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Re: SBIR proposal: Prototype mediation service for Open-Source, Universal Healthcare Exchange Language: Pilot connecting VistA and OSCAR

From: Michel Dumontier <michel.dumontier@gmail.com>
Date: Thu, 21 Jun 2012 12:26:13 -0400
Message-ID: <CALcEXf7xzK2WG=yKg-hDwKXbwwpcW8k0C49i+iiEp69P-w_geg@mail.gmail.com>
To: "Mead, Charlie (NIH/NCI) [C]" <meadch@mail.nih.gov>, HCLS <public-semweb-lifesci@w3.org>
Cc: "Eric Prud'hommeaux" <eric@w3.org>
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On Thu, Jun 21, 2012 at 10:59 AM, Mead, Charlie (NIH/NCI) [C] <
meadch@mail.nih.gov> wrote:

> SHould I send out a meeting annoucement for next TUesday's meeting to:
> w3c.hcls@gmail.com<mailto:w3c.hcls@gmail.com>?
> ________________________________
> From: Michel Dumontier [michel.dumontier@gmail.com]
> Sent: Thursday, June 21, 2012 10:40 AM
> To: team-hcls-chairs@w3.org
> Subject: Fwd: SBIR proposal: Prototype mediation service for Open-Source,
> Universal Healthcare Exchange Language: Pilot connecting VistA and OSCAR
> Charlie / Eric
>  here's a conversation i'm having that needs to happen on Tuesday as well.
> m.
> ---------- Forwarded message ----------
> From: Rafael Richards <rmrich5@gmail.com<mailto:rmrich5@gmail.com>>
> Date: Thu, Jun 21, 2012 at 10:37 AM
> Subject: Re: SBIR proposal: Prototype mediation service for Open-Source,
> Universal Healthcare Exchange Language: Pilot connecting VistA and OSCAR
> To: Michel Dumontier <michel.dumontier@gmail.com<mailto:
> michel.dumontier@gmail.com>>
> Michel,
> I would be delighted to discuss at next Tuesday's HCLS forum.
> The grant is looking for a live, active mediation service that could
> broker patient data from any EHR, recognize what language the data is in
>  (VistA-ese, OSCAR-ese, etc.), and pass it to a polling recipient system.
> Ideally this will be a pull mechanism that allows one EHR to ask for
> specific data elements of a specific patient in another EHR, and obtain
> this without human intervention. How would we design such a system?
> As the deadline for this SBIR proposal is at the end of the month, it
> leaves little time to apply.   Is there any small company within the HCLS
> community that would be a vehicle to apply for this grant, and engage the
> HCLS community in helping solve this very basic issue?
> Rafael
> On Tue, Jun 19, 2012 at 3:09 PM, Michel Dumontier <
> michel.dumontier@gmail.com<mailto:michel.dumontier@gmail.com>> wrote:
> Hi Rafael,
>  Well this is really cool :)
>  As you may be aware, Eric, Charlie and I are working on providing
> feedback to HL7 and their FHIR initiative, which includes an RDF
> representation of the patient record.  Given that we have already done work
> [1] to integrate (synthetic, indivo-based) patient records with linked open
> data, there would be a prototype to follow, but this, i imagine, is
> significantly larger and has more potential impact. Would you care to
> discuss at next Tuesday's HCLS Health Care forum?
> m.
> [1]  http://www.ncbi.nlm.nih.gov/pubmed/21624155
> On Mon, Jun 11, 2012 at 8:03 AM, Rafael Richards <rmrich5@gmail.com
> <mailto:rmrich5@gmail.com>> wrote:
> Michel,
> The PCAST recommendation for a "Universal exchange language" ,  and  need
> for mediation services between RDF sources  might make a nice topic on
> Any thoughts on projecting OSCAR's  relational tables to RDF?  Mediation
> methods between EHR endpoints?
> Please forward to the OSCAR development team and anyone in the HCLSIG
> community interested.
> There is funding available for this  (see SBIR below).
> Rafael
> __________________
> From the press releases below, it looks like VA and DoD are looking hard
> at 3M Health Data Dictionary as their semantic interoperability mediation.
>   The SBIR proposal states:
> "Through their Health Data Dictionary (HDD) product, 3M has also supported
> some degree of semantic interoperability, using a knowledge representation
> scheme linked to a unique concept identifier, but it is not a true
> first-order predicate logic ontology".
> => How does  lack "true first-order predicate logic ontology" affect the
> HDD performance?
> => Woud an RDF mediation service have "true first-order predicate logic"?
> => Why would an RDF store and mediation offer better functionality than
> the 3M HDD API?
