ICT support for applying evidence based tele wound management in a distributed semantic web environment

Abstract

Context: About two percent of the Austrian people suffer from bad healing or chronic wounds. The patients are mainly older people and often suffer from in- tensive pain that can cause immobility and social isolation. Treating patients with chronic wounds is a multi-professional task that involves specialists and nurses, often continues over an extended period of time and aims to obtain patients' self-management. Objectives: To improve the quality of the wound management and wound care and to improve the coordination and communication of the wound management procedures information and communication technologies (ICT) play an important role. ICT applications facilitate establishing an objective and integrative wound- documentation independent of time and location and making the wound- management process traceable and more transparent. The aim of this work is to show a way how electronic health records can be embedded into the wound management process for providing relations between patient information and decision- and treatment process. Methods: Recently ambitious attempts have been done defining structures and models for EHR facilitating semantic interoperability between electronic health records - and electronic patient record systems. One of them is the ISO 13606 EHR communication standard. Recently the Web Ontology Language was developed for defining and structuring data semantically. The Web Ontology Language enables higher levels of abstrac- tion and expressiveness for defining models than relational database schemata can. Results: I introduce an ontology driven application model. The ontology driven application model describes how to derive functionality from ontology knowledge dynamically and using it for application behavior. Furthermore I intro- duce a process model based on the Web Ontology Language that facilitates the definition of a standardized and unambiguous process description for the wound management process. I also describe a prototype implementation of a communi- cation server and two systems communicating EHRs. Conclusion: ISO 13606 can be implemented using the ontology driven application model yielding all intensions the standard was developed for. These are for ex- ample: semantic interoperability, longitudinal data retrieval, etc. Additionally processes can be dynamically interpreted through implementing the ontology driven application model. Following this approach the exchange of process definitions and process state information can be facilitated.