretation and sharing of data between the different health institutions;

• Connecting health communities in a scalable solution that uses a P2P based model;

• Automatizing the collection of EHRs by using a coordination model between communities that is based on a multi-agent platform.


IHE – Integrating the Healthcare Enterprise http://www.ihe.net

• Non profit organization composed of healthcare industry professionals

• Combines standards into specifications (named Profiles) targeted at solving specific medical use-cases

• The Swiss strategy recommends the use of Integrating the Healthcare Enterprise (IHE) and its profiles to make medical information systems interoperable


http://www.ihe.net

http://www.ihe.net

IHE Exchange Profiles• XDS - Cross Enterprise Document Sharing

• Enables health organisations to share patient-relevant documents by storing and retrieving them from a central registry;

• XCA -Cross-Community Access

• Defines how medical data held by other communities can be queried and retrieved;

• XCPD - Cross-Community Patient Discovery

• Locates communities that hold patient's relevant health data and translate patient's identifiers across communities holding the same patient's data.


Example: the XDS profile

Document Source

Document Repository

Document Registry

Document Consumer

Provide&Register Document Set

Retrieve Document

Query Document Actor

Register Document Set

Transaction


Limitations of these IHE profiles• XDS does not resolve document sharing among

different health communities;

• XCA requires communities to have pre-established agreements and knowledge of one another;

• XCPD does not automatise the discovery of communities and it still requires communities to have pre-established agreements for exchanging the documents.


To address IHE limitations

• We define an IHE and agent-based coordination model that supports communities to dynamically connect to one another.

• We also specify an ontology that may be used to define the knowledge base of every community.

• To model and implement this semantic coordination layer, we use the coordination framework TUCSON.


Semantic Tuple Centers in TuCSoN• TuCSoN is an agent coordination infrastructure where:

• Agents interact performing in/out/rd operations on semantic tuple centers.

• Tuples are read and retrieved associatively using tuple templates.

• Semantic tuple centers are modeled using OWL Web Ontology Language

• Semantic tuple centers:

• Are hosted in distributed nodes

• Can perform out/in/rd towards other tuple centres.

• The behavior of tuple centers is programmable in the ReSpecT language:

reaction(action, guard, react).Where: action= in/out/rd a Semantic Tupleguard= internal/external action and pre/post reactreact= logics+in/out/rd of Semantic Tuple


The ArchitectureLegend

Publish/Subscribe/Notify/Search operations

Tuple Center

Agent

Community/Node

Node

a) Logic Architecture of a Community

b) The P2P structure between CommunitiesSearch Agent

PolicyTuple Center

Log Agent Update Agent

COMMUNITY/Node

Node

Node

Node

Node

NodeNode

P2P NETWORK


Policy Tuple Centre Coordination • Every community maintains a semantic

knowledge of patients and their EHRs and

• Can share patient related data in the P2P;

• Can search data in the P2P;

• Can directly query and subscribe to updates happening in the knowledge bases of other communities;

• Can propagate updates on patient’s EHRs.


Semantic Knowledge Base

CommunityCommunity

DocumentDocument

PatientPatient

identifiernameaddress

identifierdate

identifiername

addressfatherchildren

status

author

hasHomeCommunity

RoleRole

identifier

name

activities

PolicyPolicy

identifier

name

categorydescription

ServiceService

ActorActor profession

name

contact

address

identifier

speciality

assumes

member

complies

follows

provideshas

cares

subscribe

identifiername

link

description

∐relates

attachment

DatatypeProperty

ClassObjectProperty

∐

home

Union


• Health communities can search patient data in other communities by:

• querying the P2P network about the community that holds the data of a patient and

• sending a request query to that community

Searching EHR data

• Subscriptions and update propagations are treated similarly


Results

Patient Search Community Search


Conclusions• We proposed a distributed coordination framework

to dynamically exchange EHR

• The proposed coordination mechanisms that go beyond the current IHE solutions

• In future works we will focus on defining:

• Security mechanisms for P2P based health record exchange.

• A sophisticated publish-subscribe model based on complex event patterns

• Complex reasoning and deductions over semantic data


Thank youAny Questions?


Implementation

UserAgent

Data BaseCommunityComponent

LegendSystemAgent

Jena LibraryQuery Lang.Reasoner

Logic Connection

Certification Authority

OpenXDS

TuCSoN

PTC

OWL

SPARQL

Pellet

Jena

DomainAuthority

P2P NETWORK

PostgreSQL

Community

OpenXDS

TuCSoN

PTC

OWL

SPARQL

Pellet

Jena PostgreSQL

Community

Certifying body

Peer


A Peer to Peer Agent Coordination Framework for IHE based Cross-Community Health Record Exchange

Technology

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