> These are a few of the question we would need to answer in the SBIR.
> As a pilot  why don't we also consider another open-source, community
> supported EHR that is well connected to the SemWeb community? (OSCAR).
> Thoughts  on piloting an VistA -OSCAR - SMART   RDF mediation service?
> Rafael
> _________________________________________________
> Details on 3M HDD
> Press release on VA-DoD use of 3M HDD for interoperability:
> http://news.3m.com/press-release/company/3m-opens-access-3m-healthcare-data-dictionary-under-agreement-us-departments-d
> Timeline for incorporation of VA/DoD dictionaries into 3M HDD
> http://www.hddaccess.com/timeline/
> YouTube explanation of 3M HDD:
> http://youtu.be/T_Qc93efnzI
> HDD Overview:
> http://www.hddaccess.com/intro/overview/
> HDD  Demo:
> http://search.hddaccess.com/
> http://search.hddaccess.com/demo
> This is the ideal opportunity for us get some traction for RDF as the
> PCAST report's  "Universal Exchange Language".
> The SBIR grant is below, and link here:
> http://www.dodsbir.net/sitis/display_topic.asp?Bookmark=42567
> Proposals are due at the end of June.
> This is a Three-stage SBIR, so potentially  large sums will be heading the
> RDF way if we can get this started.
> Rafael
> Proposals Accepted:
> Program:        SBIR
> Topic Number:   DHP12-004 (DHP)
> Title:          Prototype, Open-Source, Universal Healthcare Exchange
> Language
> Research & Technical Areas:     Biomedical
> ________________________________
> Acquisition Program:    Office of the Principal Assistant for Acquisition
>  Objective:    Prototype architecture to execute an open source, universal
> health exchange language, as described in a recent President’s Council Of
> Advisors On Science And Technology (PCAST) Report.
>  Description:          Most DOD, VHA, and civilian healthcare systems
> encounter significant challenges in exchanging health information due to
> the lack of a universal health exchange language. Without effective health
> information exchange, continuity of patient care is less than optimal,
> healthcare access and availability are hampered, and healthcare costs
> increase. This topic is of particular importance to DOD, which is a
> provider and payer of care for 9.6M beneficiaries. Two thirds of military
> healthcare is delivered in the civilian sector. As a matter of background,
> the PCAST Report On “Realizing The Full Potential Of Health Information
> Technology To Improve Healthcare For Americans: The Path Forward”, sets
> forth general recommendations regarding how healthcare information
> technology can be used to improve healthcare access, availability,
> acceptability, continuity, cost-effectiveness, and quality. The report
> cites the beneficial work of the HHS Office of the National Coordinator
> (ONC) for Healthcare Information Technology in developing standards and an
> initial nationwide healthcare information exchange to share data to improve
> healthcare delivery and support research for the public good. The report
> points out that “national decisions can and should be made soon to
> establish a “universal exchange language” that enables health IT data to be
> shared across institutions; and also to create the infrastructure that
> allows physicians and patients to assemble a patient’s data across
> institutional boundaries, subject to strong, persistent, privacy safeguards
> and consistent with applicable patient privacy preferences.” The PCAST
> report further states that, “creating the required capabilities is
> technically feasible, as demonstrated by technology frameworks with
> demonstrated success in other sectors of the economy. The best way to
> manage and store data for advanced health informatics is to break data down
> into the smallest individual pieces that make sense to exchange or
> aggregate. These individual pieces are called ‘tagged data elements,
> because each unit of data is accompanied by a mandatory “meta­data tag”
> that describes the attributes, provenance, and required security
> protections of the data.” Current state: Some research surrounding use of
> healthcare metadata is underway and moving from academic labs into some
> early practical uses, such as demonstrated by Dr. Parsa Mirhaji for use in
> public health surveillance. Much of this research has been conducted using
> semantic web technologies employing the Resource Descriptive Framework
> (RDF), and Web Ontology Language (OWL), and query technologies such as
> SPARQL, which utilize the concept of “tuples”, (subject, predicate,
> object), to relate data and achieve semantic interoperability. Other
> similar technologies exist, such as those from Metadata, Inc., although the
> semi-proprietary Metadata language, parts of which is available from Open
> Health Tools, is based on quintuplets vice tuples. Through their Health
> Data Dictionary (HDD) product, 3M has also supported some degree of
> semantic interoperability, using a knowledge representation scheme linked
> to a unique concept identifier, but it is not a true first-order predicate
> logic ontology. Language and Computing, now owned by Nuance, developed
> LinkBase, the world’s largest medical ontology, with limited commercial
> success. Adoption of these commercial technologies may have been limited by
> their proprietary, versus open nature, and associated licensing costs. It
> may be possible for some of these commercial technologies to be made open
> source, with companies then selling services around their technology, but
> this is a business decision that is up to the companies. Moving towards
> developing open source terminology mediation services may place these
> companies in a position wherein the Office of the National Coordinator for
> Healthcare IT could adopt those terminology mediation services for use in
> the Nationwide Health Information Network (NwHIN), and NwHIN Connect and
> Direct products (typically using a Berkeley Software Development License).
