Toward a Model for Personal Health Record Interoperability

Abstract

Health information technology, applied to electronic health record (EHR), has evolved with the adoption of standards for defining patient health records. However, there are many standards for defining such data, hindering communication between different healthcare providers. Even with adopted standards, patients often need to repeatedly provide their health information when they are taken care of at different locations. This problem hinders the adoption of personal health record (PHR), with the patients' health records under their own control. Therefore, the purpose of this paper is to propose an interoperability model for PHR use. The methodology consisted prototyping an application model named OmniPHR, to evaluate the structuring of semantic interoperability and integration of different health standards, using a real database from anonymized patients. We evaluated health data from a hospital database with 38 645 adult patients' medical records processed using different standards, represented by openEHR, HL7 FHIR, and MIMIC-III reference models. OmniPHR demonstrated the feasibility to provide interoperability through a standard ontology and artificial intelligence with natural language processing (NLP). Although the first executions reached a 76.39% F1-score and required retraining of the machine-learning process, the final score was 87.9%, presenting a way to obtain the original data from different standards on a single format. Unlike other models, OmniPHR presents a unified, structural semantic and up-to-date vision of PHR for patients and healthcare providers. The results were promising and demonstrated the possibility of subsidizing the creation of inferences rules about possible patient health problems or preventing future problems.