> In any event, the environment is ripe for continued academic and commercial
> collaboration under an STTR to advance the domain. Desired State: Research
> conducted under this topic will directly support the PCAST and ONC visions,
> but would be conducted primarily on behalf of the Military Health System,
> which provides an integrated healthcare delivery system for 9.6 million
> beneficiaries. This care is delivered through a combination of direct care
> Military Treatment Facilities and private healthcare delivery organizations
> under the TRICARE triple option health benefits program. Nearly two thirds
> of healthcare is delivered to military beneficiaries through the private
> sector. Given that military families are also highly mobile, moving on
> average every three years to new duty stations, finding a way to exchange
> data and create a longitudinal virtual electronic health record is an
> important objective of military medicine. Clearly the research would also
> be extensible to other national publically and privately funded healthcare
> delivery systems and information exchanges. The prototype to develop a
> universal exchange language for healthcare information and a digital
> infrastructure for locating patient records while strictly ensuring patient
> privacy may employ the U.S. Army Telemedicine and Advanced Technology
> Research Center’s (TATRC) Early Stage Platform (ESP) for Research and
> Development, which provides a fully replicate DOD Electronic Health Record
> and CHCS computerized physician order entry and results retrieval system
> for third party development, using virtual machine access. TATRC will
> coordinate this research closely with HHS, Office of the Nationwide
> Healthcare Information Coordinator, the Veterans Administration, and with
> the Center for Medicare Services (CMS). It is fully expected that the
> research will be extendable into the public good and will benefit the
> development of new electronic health records developed by the private
> sector that would utilize the universal exchange language.
>        PHASE I: In Phase I, the awardee will outline a strategic,
> operational, and technical alternatives to creating a prototype, open
> source, universal health exchange language service that can operate as a
> service on the NwHIN, and support health exchange for military medicine.
> Phase I work should center on a limited number of use cases to be
> determined in conjunction with the government Contracting Officer
> Representative. Phase I will also provide opportunity for consultation with
> ONC for Healthcare IT and other subject matter experts. At the conclusion
> of Phase I, the awardee will recommend a technical reference implementation
> architecture, which will then be built as a prototype in Phase II of the
>        PHASE II: In Phase II, the awardee will build the universal health
> language prototype, as an open source service on the NwHIN Connect
> solution, and demonstrate the exchange of military, VA, and civilian health
> data with semantic interoperability in a laboratory setting, potentially
> using the TATRC early stage platform for research and development. At the
> conclusion of Phase II, the prototype will be demonstrated to U.S. Army
> TATRC, Military Health System, HHS ONC for Healthcare IT, HHS CMS, Veterans
> Administration, and other government officials.
>        PHASE III: In Phase III, the universal health language service
> would be implemented on the NwHIN, or otherwise in local or regional health
> information exchanges to support scalable terminology mediation between
> electronic health records systems. Such work may also be commercialized and
> of interest to commercial electronic healthcare vendors. Ideally, the
> universal health language service would be an open source service, with the
> vendor choosing to sell services around the open technology.
>  References:   1. President’s Council of Advisors on Science and
> Technology (PCAST) Report On “Realizing The Full Potential of Health
> Information Technology To Improve Healthcare for Americans: The Path
> Forward, “ December 2010,
> http://www.whitehouse.gov/sites/default/files/microsites/ostp/pcast-health-it-report.pdf2. Marco Eichelberg, Thomas Aden And J Org Riesmeier, et al, “A Survey and
> Analysis of Electronic Healthcare Record Standards”,
> http://citeseerx.ist.psu.edu/viewdoc/download?doi= Parsa Mirhaji, Dean Allemang, Robert Coyne, S. Ward Casscells: Improving
> the Public Health Information Network through Semantic Modeling. IEEE
> Intelligent Systems 22(3): 13-17 (2007),
> http://www.computer.org/portal/web/csdl/doi/10.1109/MIS.2007.53 4. Parsa
> Mirhaji, Min Zhu, Mattew Vagnoni, Elmer V. Bernstam, Jiajie Zhang, Jack W.
> Smith: Ontology driven integration platform for clinical and translational
> research. BMC Bioinformatics 10(S-2): (2009)
> http://www.biomedcentral.com/1471-2105/10/S2/S2 5. Marco Eichelberg,
> Thomas Aden And J Org Riesmeier, et al, “A Survey and Analysis of
> Electronic Healthcare Record Standards”,
> http://citeseerx.ist.psu.edu/viewdoc/download?doi= Semantic Web Health Care and Life Sciences (HCLS) Interest Group
> http://www.w3.org/2001/sw/hcls/ 7. W3C Semantic Web in Health Care and
> Life Sciences Tutorial,
> http://videolectures.net/iswc08_prudhommeaux_swhcls/
> Keywords:       PCAST Report, Healthcare Information Technology, Universal
> Health Exchange Language, Patient Record Locator, Patient Privacy
> ________________________________
> Questions and Answers:
> Q: Could you clarify some of the above requirements for the prototype:
> 1) Topic description refers (as current state) to exchange languages used
> by existing products, languages such as RDF, OWL and few proprietary ones.
> This followed by explanation: "...but it is not a true first-order
> predicate logic ontology"
> Question: is inclusion of true first-order predicate logic ontology a
> requirement for successful exchange language?
> 2) It also mentioned among the obstacles "Adoption of these commercial
> technologies may have been limited by their proprietary, versus open
> nature, and associated licensing costs."
> Question: In light of open source requirement is commercialization
> strategy for the prototype expected to be based on potential service fees
> from DoD and other potential governmental clients?
> A: 1. No. However, the government advises that the proposer provide a
> clear description of the technologies, ontologies, and methods to be used
> in the project, along with a discussion of the advantages and disadvantages
> of those technologies, ontologies, and methods, and associated
> implementation risks, and maintenance costs.
> 2. The government prefers use of open, standards-based technologies,
> versus closed technologies. In addition, the government would prefer use of
> open source technologies, which are licensed under a variety of licensing
> models (i.e. BSD, GNU, and others), some of which are more business
> friendly than others. If the proposer bids such open source technologies,
> than it should clearly indicate in its commercialization plan how it would
> sell services around these open source technologies. With that said, some
> proposers may still choose to bid use of proprietary technologies with
> traditional end user licensing agreements or fee-based subscription
> services.
> Q: Creating a full blown Open-Source, Universal Healthcare Exchange
> Language is a massive undertaking. We specialize in patient care in virtual
> worlds where patient data is collected and transmitted back to care givers.
> This transference necessarily demands an ontology. Are you interested in
> our creating a sub-standard for patient health data under the larger
> Open-Source, Universal Healthcare Exchange Language?
> A: Perhaps. Note that there are many healthcare terminologies, lexicons,
> thesauri, controlled medical vocabularies, ontologies, and knowledge
> representation frameworks already. Our interest is primarily in how to
> automate mapping among many of these.
> Q: So, is what you are really looking for is something like an online
> HealthCare Rosetta Stone?
> A: Please define Rosetta Stone. If you are referring to Rosetta Stone™, a
> registered trademark for foreign language translation software, the answer
> is not really, but perhaps as related to healthcare. If you are referring
> to the terms Rosetta Stone in a more generic sense, and applied to
> healthcare, such as described in
> http://healthcarereformnow.blogspot.com/2007/12/health-care-rosetta-stone.html,
> and/or
> http://successfulworkplace.com/2012/03/16/translating-healthcares-rosetta-stone/,
> the answer is yes. There was also an HHS sponsored OASIS effort which
> developed a “Rosetta Stone” for Long Term Care terminology mediation,
> http://aspe.hhs.gov/daltcp/reports/2011/StratEng-E.htm; some of that
> thinking is applicable. Given all of this past history, though, the new 3M
> Open HDD may provide for universal health language exchange. Additional
> research is necessary on how this product would be implemented in
> electronic health records and health information exchanges.
> Q: Successful execution of this project will require critical engagement
> with federal partners that can help guide the development of protocols and
> frameworks that meet the expectations of the proposed DoD/VA environment.
> Please comment on the anticipated accessibility of the health IT leadership
> at the DoD/VA to help the project team identify and execute the highest
> impact use cases across different phases of this project.
> A: The Contracting Officer's Representative will make a best effort to
> integrate this work with a specific use case or more immediate research
> need which may present in the TRICARE Management Activity; HHS Office of
> the National Coordinator for Healthcare IT, Veteran's Administration; or
> DOD/VA Integrated Program Office. Key staff in these organizations are
> aware of the SBIR topic. With the announcement that certain aspects of the
> 3M HDD will be made open source, and considered for use in the DOD/VA joint
> integrated electronic health record; and a recent announcement that the VA
> has an RFI on the street to have a vendor assess the applicability of the
> Open 3M HDD to use with VA's VISTA system; this SBIR may be able to support
> that effort, and presents a possible route for technology transfer within
> government.
> Q: A key validation of the PCAST framewrork is the extent to which it's
> able to address secondary and unexpected uses of healthcare data. Visionary
> and motivated sponsors within the federal government, specifically within
> MHS and VHA, are critical for helping define the PCAST framework. Thus, are
> candidate sponsors readily identifiable and available for applicants to
> interview prior to submission of proposals in response to this solicitation
> in order to better understand the MHS and/or VHA vision for the PCAST
> framework?
> A: The Contracting Officer Representative will make a best attempt effort
> to have the recipient(s) of this SBIR Phase I funding work directly with
> representatives in the U.S. Army Telemedicine and Advanced Technology
> Research Center; Joint Program Committee-1; TRICARE Management Activity;
> HHS Office of the National Coordinator for Healthcare IT; VA; and DOD/VA
> Integrated Program Office (IPO), on this topic.
> Q: Is the primary intent of this SBIR solicitation to demonstrate
> feasibility of the proposed UEL across a wide variety of use cases, or is
> it to address the technical scale and performance, as well as enterprise
> governance issues, for it to work in a realistic DoD/VA setting?
> A: Given recent announcements at
> http://www.healthdatamanagement.com/news/3M-data-dictionary-open-source-interoperability-coding-44468-1.html,
> efforts are underway to determine if the VA and DOD/VA Integrated Program
> Office are interested in applying the effort of this SBIR to analyzing the
> use of the Open 3M HDD with the DOD/VA Integrated Electronic Health Record,
> which is under development.
> Update from TPOC w/ additional information:
> Open 3M HDD Access at: http://www.hddaccess.com/intro/faq/#answer3
> Also: http://concepthub.org
> Q: 1. Who would be the immediate consumers of the framework and system
> created through this SBIR initiative?
> 2. Additionally, are there relevant, high-priority projects already within
> MHS and/or VHA that can be described to the applicants prior to submission
> of the Phase I application?
> A: There are several potential consumers of such a universal healthcare
> exchange language: the Nationwide Health Information Network, State HIEs,
> Regional HIEs, Local HIEs, individual medical centers who desire to
> exchange data internally for various use cases. The work may be of interest
> to commercial EHR vendors and HIE vendors. Given the recent announcement
> that the 3M HDD will become open, and potentially be used as a major
> component of the DOD/VA Joint EHR, the DOD/VA Integrated Program Office
> would be another likely consumer of the framework.
> Q: Should a response to this solicitation focus on the life cycle,
> workflows, and tools for creation and management of UEL expressions
> implemented in the context of appropriate use cases, or, alternatively,
> should the response be centered around developing a minimal UEL framework
> that illustrates value and jump starts a community of practice around this?
> A: The government is flexible to a proposal from either approach.
> Q: PCAST makes ambitious recommendations around meta-data representation
> frameworks, UEL, identity management, encryption and protection,
> authentication and authorization, index/search/access/retrieval of
> distributed health information, to granular consent representation and
> patient centered consent management, context aware visualization and
> representation of health information. Given the ambitious nature of the
> report's recommendations, what specific area(s) is this SBIR solicitation
> targeting?
> A: We concur that the PCAST report is ambitious. The government views the
> topic broadly and will accept proposals for any of the areas outlined in
> the PCAST report that rely on a universal exchange language. The government
> recognizes that an SBIR managed by the Army will not solve the complex
> challenge at hand, but the SBIR does provide an opportunity to jump start
> research in this area. Of particular concern is how the new 3M Open HDD may
> be implemented in the DOD/VA Joint EHR under development by the DOD/VA
> Integrated Program Office (IPO).
> --
> Michel Dumontier
> Associate Professor of Bioinformatics, Carleton University
> Chair, W3C Semantic Web for Health Care and the Life Sciences Interest
> Group
> http://dumontierlab.com
> --
> Michel Dumontier
> Associate Professor of Bioinformatics, Carleton University
> Chair, W3C Semantic Web for Health Care and the Life Sciences Interest
> Group
> http://dumontierlab.com

Michel Dumontier
Associate Professor of Bioinformatics, Carleton University
Chair, W3C Semantic Web for Health Care and the Life Sciences Interest Group
Received on Thursday, 21 June 2012 16:27:18 UTC

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